Q. What treatment is available for OSA?
A. CPAP, or continuous positive airway pressure, is gold standard treatment for Obstructive Sleep Apnea (OSA). Sleep Apnea is a common disorder where your airway collapses or is blocked during sleep. When you try to breathe, any air that gets passed the blockage can cause loud snoring. CPAP is a relatively simple, non-invasive means of treatment that is almost always successful. The mild air pressure from your CPAP machine works by “splinting” your airway open in order to overcome the blockage and snoring.
Q. Is OSA treatment covered by insurance?
A. The cost of the CPAP/AutoCPAP equipment is approximately $1700 to $2500 and it is not covered by Goverment Health Care, but may be covered by private health insurance companies such as Blue Cross, Great West Life, Sun Life, Manulife, etc. We suggest you check with your insurance provider, and ask the following questions:
Q. I have been diagnosed with Obstructive Sleep Apnea; what do I need to submit to access my insurance coverage?
A. You will require the following: Sleep study result, Prescription from Doctor and invoice from the provider
Q. Do I require a pre-approval and if so, what do I need to submit to get my pre-approval?
A. Most of the time pre-approval is not required, but we can send an estimate if requested.
Q. Does my insurance provider bill you directly?
A. Some insurance can be directly billed and may require payment first.
Q. What percentage of coverage do I have? (80% or 100%)
A. You can call your insurance provider to find out.
Q. What is the maximum amount covered?
A. Normally the maximum varies between $2,000 and $2,500.
Q. How often is CPAP accessories /replacement supplies covered?
A. Most insurance companies allow you to replace your mask, tubing and other accessories about every 6 months.
Q. Are filters covered?
A. Yes, most insurance companies will cover the cost of filters when they need replacing.
Q. How often should my machine be replaced?
A. Your machine should last 5-7 years. Most insurance companies allow you to replace your machine every 5 years with a new prescription.
Q. What is the recommended renewal schedule for CPAP and accessories?
A. We recommend that you replace parts of your CPAP machine regularly. Your CPAP machine will contain an air filter – check your owner’s manual for the replacement timeline specific to your machine. The hose, headgear and mask should be replaced once per year, or earlier if showing signs of wear. The machine itself will need to be replaced every 7 or 8 years, or as often as your insurance would replace it.
Q. Can I get replacement parts for my CPAP machine from you?
A. Yes, we can help you obtain replacement parts for a machine you already have. Do I need a referral from my doctor to make an appointment? We take patients based on referrals from physicians and we can also make appointments directly with patients without a referral or prescription.