Buying a new CPAP machine and a CPAP mask is a big financial investment. For Sleep Apnea patients, it’s a medical necessity that can cost hundreds to thousands of dollars. This article details how, depending on your insurance coverage, you may be able to get reimbursement from your insurance company after purchasing a CPAP machine.
Does Insurance Cover CPAP?
Insurance companies cover CPAP machines, but in most cases, they prefer you to use their in-network provider. By purchasing your machine from CPAP.com — it’s all yours. You’ll also be able to select a machine that works for you and your lifestyle. That’s why many people choose to get their CPAP machine online, from a company like CPAP.com.
Insurance Reimbursement for CPAP Machines
CPAP.com is considered an out-of-network DME by insurance companies, and for those companies that provide CPAP insurance coverage for out-of-network DMEs, CPAP machine cost reimbursement may be possible when filing a claim. Of course, your insurance company could have no out-of-network coverage for CPAP machines and related products, in which case you would not qualify for reimbursement. It’s critical to verify with your insurance company before placing your order, as CPAP.com makes no guarantee of reimbursement.
For customers who have out-of-network coverage, CPAP.com has streamlined the process for self-filing insurance reimbursement. We’ve created an Insurance Self Filing Tool that allows you to select an insurance carrier and download the appropriate forms that you’ll need to fill out. Since insurance forms differ with each insurance provider, it’s important to be able to select the right forms for the correct company. With most major carriers represented, downloading the correct form is easy. Here’s how to use the tool:
- Navigate to the Self Filing Insurance Coverage Tool
- Locate the box with the name of your insurance provider listed, and click on it.
- Click on the link that says “Fill Out Claim Form”. Your form will start downloading.
- Follow the instructions on the form, attaching your receipt and prescription.
- Submit claim form to your insurance provider.
- Your insurance company will evaluate your coverage and your claim and ultimately decide on what reimbursement you’re entitled to.
We designed this page to be a hub to help streamline the reimbursement process. It’s a central space that has forms from top insurance carriers:
- United Health Care
- Blue Cross Blue Shield
- Kaiser Permanente
Insurance Provider Not Listed?
If your provider is not found on the list above, no worries! We provide a generic form that you can use that has all the required information your provider needs to be able to process the claim. When you complete your purchase, we’ll send you an insurance compliant invoice that has the right billing codes. It should be everything you need to file your claim.
By making it easy to locate reimbursement forms for your insurance provider, we’re helping to streamline the process for reimbursement, making the process a little simpler. Using our Self-Filing Insurance Reimbursement Tool, it’s possible to not only file for reimbursement for new purchases, but you can also file claims for past purchases as well. The time limit on compensation for previous purchases will depend on the rules of your insurance provider, so you’ll want to verify with them before submitting a claim. Please be advised that CPAP insurance coverage rules vary from provider to provider.
We hope you’ll find this new feature to be helpful and easy to use. So what do you think? Do you like this new feature? Has it been beneficial? Let us know in the comments below!
David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.