I Cant Afford A New Cpap What Are My Options
If you cant afford a new machine outright or are having issues with your insurance provider, rest assured that there are several options that exist to find low-cost or free CPAP equipment, including government assistance or charity donation programs. We created this helpful guide to finding a low-cost CPAP machine if you cant afford to purchase a new machine. We encourage you to read it if youre experiencing hardship during this recall.
What Other Sleep Apnea Devices Does Medicare Cover
People who have mild to moderate sleep apnea or cannot tolerate a CPAP machine are good candidates for oral appliances. Like a sports mouth guard, the oral appliance holds the jaw forward in a way that keeps the airway open. Oral appliances are comfortable to wear and are quieter and more portable than CPAP machines.
If a CPAP machine isnt effective in treating your sleep apnea, its possible that a bi-level positive airway pressure, or BiPAP, machine could work for you. BiPAP machines provide more air pressure for inhalation and less for exhalation than a CPAP machine. Medicare will pay for a BiPAP machine if the beneficiary has obstructive sleep apnea and has tried a CPAP machine but hasnt found relief.
Keeping Cpap Equipment Clean
CPAP manufacturers, suppliers, and sleep physicians all recommend cleaning CPAP equipment regularly. Basic cleaning instructions include:
- Wash the mask, tubing, and water chamber daily with liquid dish soap and hot water.
This cleaning standard can be hard to maintain. Therefore, some people never clean their equipment. But, dirty equipment can lead to significant problems, including:
- Minerals may accumulate within the water chamber.
- Mucus may collect in the mask.
- Germs may harbor in the tubing.
- Mold may grow in moist environments.
- There may be unpleasant smells.
- The equipment may appear unhygienic.
Also Check: Why Is Medicare Advantage Free
Cpap Cleaner Hidden Costs
The cost of using a CPAP cleaner may not end when you take it home from the store or receive the shipment at your door. While these expenses are mostly minimal, they contribute to the total cost of a CPAP cleaner.
- Many CPAP cleaners have filters that need replacing every three to six months. Filters typically cost from $10 to $40.
- All CPAP cleaners we researched directed users to cleanse face masks with special wipes. The wipes clean accumulated facial oils and other dirt, and cost around $7 to $10 per container.
- You may want to use a special liquid detergent to remove odors and residues from your CPAP machine before you first use your cleaner device. This is only necessary if youve been washing the parts by hand and notice a lingering smell or buildup. The cost is around $10.
- If you buy an ultrasonic CPAP cleaner, youll pay $4.50 to $6 per month for cleaning tablets.
How Often Can You Get A New Cpap Machine Under Medicare
CPAP machines are used to deliver constant, steady air pressure to patients with obstructive sleep apnea while they are sleeping. Sleep apnea is a medical condition that causes pauses in breathing during sleep.
Medicare does cover CPAP machines if you are diagnosed with sleep apnea. Medicare Part B may cover a 3-month trial of CPAP therapy.
If the CPAP therapy is successful, your doctor may be able to extend the treatment and Medicare will cover it. If you rent a CPAP machine for 13 months, you own it.
Medicare Part B is usually responsible for covering durable medical equipment like CPAP machines.
Read Also: When Am I Available For Medicare
Does Medicare Cover Cpap
Medicare considers CPAP devices to be durable medical equipment and provides 80% coverage under Part B as long as you meet certain conditions. First, your doctor must diagnose you with obstructive sleep apnea following an approved laboratory sleep study or an at-home sleep study, and give you a prescription for a CPAP machine.
Then, Medicare covers a 12-week initial period of CPAP therapy for obstructive sleep apnea, as long as you meet the following requirements:
- You have an hourly AHI between 5 and 14 and a comorbid condition related to obstructive sleep apnea, including hypertension, history of stroke, heart disease, excessive daytime sleepiness, insomnia, mood disorders, and impaired cognition or
- You have an hourly AHI of 15 or higher.
You must also meet Medicares compliance requirements, which state that you must use the machine at least 4 hours per night, 70% of the time or more, during the first 3 months. If you fail to meet these requirements, you have to begin the process again. This involves completing another sleep study, either in a lab or at home, and obtaining another prescription from your doctor.
Does Medicare Pay For A New Cpap Machine
Yes, but there are stipulations. Medicare will usually help cover the cost of renting a CPAP machine for 13 months. If you use it without interruption throughout that time, youll own it at the end of the term. Talk to your doctor if your CPAP machine breaks or you need a new one. If its old enough or meets other guidelines, Medicare may pay for a new CPAP machine.
What extra benefits and savings do you qualify for?
Can You Really Access Insurance Coverage For Your Cpap Cleaner
CPAP cleaners are increasingly becoming a darling of users due to their convenience and effectiveness. The question has, therefore, been posed by many: Are CPAP cleaners also covered by insurance?
The answer is no.
Presently, most insurance providers do not cover CPAP cleaners in their plans. How, then, can you benefit from some form of insurance for your CPAP cleaner? There are two possibilities: You can use your Flexible Spending Account or otherwise the Health Savings Account for purchases associated with CPAP cleaners.
The reality is, most users generally have to operate on a tight budget but still feel they should access a CPAP cleaner checkout. We will strive to answer a few pertinent questions touching on the crucial subject of insurance possibilities for our much-loved CPAP cleaning machines.
Let us talk about a few.
Frequently Asked Questions About Cpap Cleaners
Does Medicare pay for CPAP cleaners?
While Medicare and health insurance cover the cost of a CPAP, neither pay for CPAP cleaners. If you have a Medicare Advantage plan, check to see if you have coverage for a cleaner. Medicare Supplement insurance may pay for a CPAP cleaner depending on your policy.
Are the low-cost CPAP cleaner filters and parts sold online safe to use?
If you find bargain-basement priced filters or other parts online, proceed with caution. There have been reports of counterfeit CPAP cleaner parts and filters sold on Amazon and eBay. These cheap CPAP parts can damage your cleaner or disrupt the seal on ozone machines.
You may find sales and discounts on legitimate filters and parts. Just remember if a deal seems too good to be true, it probably is.
Is there any way to finance a CPAP cleaner?
CPAP cleaner companies that sell directly to the consumer usually offer financing deals with six to 12 months to pay. Some retailers provide financing from time to time. If paying upfront is difficult, ask the seller about financing.
Do all CPAP machines work with each CPAP cleaner?
UV and ozone-based cleaners may not be compatible with all CPAP machines. We found compatibility problems with some ResMed CPAPs and tubing on mini CPAP machines. Ask a manufacturers representative if the model youre considering works with your CPAP if you have any doubts.
Recommended Reading: Is Medicare Solutions A Legitimate Company
Does Soclean Enjoy Insurance Cover
SoClean currently does not have insurance policies. However, you can use the funds held in the ESA or HSA to purchase a Soclean Cpap Cleaner. Both the ASF and HSA will have excellent cost-reducing solutions. If you want to ensure that your cleaning machine receives insurance benefits, here are the best choices.
Philips Cpap Machine Recall
In June 2021, millions of CPAP and BiPAP machines were recalled by Philips Respironics due to the degrading of sound abatement foam inside the machines, which can break down and lead to serious health issues like inflammation in the respiratory system, cancer and other dangerous effects.
The recall was classified by the U.S. Food and Drug Administration as a Class I recall due to the toxic effects from the machines as capable of causing severe injury or death.
According to Philips, these products are not affected by the recall:
- Trilogy Evo
Recommended Reading: Is Pace A Medicare Advantage Plan
Where Do I Pay For My Machine
You must receive the CPAP machine through one of the WRHA contracted vendors Medigas or VitalAire. The $500 payment will be made directly to the vendor of the equipment. You will make arrangements directly with the vendor for payment. The vendor will work with WRHA to receive the remainder of the payment.
How Much Do Cpap Cleaning Machines Cost
The cost of a CPAP cleaning machine differs depending on the type of cleaning machine. For starters, a UV light cleaner may cost from $250 to $350.
Another type of cleaning machine is activated oxygen, and you may pay from $80 to $360.
The cheapest option for a CPAP cleaning machine is Ultrasonic Tank. And it may cost you around $60 to $175.
You May Like: Is Bevespi Covered By Medicare
Can You Buy Cpap Sanitizer And Supplies Using Cash Or Insurance
You might assume that since you have healthcare insurance, the expense of your CPAP machine is protected. CPAP machinery insurance policy is becoming more difficult every year, and insurance will eventually cost you much more than spending out-of-pocket. It all depends on your policies.
We highly recommend that you check your coverage before buying your CPAP unit. Things to be considered include the right prices, leasing vs. owning, non-refundable supplies, minimal supplies, stock availability, and long-term customer service.
Want To Pay Another Way
Paying with Cash
You can always pay out-of-pocket with Health Sqyre. Just browse our selection of CPAP supplies, click on a product, and youll see your cash price.
Paying with Medicare
Health Sqyre works with approved Medicare providers in every state, as well as many Medicare Advantage health plans nationwide.
Paying with FSA/HSA
You can use a flexible spending account or a health savings account to purchase most CPAP equipment as long as your FSA or HSA card is affiliated with a major credit card.
Out of Network Providers
Most insurance carriers allow direct reimbursement for cash purchases just submit your receipt with a claim form, usually available through your insurance companys member portal.
Read Also: How Does Medicare Plan G Work
What Is Sleep Apnea And How Is It Treated
Sleep apnea is a potentially serious disorder in which your breathing repeatedly stops and starts during sleep. Apnea occurs when your airflow stops for at least 10 seconds.
According to the Mayo Clinic, if you snore loudly and feel tired the next day even after a full nights sleep, you may have sleep apnea.
Most Common Types of Sleep Apnea
- Obstructive Sleep Apnea
- Occurs when the airway at the back of your throat becomes physically blocked. This obstruction causes you to temporary stop breathing.
- Central Sleep Apnea
- Occurs when there is a problem with how your brain controls muscles involved in respiration, which leads to slower and shallower breathing.
Research has found OSA to be much more common than CSA. When people use the generic term sleep apnea, theyre usually referring to OSA.
Common Signs and Symptoms of Sleep Apnea
- Loud snoring
- Excessive daytime sleepiness
Sleep apnea is most common in people who are overweight, use alcohol or sedatives, smoke or suffer from certain medical conditions such as congestive heart failure.
The condition is also more common in men than women.
The most common treatment for moderate to severe sleep apnea is a breathing device, such as a Continuous Positive Airway Pressure, or CPAP, machine.
CPAP therapy delivers a flow of pressurized air from a machine through a mask that fits over your mouth or nose. This helps keep your airway open and breathe more easily while you sleep.
Insurance And Cpap Supplies
When beginning CPAP treatment, the biggest upfront cost is the CPAP machine itself. Then there are supplies that need to be replaced over time, including:
|Every 6 Months|
However, each provider has its own replacement guidelines. Among state Medicaid programs, 51% adhere to these guidelines, but 39% allow for less frequent replacement of CPAP equipment. Only 10% allow for more frequent replacement.
Read Also: Will Medicare Pay For Diapers
Should I Keep Using My Recalled Machine
After youve registered your machine with Philips and have scheduled an appointment with your sleep care physician to discuss a new treatment plan, you may be wondering if you should keep using your recalled machine and what options exist if you decide its time to purchase a new machine altogether.
Since solutions for the recall are almost as personalized as individual pressure settings themselves, its important to have a discussion with your doctor as soon as possible to determine the next steps.
While Philips recommends patients to discontinue use of your device and work with your physician or Durable Medical Equipment provider to determine the most appropriate options for continued treatment, we understand that many are not satisfied with this answer.
We recently spoke with Dr. Daniel Barone, an Attending Neurologist at New York Presbyterian/Weill Cornell Medical Center, to address some of the questions you may have about the recall and the impact it has on your sleep apnea treatment. In the article, Dr. Barone discusses the risks of abruptly ending treatment versus using a recalled device.
For those who cannot currently afford new equipment but who have been encouraged to continue their sleep apnea treatment, weve included a few solutions at the end of this article that we hope can be beneficial to you.
Sleep Apnea And Medicare
Navigating coverage for sleep apnea can be tricky, but luckily, Medicare often picks up a majority of the cost. If youre diagnosed with obstructive sleep apnea, you may qualify for CPAP therapy, including routine accessories for your CPAP machine.
If you already have sleep apnea and are considering a backup oxygen concentrator, there are plenty of affordable oxygen concentrators to consider. While there may be certain restrictions and requirements for Medicare coverage of your CPAP machine, it will definitely offer some form of assistance.
To learn more about Medicare coverage, check out our helpful guides:
You May Like: What Is Medicare Ffs Program
Don’t Miss: Does Medicare Pay For Stem Cell Treatment
Some Cpap Products Are Not Reimbursable By Insurance
Review the health care coverage again. Just because the doctor agrees and also prescribes CPAP therapies to tackle your sleep apnea does not mean that the device is covered. There are some items that the insurer has considered non-refundable, which ensures that you will still have to pay out of pocket.
In these situations, its worth doing research and some internet shopping. Find out sales or offers, sign up for updates, and compare the expense to an e-commerce retailer against a DME supplier.
What Is Sleep Apnea And How Is It Treated Through Cpap Therapy
Sleep apnea is a common condition that often plagues older adults. It is a potentially serious disorder that is characterized by repeated breathing disruptions during sleep, when ones breathing may start and stop irregularly. Sleep apnea is officially diagnosed when ones airflow stops for at least ten seconds.
Common symptoms of sleep apnea include:
- Loud snoring
- Gasping for air during sleep
- Waking up with a dry mouth
- Waking up feeling unrested or excessive daytime sleepiness
- Headaches in the morning
Sleep apnea most commonly occurs in those who are overweight, suffer from certain medical conditions (such as congestive heart failure, use tobacco, or regularly use alcohol or other sedative drugs. Sleep apnea is more common in men than women, but can affect both sexes.
There are two primary types of sleep apnea: Obstructive Sleep Apnea , in which the airway at the back of ones throat becomes blocked during sleep, and Central Sleep Apnea , which occurs when there is a miscommunication between ones brain and the control of their breathing during sleep.
Both forms of sleep apnea are typically treated through the use of a Continuous Positive Airway Pressure, or CPAP, machine, which delivers a flow of pressurized air through a mask that fits over your mouth and nose during sleep. This treatment, known as CPAP therapy, helps to keep your airway open and assist you in breathing more easily during sleep.
You May Like: Who Is Entitled To Medicare Benefits
Medicare Part B And Sleep Apnea Treatment
As mentioned, with Medicare Part B, you will be responsible for paying 20% of the Medicare-approved amount to rent a CPAP device and necessary parts or accessories, and the Part B deductible applies. Medicare pays the supplier to rent the CPAP machine for up to 13 months, and after that, the CPAP machine is considered yours.
Tips For A Wise Buyer
A Journal of National Sleep Medicine study concluded that your CPAP could cause respiratory infections if not cleaned properly. Many CPAP machines use heated water to humidify the oxygen for the patients comfort. This water can become contaminated due to dirty filters or humidifying tanks. CPAP masks can quickly get grimy and are subject to mold without sufficient cleaning.
Your CPAP machine is not self-cleaning, and over time bacteria can get into the water reservoir and mold can grow on the mask. A CPAP cleaner ensures the device stays free of contaminants. Using one of these sanitizing systems is simple and much less time-consuming compared to disassembling and cleaning a CPAP by hand.
Recommended Reading: Can A 60 Year Old Get Medicare