Best CPAP Suppliers in Ohio

How to Choose a CPAP Supplier

Navigating the process of getting a CPAP machine through insurance isn’t always easy, but taking the time to choose the right supplier is worth it. Suppliers and stores that take insurance for CPAP will work with you to make sure you get the equipment that works best for you, guide you through insurance requirements, and provide support if something goes wrong.

Making an informed choice now can save you a lot of hassle — and money — down the road. Here’s what to keep in mind.

Insurance and Prescription Requirements

Insurance companies require a valid prescription for CPAP equipment, so make sure you have that first. Then confirm the supplier works with your health insurance plan by contacting your insurance provider to understand what’s covered, including copayments, deductibles, network restrictions, and out-of-pocket costs.

Product Selection and Availability

A quality CPAP supplier should offer a wide range of CPAP machines, masks, tubing, humidifiers, filters, and other accessories to increase the likelihood of finding your most comfortable and effective setup. Look for suppliers that carry top-rated brands and different mask types, such as nasal, full-face, and nasal pillow masks.

Company Reputation

Check customer reviews for mentions of product quality and how helpful their customer service is. A reputable supplier should provide helpful, responsive support whether you need guidance setting up your equipment, troubleshooting issues, or making a return. Also, make sure the supplier is transparent about costs. Reputable brands won’t leave you guessing about what you’ll pay versus what insurance covers.

Returns, Shipping, and Location

Review the company’s return, exchange, and warranty policies. This is especially important if you’re experimenting with different masks or devices to find what works best. If you prefer the convenience of online shopping, check shipping options and delivery times. Also, consider whether the supplier has a physical location near you where you can try equipment in person or pick up your order. Some suppliers may offer both online and in-person options, giving you even more flexibility.

How CPAP Insurance Coverage Works

Does insurance cover CPAP therapy? That depends. Most private and government insurance plans provide at least partial coverage for CPAP machines and accessories, as long as the user has a sleep apnea diagnosis and prescription. But it’s important to check your policy to see what’s covered and what’s not.

Here’s how CPAP insurance coverage works—what’s typically covered, what requirements to expect, and how to avoid surprise costs. 

Private Insurance

Private insurance plans are provided by an employer or bought on the marketplace, and their coverage varies, as do out-of-pocket costs for CPAP users. Typically, the insurance company will cover at least part of a CPAP machine and accessories, though it may not be until you meet your deductible. Certain plans pay for the machine up front while others reimburse you after you make the initial purchase.

Because private insurance coverage varies so much, you’ll need to work directly with your insurance company to make sure you choose an approved machine, otherwise the one you choose may not be covered.

Medicare

Medicare is a government insurance plan for people 65 and up as well as those with qualifying illnesses. Medicare covers 80% of a CPAP machine after you meet your Part B deductible. You’re then responsible for the remaining 20%.

During the first 12 weeks, you must use the machine for four or more hours a night, at least 70% of the time to continue to qualify for coverage. If the initial 12 weeks of therapy improve your symptoms, Medicare will continue to cover your machine for a total of 13 months. After 13 months of proper use, you’ll own the machine outright.

What’s Covered

Medicare Part B covers 80% of the cost of durable medical equipment (DME), which includes CPAP machines, as well as related accessories like masks, tubing, and headgear and their regular replacement. Machines qualify for replacement after 5 years, while masks and tubing can be replaced every 3 months. Medicare does not cover accessories like CPAP pillows or cleaning tools.  

Private insurance companies generally cover CPAP machines, accessories, and replacements as well, but you’ll need to check with your provider for details about your individual plan.

How to Get a CPAP Machine Covered

To get a CPAP machine covered, look closely at your plan’s requirements, including whether you need a sleep study, a prescription, and prior authorization. Knowing the steps ahead of time can help you avoid delays and out-of-pocket surprises.

1. Get Your Diagnosis and Prescription

If you’re wondering, “Do you need a prescription for a CPAP machine?” The answer is yes. To qualify for CPAP coverage under either private insurance or Medicare, you’ll need a sleep apnea diagnosis and a prescription. Medicare requires an apnea-hypopnea index (AHI) of 15 or more events an hour, or an AHI between 4 and 14 with a sleep apnea-related comorbidity (ex. hypertension, obesity, diabetes). 

Private insurance requirements differ between companies, but you’ll generally need to complete an in-person or at-home sleep study. Check with your insurer for exact requirements.

2. Find an In-Network DME Supplier

Since CPAP machines and accessories are considered durable medical equipment, Medicare and private insurance only cover CPAP machines and accessories if they come from a DME supplier.  

You can find out exactly what equipment your provider covers by looking at medical billing codes. Use a reputable DME supplier and look at the codes that correspond with the products you want, then check your plan details to see if that medical code is included. 

The supplier or your doctor will then send your sleep study results, prescription, and prior authorization (if needed) to your insurance provider.

3. Purchase or Rent Your Machine

Some insurers require a rental period before approving full ownership of the CPAP machine. For example, Medicare covers a 13-month CPAP rental. You’ll own the device yourself after 13 months of correct use. Some private insurers use a similar rent-to-own model, while others buy the machine outright with either co-pays or reimbursement methods. 

Keep in mind that there are some advantages to buying a machine out of pocket rather than going through insurance. Buying a device yourself is more expensive up front, but it allows you to buy the exact device you want, avoid follow-up requirements, and keep your data private.

4. Stay Compliant

Most insurers, including Medicare, require you to prove that you’re using the device correctly and for a minimum number of hours (usually four or more hours per night on 70% of nights). This is referred to as compliance. Your device records usage data and either stores it on an SD card or transmits it directly to your provider.

Why You Should Trust Us

Our team of experts includes licensed respiratory therapists, sleep disorder specialists, and experienced medical professionals who understand the ins and outs of both sleep apnea treatment and insurance coverage. We’re here to help you navigate the often confusing process of getting a CPAP machine and supplies through insurance, while ensuring your personal health information is handled with complete HIPAA compliance.

From understanding your coverage to staying on track with your therapy, we’re committed to making your CPAP journey easier, more affordable, and fully supported.

Additional Resources

• Types of CPAP Machines
• How Much Is a CPAP Machine?
• How Long Does a CPAP Machine Last?
• How to Buy a CPAP Machine
• CPAP Machine Rentals