CPAP Machine Insurance Coverage

Insurance Requirements for Your CPAP MachineMany insurance policies cover CPAP machines. CPAP is considered to be a durable medical device, and you can call your insurer to find out the particulars of your coverage. Deductibles and copayments for medical devices may be different than what you pay for office visits or prescriptions. CPAP cleaning machines are covered by Medicaid insurance, but it will require authorization.

CPAP accessories are covered separately, and the amount of coverage differs by state. Deductibles and copayments can apply depending on whether or not you have secondary CPAP insurance.

What Type of Mask Should I Get for My CPAP?

Nasal pillow systems, nasal masks, and full-face masks are available in all sizes, shapes, and styles from many vendors. They are all effectual. The delivery system choice is very personal. On the night of a CPAP titration study (similar to the sleep study), we encourage patients to try various kinds of different kinds, guided by our experienced technicians. We ask patients to select a first and second choice and let us know if they are uncomfortable during the night to make a change. We find that even with maximal attention to mask/pillow fit before the first night, about 10-15% of the time, patients may have an issue with irritation, air leaks, or discomfort and may require to make a change over the first few weeks to optimize adaptation.

What If I’m Having Difficulty Breathing?

Difficulty breathing with CPAP can be as a result of the newness of the experience or pressure problems. High prescribed pressures may be uncomfortable initially, and low settings, like 4 cm, may create a sensation of being “air starved.” Contact your home care provider to check your machine’s accuracy and discuss the problem with your sleep professional so they can determine if a pressure adjustment is needed.

How Do I Clean My CPAP Machine?

You should receive specific cleaning/maintenance instructions from the company that delivers your machine. We recommend taking the mask, tubing, and headgear in the shower with you once a week, rinsing it with mild dish soap (odorless or with a smell you can tolerate), hanging it over the showerhead to dry and remember to hook it back up the following night. Filters should typically be checked once a month, more often if the environment is dusty. The humidifier chamber should be rinsed daily, and the use of distilled water will maintain it clean and free of mineral deposits.

How Long Do I Have to Wear My CPAP Every Night for it To Be Effective?

CPAP Machine Health Insurance CoverageResearches indicate that at least 6 hours of CPAP usage per night is required to reduce the long-term health risks of obstructive sleep apnea. We encourage our patients to put the CPAP on at lights out every night and to make every attempt to put it back on after nighttime awakenings. If there are regular awakenings or finding the mask on the floor in the morning, then pressure adjustment or a mask refitting may be needed.

Who Should I Call if There’s an Issue?

For technical issues with the equipment, check in with the homecare company. Your physician/sleep lab should also provide troubleshooting services if the problem has to do with mask fit or pressure adjustments instead of the equipment’s workings.

References and Resources