Chapter 1: Get Your CPAP Supplies Paid For

 

Why: Device and supply maintenance is key to success with CPAP therapy and ultimately improving yours, or your loved one’s quality of life. ResMed suggests 7 out of 10 users say they’ve slept better after replacing their supplies, but even better is that patients are also more compliant with their therapy. The following study concludes that “Patients treated with PAP therapy in routine clinical practice showed that a resupply program was associated with statistically and clinical significant increases in average daily usage and reduced therapy drop-out rate.”  

Positive Airway Pressure (PAP) Therapy Compliance on a Resupply Program: A Retrospective Analysis 

How: Insurance companies know the above too (including Medicare). That is why many of your cpap supplies are reimbursable at regular intervals throughout the year on most commercial plans too. You might not even be aware of the all the supplies you are likely eligible for: masks, cushions, headgear,  chin straps, filters,  tubing, water chambers, heated humidifiers and of course, your actual CPAP machine. 

Below we will review a scenario that occurs in the United States. It’s worth noting that many other countries have insurance reimbursement programs for CPAP; However, the US is very modernized in that most of the time suppliers are incentivized to make sure that CPAP therapy is effective, and patients are compliant, before insurance will pay anyone, for any supplies. This is quantified with the CPAP device compliance data. 

I’ll give you a few examples. If you are a nasal pillow user, let’s say an AirFit P10, but you also use a DreamStation 2 CPAP. Below is what a typical reimbursable supply replacement schedule could look like in a year, if you were starting January 1st. For your actual CPAP machine and humidifier, we will exclude for simplicity, but they most commonly run on a 5-year replacement schedule. 

January 1 and July 1: 

  • 1x AirFit P10 Frame Interface (Every 90 Days) 

  • 1x AirFit P10 Headgear (Every 180 Days) 

  • 6x AirFit P10 Cushions (Every 90 Days) 

  • 1x Chin Strap (Every 180 Days) 

  • 1x Philips HT15 Heated Tubing (Every 90 Days) 

  • 1x Humidifier Water Chamber (Every 180 Days) 

  • 1x Reusable Pollen Filter (Every 180 Days) 

  • 6x Disposable Ultra Fine Filters (Every 90 Days) 

April 1 and October 1: 

  • 1x AirFit P10 Frame Interface (Every 90 Days) 

  • 6x AirFit P10 Cushions (Every 90 Days) 

  • 1x Philips HT15 Heated Tubing (Every 90 Days) 

  • 6x Disposable Ultra Fine Filters (Every 90 Days)

There are often other items beyond the above that you use with your CPAP therapy, like a hose cover. Most of the items that aren't covered by reimbursement, are covered through Flex Spending or Health Spending Accounts. On Amazon for example, you will notice the FSA or HSA eligible tag on the listing.

Question: Did you already know that you might qualify for all the above each year for reimbursement?

If you wish to learn about the resupply reimbursement you could be eligible for, set up a free consultation with our cpap coaches. 

Email us: brady@resplabs.com

Call us: 1 (888) 709-7377


Best,

Brady


Brady Nelson RRT
President, resplabs