Does this scenario sound familiar? You have a snoring problem. You come into a sleep lab to have a sleep study conducted and find out you have been diagnosed with sleep apnea.
The next thought is “ok, so how do I treat my sleep apnea?”
The most common way to treat sleep apnea is to be put on a positive airway pressure (PAP) machine while you sleep. PAP Therapy involves placing a small mask or nasal pillows over the nose or nose and mouth and blowing compressed air into the lungs.
PAP machines are also known as Durable Medical Equipment (DME). DME is the medical term for long lasting medical equipment prescribed by a doctor for use in your home.
There are three different types of sleep apnea DME devices available to help relieve sleep apnea symptoms:
AutoPAP: Auto-adjusting PAP devices automatically vary PAP pressures during the night to the lowest levels required to eliminate apneas and hypopneas. Some persons with OSA may find AutoPAP devices more comfortable to use, but they may be more expensive.
BiPAP (BiLevel): With Bilevel PAP, the pressure during inhalation is higher than during exhalation. The pressures needed to control apnea and hypopnea events with Bilevel PAP are sometimes lower than with CPAP. Because some persons have difficulty tolerating high CPAP pressures. Bilevel PAP may be used when pressures required for CPAP are relatively high.
CPAP: Continuous Positive Airway Pressure is the most commonly used PAP device. With CPAP, the level of pressure delivered to the airway is the same during both inhalation and exhalation.
Since CPAP devices are the most commonly prescribed sleep apnea breathing machines this will be the subject of our price breakdown.
CPAP Machine Costs
The initial total cost for a DME setup for new patients consists of the purchase/rental of the CPAP machine, humidifier, heated hose, face or nasal mask, and filters. CPAPs typically cost about $1000-$4,000 (without insurance) depending on the make and model of the machine and its features.
Does health insurance cover CPAP Machines? The short answer here is YES; sleep apnea devices are covered by almost all health insurances. However, some health insurance plans have different rules regarding DME than others. Prior to the purchase of a PAP device from Alaska Sleep Clinic, your insurance carrier will be contacted and you will be provided with an estimate of your total patient portion.
PAPs and Insurance Coverage
An increasing number of insurance carriers are requiring that the Alaska Sleep Clinic prove that you are using the device for them to reimburse. While the carrier may refer to this as your “rental period”, it would be more accurate to call this your “compliance period”
The length of the compliance period can range from 1 month, to as many as 10 months. During this compliance period your carrier will receive a bill on a monthly basis, along with proof that you are using the machine. Additionally, many commercial carriers will require that you see a Sleep Medicine Specialist to discuss your therapy for continued reimbursement.
As part of the Alaska Sleep Clinic’s comprehensive follow-up program SleepN, our PAPs come with wireless cellular modems to help track the patients' usage and provide compliance data for health insurance requirements.
Travel CPAP Machines
These small machines are fabulous for travel, hunting, fishing, camping, etc. They aren’t recommended for continual daily use so you will not want to use them as an alternative to your more robust every night CPAP machine. They are only designed to be used for shorter periods of time.
Unfortunately, most health insurance plans will not cover the smaller, portable, travel CPAP Machines. The reason is, these smaller machines are deemed to be a “luxury item” by health insurance companies.
Can I buy a CPAP Machine online?
You can. There are several online retailers who sell different CPAP machines. However, many of these retailers do not work directly with health insurance companies. You will have to work with your health insurance company directly for submitting claims and requesting reimbursements.
You can learn more regarding the pros and cons of ordering CPAP machines online here.
What if I don’t have health insurance?
Here at the Alaska Sleep Clinic, we believe that a person’s financial situation should never prevent them from seeking treatment for debilitating sleep disorders. For this reason, our financial coordinator is available to speak with patients about extended payment options prior to appointments or the provision of supplies.
If you have any further questions regarding CPAP therapy, sleep studies, sleep apnea, or any other sleep troubles you're having, feel free to contact the Alaska Sleep Clinic.
At the Alaska Sleep Clinic, we specialize in sleep-related DME and strive to provide the best education available for your sleep apnea and its treatment. As professionals in the field of sleep medicine, we are able to ensure that you are familiar with any form of treatment your physician determines is best.
We carry an extensive inventory of machines, masks, and other sleep-related products to meet every patient’s unique needs and lifestyle.