Updated: February 11, 2019
When it comes to CPAP machines, (or any large purchase) nothing’s worse than overpaying.
Here’s a pro tip when it comes to the cost of a CPAP machine:
If you get your machine through your insurance company, you may overpay for your new machine. By a lot.
Read on to find out the secrets to saving money on healthcare by purchasing your first machine online. We’ll answer:
- How much does a CPAP machine cost with insurance?
- How much does a CPAP machine cost without insurance?
- How much do CPAP supplies cost?
- Should you buy your CPAP machine online?
And much more!
What is the cost of a CPAP machine with insurance?
The cost of a CPAP machine with insurance is often much higher than the cost to buy it with cash online.
CPAP machines can cost a lot, and it may be tempting to have your insurance get you one and make things easy and convenient.
Here are some myths about getting your CPAP machine with insurance that you might not have known:
- Myth #1: Insurance Picks Up Most of the Cost
- Myth #2: You’ll Get the Best Machine
- Myth #3: Once You Get the Machine it’s Yours
You heard that right. Many people assume these things about buying a CPAP with insurance, and they’re all false in many cases. We’ll explain more in a second.
But first, you may be asking the question:
Does insurance cover CPAP machines? Wouldn’t they cover it like any other expense?
That’s a good question and it depends. With most insurance companies, your machine is covered if you’ve met your annual deductible. If you haven’t met the deductible yet, you’ll be on the hook for the cost of the machine. This is a prime example of how healthcare can get expensive, and out-of-pocket costs can accelerate much faster than you’d expect. This is why many people are frustrated with their insurance company, and why many people choose to forgo it altogether.
Another thing that commonly happens with insurance, is this scheme:
They’ll get you a CPAP machine, but they’ll offer it to you on a rental plan that can cost a lot of money per month. What’s worse, if you miss too many days of therapy, they’ll just take it from you.
That’s only the beginning. Before you go and get a machine through insurance, you’ll want to know more about these myths, so let’s dive in.
Myth #1: Insurance Picks Up Most of the Cost
Most people are used to paying a copay for medications. Many people assume getting a CPAP works the same way. You order a machine, they pay most of it, and then you pick up the rest. Easy right?
When it comes to CPAPs, most insurance companies don’t work that way. In most cases, you’re paying for the whole thing over time, one way or another. You’ll either:
- Rent to own the machine (and may pay much more than what it’s worth).
- Or you’ll have to buy it outright (if you haven’t met your deductible).
- If you have Medicare, you’ll pay 20% of the cost up front, and then rent it for 13 months.
CPAP.com doesn’t bill insurance for our machines, and we don’t accept Medicare. That’s how we’re able to keep our prices low. You’ll have to pay cash, but chances are, even if you buy a CPAP machine with insurance, you’ll still have to pick up the tab.
You might as well save some money in the process.
Myth #2: You’ll Get the Best Machine
When getting a CPAP machine with insurance, many people assume they’ll get the best machine.
This isn’t always true.
In many cases, the CPAP supplier your insurance company recommends is reimbursed the same if you get a great machine or an average one. Thus, there’s no incentive at all for the CPAP supplier to give you the best machine.
If they give you a cheap, average machine, they can pocket more of the insurance company’s reimbursement than if they give you a more expensive, higher quality machine. Some companies will provide a high-quality machine, but many don’t.
By purchasing your first machine with CPAP.com, you can choose whether you get a great or average machine. You’re in full control, and you’ll get the best price.
Myth #3: Once You Get the Machine with Insurance, You Own It
This would seem logical, right? If you pay for your therapy equipment, you should keep it– especially if you’re making all your payments on time.
When it comes to CPAP machines, insurance companies don’t work that way. Renting a machine (the most common way people start CPAP therapy) means you’re required to use it. If you don’t use it on a regular basis, your insurance company can take it from you.
You heard that right.
If you don’t use the machine often enough, the insurance company will want it back.
It’s a process called “compliance monitoring”. Every night, your insurance company is monitoring your data, and if you go a few days without using it, it may indicate to your insurance company that you’re not serious about your treatment. In these cases, many times they’ll pull the plug.
Buying a CPAP machine online means you’re always in charge of your therapy. We won’t take it from you, and you’ll own it from day one. That’s a lot better than renting.
It’s also a lot less expensive to own than rent– by a lot. What typically happens in rent-to-own scenarios put forth by insurance companies, is the monthly rental fees add up to a cost that’s MORE than the machine sells for at an online retailer. This is because the CPAP supplier in no way is obligated to give an insurance client the best price.
On the cash market, retailers compete by offering the lowest price for CPAP machines allowed by the manufacturer. This is what consumers are used to– and it’s what they expect. It’s yet another reason many people get their machine from an online supplier instead of their insurance company.
Should You Buy Your CPAP Machine Online?
There are generally two ways to get a CPAP machine:
- You can work with your doctor (who works with a CPAP supplier called a “Durable Medical Equipment Provider” or a DME).
- Or, you can buy a CPAP machine online.
Keep in mind that it may be cheaper to buy your CPAP machine online. When you buy online, you have a larger selection. This increases the likelihood of finding the right machine for you.
Hear a firsthand account of why this CPAP user felt like going through his insurance company to get his first CPAP machine was a mistake. Hopefully, his experience can help you as you plan to get your first machine.
What is the Average Cost of a CPAP machine?
The initial cost of a CPAP setup is usually a little over $1,000, and includes a CPAP machine, CPAP mask, CPAP hose, CPAP supplies, and accessories. Many people include a humidifier with their first CPAP machine, but this is optional.
For a quality APAP machine you’ll typically pay:
- $800 for the machine itself
- $150 for the mask
- $30 for the hose
- $125 for the humidifier (if not included with the machine purchase)
For a quality CPAP machine you’ll typically pay:
- $300 – $500 for the machine itself
- $150 for the mask
- $30 for the hose
- $125 for the humidifier (if not included with the machine purchase)
The savings of going with a CPAP machine are huge, but be careful.
Pressure changes with a CPAP mean you’ll have to have your doctor change the pressure, which can mean more sleep studies– and more copays
APAP machines change pressure automatically by observing changes in your breathing, so you won’t have to visit the doctor if your pressure needs tweaking. Nice!
As a general rule of thumb across different devices:
- CPAP (delivers therapy air at one set pressure): average price of around $500
- APAP (automatically adjusts pressure): costs around $800
- BiPAP (delivers therapy air at two set pressures for inhalation and exhalation): starts out at $1,300
- Travel Machines: costs around $800
If you’re planning on asking your insurance company for a travel machine, you may be out of luck. Insurance companies typically only supply a person a home unit. If you’d really prefer a travel machine, you may want to consider getting one from a retailer– not your insurance.
These average CPAP machine costs do not include CPAP masks and other necessary accessories, such as a hose or filters. You’ll want to make sure when you buy your first CPAP that you have these items.
Just like with other electronics, machines with advanced features generally cost more. The overall cost of your CPAP equipment will also depend on different factors, such as whether or not you use humidification, or add other accessories like a heated hose.
You may be wondering:
How long does a CPAP or APAP machine last?
Many people use their same machine for years, and the length of time your machine can last depends on how well you take care of it. If you care for it well, many people can get 3-5 years out of their CPAP machine.
Before you can buy a CPAP, APAP or BiPAP machine, you’ll need a prescription. We’ll cover that next:
CPAP Machines are Prescription Only
Before you can order a CPAP machine, you’ll need to get a prescription from a doctor.
You’ll need a prescription if you’re buying a new CPAP machine, CPAP mask, or Oxygen Concentrator.
Before you can get a prescription, your doctor will need to confirm you have Sleep Apnea.
This process happens from conducting a sleep study.
You can do a sleep study in a medical sleep lab, or you can do one at home, using a home sleep test. The cost breakdown for sleep studies works out like this:
- a home sleep study costs about $185
- a sleep study in a lab costs about $5,000
If you have Medicare, and need to do a sleep study in a Sleep Lab, Medicare covers sleep lab tests if you show symptoms of Sleep Apnea. They must be done in a lab, but you’ll be on the hook for 20% of that cost.
A home sleep test is usually much cheaper than an in-lab sleep study. However, it generally checks for Sleep Apnea only, while a sleep lab can check for other disorders and is generally more comprehensive.
How Much Do CPAP Accessories Cost?
In addition to the CPAP machine itself, you may have to consider the cost of accessories and add-ons, such as humidifiers, various parts, and cleaning supplies. Supplies are covered by insurance, but coverage levels vary from state to state:
Humidifiers – $150 to $200 – Humidifiers aren’t required for CPAP therapy, though they have been proven to make CPAP therapy more comfortable.
Humidifiers add moisture to your therapy air. They work by either having air pass over a tank of water, picking up moisture as it passes over, or– the humidifier tank sits on a heating plate which turns some of the water to gentle steam. It travels through the hose and mask, and gently adds moisture to nasal passages and the mouth.
When bought separately, humidifiers may cost $150-$200.
Sometimes, the machine you select has a humidifier built-in and ready to go when you purchase the machine– nothing extra to buy! Here’s all the machines we sell at CPAP.com with a built-in humidifier. We’ve got a wide selection for all different budgets!
CPAP Masks – $35 to $150 – CPAP masks are where the machine meets your face or nose, and should be replaced every 3-6 months. Prices on CPAP masks vary, but most average between $35 to $150.
The costs vary depending on style, features, and quality. Some of the older, less expensive masks cost less money than newer masks with modern designs and advanced features.
CPAP Hoses – $10 to $40 – CPAP hoses and tubing are the connection from the CPAP machine to the mask and should be replaced every 6-12 months. Prices on hoses can range from $10 to $40 dollars depending on what kind you need.
There’s a big price difference between heated hoses (more expensive) and standard hoses (less expensive). Heated hoses have heating coils, which add additional cost.
Heating coils cut down on the formation of condensation inside the hose itself. This means less water in the tube, and perhaps a better experience.
Parts – Few Dollars to $30 or $40 – Every CPAP machine is different and will require different parts. Almost all CPAP machines have different filters that are used to remove atmospheric irritants from the air you breathe. These filters cost only a couple dollars and need to be changed every month, or every 6 months, depending on the filter.
There are three types of filters:
- Disposable (fine) Filters
- Reusable (foam) Filters
- Bacteria Filters
Disposable Filters: Disposable filters are found on most machines and their design is specific to each machine. Disposable filters should be replaced frequently, and cannot be washed. They cost only a couple dollars and are needed to help remove dust, smoke, and other irritants from the air making it better for your therapy air quality.
Reusable Filters: Reusable filters are made of foam, and are intended to be cleaned periodically. You would wash a foam filter with mild soap and water regularly to be reused. Once clean, you can put it back in the machine. Reusable filters aren’t used by every machine and they’re not a replacement for disposable filters and some machines use both.
Reusable filters are still only a few dollars, but cost just a little more than fine filters, between $9 – $20.
Bacteria Filters: Bacteria filters are completely optional, but some people like them because they add another level of protection to your setup. They’re designed to filter out mold, bacteria, and other tiny particles that make it past your machine’s defenses.
Bacteria filters cost almost $20 for a 5 pack, and many people choose to make the investment.
Costs for Cleaning Supplies
CPAP.com sells many different cleaning solutions— including mask wipes and other cleaning products. For a comparison of the different prices of cleaning products, here are a few examples:
You Can Still File a Claim When You Buy With CPAP.com
Just because you buy your machine through us, doesn’t mean you can’t also bill your insurance company for reimbursement for your CPAP therapy equipment.
CPAP.com is considered an “out-of-network” DME or CPAP supplier, so be sure to check with your insurance company to see their coverage for out-of-network providers BEFORE you order.
When you purchase from CPAP.com, if you have coverage, we can help you get reimbursed by your insurance company.
We’ll provide an insurance guide, an insurance-compliant invoice, and a brochure showing you what paperwork you need and the common reimbursement challenges.
It’s important to remember that just because you receive an insurance compliant invoice, it’s not a guarantee that you will get reimbursed. It’s important to check with your insurance plan if you’re planning on reimbursement.
Insurance plans differ in coverage for out-of-network DMEs, and CPAP.com is considered an out-of-network DME by most insurance companies. If you’re planning on getting paid back, check first before you order!
There’s always a lot to get used to when you start with CPAP therapy. There’s equipment to buy and a new bedtime routine which will be an adjustment for most people.
But one thing is for sure: once you find the correct CPAP machine for you, you can’t put a dollar amount on a good night’s sleep.
For more information on this and other topics, please see the following comprehensive resource on: CPAP machines. There you’ll find more information about CPAP machines and how they’re used to treat Sleep Apnea, providing additional information to help you on your journey.
If you have questions or want to know more, contact one of our CPAP experts at 1-800-356-5221.
Daniela has researched and published over 60 articles covering topics that aim to inform and empower people living with Sleep Apnea. As an avid reader and researcher, Daniela continues to grow her knowledge about Sleep Apnea and CPAP therapy everyday with the help of coworkers, CPAP.com customers, and members of other CPAP communities online.