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Do You Need a Prescription for a CPAP Machine?
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Key Takeaways
- You need current prescription from a healthcare provider to buy a CPAP machine. APAP and BiPAP machines also require a prescription.
- Your doctor’s prescription for a CPAP machine includes specific information, such as the type of machine and the required pressure settings.
- Sleep Doctor streamlines the process, handling initial sleep study approval, sending you the test, walking you through your results, getting you a prescription, and ordering you a CPAP machine and supplies.
Why You Need a Prescription for a CPAP Machine
You can’t buy a CPAP machine without a prescription because the U.S. Food and Drug Administration (FDA) categorizes all PAP machines as Class II medical devices.
Requiring a prescription for a CPAP machine ensures that people will work with a doctor or other healthcare provider before determining that CPAP therapy is the best treatment for them. Healthcare professionals also monitor and tailor treatment to make sure people on CPAP therapy are using it safely and benefitting from it.
Confirm a Sleep Apnea Diagnosis
Prior to receiving a CPAP therapy prescription, a person must undergo assessments to identify the nature of their sleep problems. Many sleep and medical disorders produce symptoms similar to sleep apnea symptoms, so the cause can't be assumed without testing.
Obstructive sleep apnea can be confirmed through two types of testing. A sleep study is conducted overnight in a sleep lab or clinic. This requires an overnight stay. A home sleep test (HST) is conducted overnight in a person's home.
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Measure key sleep metrics and review your results with a licensed sleep-care provider. Discuss sleep issues and options to make restless nights a thing of the past.
Optimize Your CPAP Therapy
If you receive an OSA diagnosis and are prescribed CPAP therapy as treatment, your doctor or sleep specialist will work with you every step of the way. They will:
- Ensure CPAP therapy is safe for you before you begin
- Identify the best CPAP machine and accessories for you
- Help you choose the best CPAP mask type for you and make sure it fits
- Determine the right pressure settings for your needs
- Demonstrate how to use your CPAP machine once it arrives
- Work with you through any side effects or problems using the CPAP machine
- Assess how effective CPAP therapy is for you and make changes if needed
How to Get a Prescription for a CPAP Machine
People are typically prescribed CPAP therapy to treat obstructive sleep apnea and other sleep-related breathing disorders. If you suspect you have sleep apnea, your doctor may refer you to a sleep specialist for an evaluation and sleep study.
Sleep Doctor offers the same process from the comfort of home, making it easier to get tested, diagnosed, and treated without visiting a sleep lab.
Order Your Sleep Test
Start by ordering an at-home sleep test directly from Sleep Doctor. Our easy-to-use testing kit is shipped straight to your door and includes everything you need to measure your breathing, oxygen levels, and sleep patterns—all from the comfort of your own bed.
Talk to a Doctor
Schedule a quick video chat with one of Sleep Doctor’s board-certified physicians to discuss your symptoms, such as loud snoring, gasping for air at night, or excessive daytime sleepiness. The doctor will review your health history, answer questions, and approve your home sleep test if appropriate.
Take an At-Home Sleep Test
Follow the simple instructions to complete your test overnight. Once you’re done, return the device using the prepaid label. Your data will be analyzed by one of Sleep Doctor’s board-certified sleep physicians to confirm whether you have obstructive sleep apnea or another sleep-related breathing disorder.
Review Your Results and Get Your Prescription
Within just a few days, you’ll receive your personalized sleep report and treatment recommendation. If you’re diagnosed with sleep apnea, one of our licensed physicians will provide a prescription for the therapy that best fits your needs, which typically includes a CPAP machine.
Where to Buy a CPAP Machine
If you’ve been prescribed CPAP therapy, you can order your CPAP machine, mask, and accessories directly through Sleep Doctor—no need to visit a clinic or store.
You can also purchase CPAP equipment through other channels:
- Sleep clinics: You can buy a CPAP machine and accessories at some sleep centers provide, following a sleep study.
- Medical supply stores: Local medical equipment suppliers offer in-person assistance and same-day pickup options.
- Online retailers: Other online vendors sell CPAP devices with a wide range of styles and features, though availability and support may vary.
Can You Rent a CPAP Machine?
In addition to purchasing, you can rent CPAP machines. Many insurance providers require people to technically rent their CPAP machine for the first 12 or 13 months and make monthly payments. After the specified time is up, they then own the machine.
Check with your health insurance company to see if they cover the supplier you're considering, as well as to find out how their coverage works.
Does Insurance Cover CPAP Machines?
Many health insurance companies cover CPAP devices prescribed for obstructive sleep apnea and other sleep-related breathing disorders. Medicaid and Medicare often cover CPAP therapy, as well. However, even when insurance covers CPAP therapy, the policy-holder may have to first meet a deductible or pay co-payments, which often end up being 20% of the total cost.
Additionally, as a condition of continuing coverage, some insurers check to see that a sleeper uses the CPAP machine as prescribed. For instance, some may require data from your CPAP machine to prove you've used it at least four hours a night on 21 or more nights a month.
Can You Get a CPAP Machine Without Insurance?
If you don't have insurance, you can choose to rent a CPAP machine or purchase it directly as long as you have a prescription. Sometimes people who have insurance opt to pay for CPAP machines or accessories out of pocket. This approach may speed up the buying process, offer greater freedom of selection, and protect the buyer's data from being sent to an insurer.
Frequently Asked Questions
What does my CPAP prescription need to say?
Your doctor or sleep specialist may give you a CPAP prescription on paper or digitally. All CPAP prescriptions must contain the following information:
- Patient information: your full name and date of birth
- Diagnosis: your diagnosis, such as obstructive sleep apnea
- Equipment details: type of PAP machine prescribed, pressure settings, mask type, whether or not humidification is needed, and how long therapy will be needed (often inputted as "lifetime" or "99 months")
- Prescriber information: your doctor's name, signature, contact information, and 10-digit National Provider Identifier (NPI) number
How long is a CPAP prescription valid for?
A CPAP prescription is valid for the length of time the prescribing doctor notes on the prescription. Doctors may put that a prescription is valid for a "lifetime" or for "99 months." That said, CPAP machines generally need to be replaced every five years, and it's a good idea to maintain regular doctors visits to discuss CPAP therapy over time.
Do CPAP masks require separate prescriptions?
Sleep specialists often write one prescription for both a CPAP machine and mask system, but they could also write separate prescriptions if they chose to do so. Like CPAP machines, CPAP masks require a prescription because they are considered Class II medical devices by the FDA. Some individual mask components, like nasal pillows, don't require a prescription.
Can you borrow a CPAP machine?
It’s not recommended to borrow or share a CPAP machine. Each device is prescribed and calibrated to an individual’s specific pressure needs, and using another person’s machine could be unsafe or ineffective.
Additionally, borrowed machines may not be properly sanitized, increasing the risk of infection. Always use your own prescribed and fitted device to ensure safe and effective treatment.
References
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