Revision as of 10:33, 1 December 2018

How to acquire a CPAP.

UNITED STATES

With Insurance

The common path with health insurance is to

1. Make an appointment with a Sleep Doctor
2. Get an appointment for a Sleep Study to Test for the presence of a sleep disorder, commonly Sleep Apnea, and determine what type of Apnea you have and how bad it is.
3. Get an Appointment for a Titration Sleep Study to determine settings for your new CPAP machine
4. Get prescription for the CPAP machine of your choice, Preferably an Auto CPAP (More Flexiblity in use), is recommended from your Sleep Doctor.
5. Visit your DME to pick up your CPAP machine from your DME

Purchase considerations:

• Fully Data Capable, you want data with which to soundly make changes
• Compatible with Sleepyhead (for other data system) to produce detailed Daily Charts
• Get the right machine for your apnea
• Auto mode (This provides Flexibility)
• 0 or low total run hours (not usage hours which can be reset) Note: DMEs have been known to deliver used machines as new

It is strongly suggested that you post a full copy (with personal information redacted) to the Apnea Board Forum so that you know what kind of CPAP would be best for you. For pure Obstructive Sleep Apnea (OSA) this is typically an Auto CPAP which is flexible and fully compatible with The best software available for you to monitor your therapy. Note that these studies often indicate or hint at more complicated apneas which may need a more advanced version of a CPAP than is initially recommended to treat.

without Insurance

The reasons for purchasing without insurance boil down to two reasons, you do not have insurance, or you are choosing to purchase out of pocket.

Note: Legally the US Requires a Prescription to purchase any CPAP or any CPAP mask. That said it is possible to make a purchase without a prescription.

Caution: It is preferred / safer to purchase through storefronts either brick and mortar or on the internet. These sources may change frequently and use this as a guide.

Where to Purchase, not in any particular order

1. Always first choice The Apnea Board Suppliers List but they usually require an Rx (supplier #2 and Supplier #33 have good prices and ship internationally).
2. Amazon
3. eBay
4. craigslist
5. Letgo
6. Facebook Market Place
7. Offerup
8. garage sales
9. estate sales
10. want ads

Many of these exist because unfortunately many people refuse to treat their apnea and sell their machines. Usage and condition may vary from brand new, sealed units to having many thousands of hours on them (know how to check Run hours not user hours which can be reset)

Purchase considerations:

• Fully Data Capable, you want data with which to soundly make changes
• Compatible with Sleepyhead (for other data system) to produce detailed Daily Charts
• Get the right machine for your apnea
• Auto mode (This provides Flexibility)
• 0 or low total run hours (not usage hours which can be reset)
• non-smoker and non-smoker house
• Recommend replacing the filter(s), Mask, Tubes, and Humidifier chamber

AUSTRALIA

Diagnosis & testing

If you believe you might have sleep apnea, ask your GP for a referral for a sleep study. Studies are conducted at specialist clinics, usually attached to hospitals in capitals and major regional cities.

Prescription requirements

There is no legal requirement for a prescription to purchase a CPAP machine or supplies in Australia. Notwithstanding this, some sleep doctors try to pretend there is a requirement and some suppliers (such as CPAP Australia which is owned by Resmed) require a prescription.

Insurance and Medicare

Sleep test:

There is a large number of applicable Medicare item numbers applicable, depending on the exact nature of the test and whether the patient is an adult or child. Many sleep clinics will bulk bill the procedure cost, but check first.

If you have the test as a public patient at a public hospital, there should generally be no cost.

For private facilities, your private health insurance may cover some or all of the facility cost for the overnight stay. This will vary depending on the type of facility, your health fund and which table you are on. Check with the fund and facility prior to committing.

Machine

Medicare does not cover the cost of a CPAP machine, though there may be special payments available if you are in financial difficulties. Check with your friendly CentreLink office.

CentreLink may provide a subsidy towards the running cost of a machine (currently $157 pa) - https://www.humanservices.gov.au/individuals/services/centrelink/essential-medical-equipment-payment

Your health fund will make a one-off payment towards the purchase of a machine. This varies from $150 to $1,000 depending on the individual fund and the table you are on. Some funds require a doctor's prescription or statement of medical necessity. A few require proof of compliance. As always, check with your fund before committing.

Suppliers

Most sleep clinics also supply machines. This can lead to a conflict of interest so consider if it is better to buy from an independent supplier

There are many on-line suppliers in Australia, usually with well designed web sites which make buying simple.

Many pharmacies also supply CPAP machines and supplies, along with some form of diagnostic and advisory services.

Buying from outside Australia

It is often cheaper (sometimes substantially so) to purchase a machine from the United States rather than Australia. See the Apnea Board Supplier List http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List

Some clinics will try to tell you it is illegal to import a machine - it is not.

Many American suppliers require a prescription which can be provided by your GP.

When comparing prices take into account the current exchange rate and shipping charges. CPAP is GST exempt, but will likely attract a Customs fee (currently around $80.00).

Remember also that if you have any problems you may need to refer back to your overseas supplier. You will not get warranty cover here in Australia, even if your machine was manufactured here.

Donate to Apnea Board