Once you've been diagnosed with sleep apnea, getting a CPAP machine is an essential step toward better sleep and improved health. Learning how to get a CPAP machine involves understanding requirements for getting a prescription, navigating your insurance coverage options, and choosing where to make your purchase.ย
Our step-by-step guide on how to get a CPAP machine will walk you through each step of the process to help you start CPAP therapy with confidence. Whether you're newly diagnosed or looking to replace an existing machine, this article covers everything you need to know about obtaining your CPAP equipment.
Step-by-step guide to getting a CPAP machine
Get tested for sleep apnea via a home sleep test or lab study
Receive your prescription for CPAP therapy and pressure settings
Consider your options for insurance coverage requirements and policies versus self-pay
Choose where to buy your CPAP machineโa local brick and mortar supplier or online shop
Select the CPAP device that's right for you, based on cost, features, and product specs
Order the other CPAP gear needed to get started, such as the mask and cleaning supplies
Submit your CPAP prescription to the seller
Finalize your order and submit payment
Did You Know?
There are at leastย 30 million Americansย with obstructive sleep apnea (OSA). It's believed that up to 80% of them are undiagnosed.
Step 1. Get tested for sleep apnea
Before you can get a CPAP machine, you'll need confirmation that you have sleep apnea. This requires a sleep study, and afterwards a sleep specialist will analyze your sleep test results, including your AHI (apnea-hypopnea index) score.
AHI is a measurement of how many breathing disruptions you experience per hour. Your doctor will use these results to determine if CPAP therapy is right for you, and if so, what specific pressure settings you'll need.
There are two main ways to get evaluated for sleep apneaโhome sleep test or an in-lab sleep study.
Home sleep apnea test
HSTs are considered a more convenient way to test for sleep apnea and are performed by you, with minimal equipment, from the comfort of your own home. To qualify for this test, your provider must have reasonable suspicion that you have obstructive sleep apnea without any other known diagnoses that could affect your results.
Lab sleep study
Also known as a polysomnogram, this overnight sleep test takes place in a lab and is administered by a sleep technologist. Lab studies are used to diagnose a wide range of sleep disorders from sleep apnea to narcolepsy. If your sleep study shows signs of sleep apnea, the lab may use part of your session to see how you respond to CPAP therapy.
| Home Sleep Apnea Test (HST) | In-Lab Sleep Study (Polysomnogram) | |
|---|---|---|
| Location | Home | Sleep clinic or lab |
| Diagnosis | Obstructive sleep apnea | Obstructive sleep apnea, central sleep apnea, complex sleep apnea, other sleep conditions |
| Measurements | Breathing, heart rate, oxygen levels, hand movements | Breathing, heart rate, oxygen levels, body movements, sleep stages |
| Administered By | Self | Sleep technologist |
| Equipment Used | Minimal | Moderate to advanced |
| Time Frame | 1-3 days | 1-3 days |
| Results | 5-10 days | 1-2 weeks |
| Cost | $200 | $300-$5,000 |
Did You Know?
CPAP machines are classified as Class II medical devices by the FDA, which means they legally require a prescription, along with most CPAP masks and CPAP humidifiers.ย
Step 2. Get your CPAP prescription
Once your doctor has diagnosed you with sleep apnea, you will be given a prescription for CPAP therapy.
Unlike medication prescriptions that expire quickly, CPAP prescriptions are usually valid for a long timeโoften for your entire life. Keep in mind that you will need to present your prescription whether you purchase your CPAP machine through insurance or self-pay.
To learn about your options for obtaining a prescription for CPAP therapy, read about cost-effective ways to get a CPAP prescription.
Here's what your CPAP prescription covers:
๐ธ The type of machinesโtraditional CPAP, auto CPAP, or Bi-Level PAP
๐ธ Machine pressure settings
๐ธ The lifespan of the prescriptionโusually lifelong
๐ธ Your provider's name and contact information
Step 3. Consider how you want to pay for your CPAP machine
The next thing to consider when getting a CPAP machine is how you're going to pay for it. This is an important step because it will affect where you can go to buy your new machine and supplies.
- Do you want to use health insurance or self-pay?
- Are you interested in buying a CPAP machine outright or renting one?
Buying a CPAP through self-pay may be right for you if you prefer...
๐ธChoosing your own machine
๐ธAvoiding insurance delays
๐ธTaking advantage of sales
๐ธNo compliance requirements
๐ธOwning your machine outright
Buying a CPAP through insurance may be right for you if you...
๐ธHave a low deductible
๐ธHave a decent copay
๐ธMeet compliance requirements
๐ธDon't have machine preference
๐ธPrefer smaller paymentsย
๐ธDon't mind rent-to-own
What to consider when deciding between insurance vs self-pay for CPAP therapy
Check your policy's coverage details
Each health insurance policy is a little bit different, but most cover 70-80% of your CPAP therapy costs once you've hit your deductible. This requires you to get your CPAP from a seller that is approved by your insurance.
You'll need to contact your insurance provider directly to understand these coverage details. In some cases paying with insurance is cheaper, but if you have a high deductible or co-pay, it may actually be cheaper to pay out-of-pocket.
Insurance requires you to meet minimum usage requirements
Most insurance companies require you to complete a 90-day compliance trial to prove that you will use your CPAP machine regularly and that your symptoms are improving.
To be considered compliant you must use your CPAP for at least 4 hours per night, for at least 21 nights per 30-day period. If you fail compliance, your insurance may refuse to pay the remaining portion of your machine cost.
Total cost for CPAP machine through insurance versus self-pay
Determining how much you'll pay for a CPAP with insurance isn't as simple as looking up that machine online and calculating your portion based on your co-pay.
The base price for a CPAP machine oftentimes depends on whether you are paying with insurance versus totally paying out of pocket. Most CPAP machines cost $700-$1,100 if you are self-paying, but that same machine may cost more overall when purchased through insurance.
Burden of upfront costs versus monthly rent-to-own payments
When you buy a CPAP machine using self-pay, you are usually required to pay for the entire machine upfront or apply for financing.
On the other hand, most insurance providers will place you on an initial 3-month rental agreement. Once you meet compliance requirements, they will extend your rent-to-own plan for an additional 10 months.
Step 4. Choose where to get a CPAP machine
There are a few different options when you're deciding where to buy your CPAP machine. Remember, each of these sellers will require you to submit your CPAP prescription before completing your purchase.
- Durable medical equipment supplier
- Online CPAP store
- Sleep clinic
- CPAP rental shops
When deciding where to get your CPAP machine, consider:
๐ธCost
๐ธConvenience
๐ธInsurance requirements
๐ธHow much support you'll need
๐ธReturn policies
๐ธExtra warranty guarantees
๐ธDelivery timing
Buying a CPAP through a durable medical supplier
Most DME suppliers will accept insurance coverage or self-pay. If using insurance, you'll typically need to purchase through an approved durable medical equipment (DME) supplier.
You will need to make sure your DME is insurance approved if you are using coverage, because insurance won't pay otherwise. Most pharmacy-based or hospital-associated DMEs are accredited.
DME suppliers can usually be found online and in local brick-and-mortar stores. One big benefit to choosing a local DME is being able to make an in-person visit if you need help troubleshooting your CPAP equipment.
Benefits of buying a CPAP from a durable medical equipment supplier:
๐ธ Accepted by insurance
๐ธSelf-pay often accepted
๐ธAvailable online and locally
๐ธ Can visit local stores for in-person support
Drawbacks of buying a CPAP from a durable medical equipment supplier:
๐ธLimited equipment selections
๐ธBase pricing may be higher
๐ธMust confirm insurance coverage
Buying a CPAP through an online seller
The main benefit of choosing an online seller is that there are many products to choose from and the prices are often better than other alternatives. While some online CPAP retailers accept insurance, many are self-pay only, however, most do accept FSA/HSA payments.
If you are buying from an online store, you'll need to make sure that you are using a reputable seller that has been authorized to sell CPAP equipment. You should always be asked to submit a prescription when buying a CPAP machine.
Heres how to tell if on online seller is legitimate:
- An established history of sales
- Clear return policies
- Positive customer reviews
- Listed by the Accreditation Commission for Health Care (ACHC) or another DME accreditationย
- Recognized by CPAP manufacturers as an authorized dealer
Benefits of buying a CPAP from an online seller:
๐ธ Lots of product options
๐ธSelf-pay accepted
๐ธFSA/HSA payments accepted
๐ธQuick self-service
๐ธLower prices than DMEs
๐ธView customer reviews
๐ธSales and discounts available
Drawbacks of buying a CPAP from an online seller:
๐ธMay not accept insurance
๐ธNo in-person support
๐ธDouble check seller is legit
Buying a CPAP through a sleep clinic
Some sleep centers sell CPAP equipment directly. This is usually available with insurance.ย
While typically more expensive, this option provides a direct line of care from diagnosis through treatment and ongoing support from the same medical professionals managing your sleep apnea.
Benefits of buying a CPAP from a sleep clinic:
๐ธ Accepted by insurance
๐ธSelf-pay may be accepted
๐ธLocal brick-and-mortar
๐ธComprehensive support
Drawbacks of buying a CPAP from a sleep clinic:
๐ธLimited equipment selections
๐ธBase pricing may be higher
๐ธMust confirm insurance coverage
Renting a CPAP through a CPAP rental program
Choosing to rent a CPAP versus buying one is generally not the best option if you're looking for a cost-effective solution. Over time, renting a CPAP out of pocket tends to be more expensive than buying one outright.ย
But if you're interested in trying out CPAP therapy or testing a new machine before fully committing to one, getting a temporary CPAP rental can be a good option.
These programs are occasionally offered online, but you may find a local store that offers CPAP rentals as well.ย
Benefits of renting a CPAP from a rental program:
๐ธ Lower upfront cost
๐ธTry before you buy
Drawbacks of renting a CPAP from a rental program:
๐ธLimited equipment selections
๐ธHigher cost over time
๐ธCan be hard to find
Step 5. Select your CPAP equipment
Picking a CPAP machine
Choosing a CPAP machine may sound complicated but it's actually fairly straightforward these days.
Most devices offer a standard set of basic comfort features, but each machine differs slightly in feature settings and technological specs. If you're looking for the perfect machine, we highly suggest reading reviews and watching at least a couple of videos.
You can expect modern CPAP machines to offer:
- Built-in humidity
- Pressure relief
- Pressure ramping
- App pairing
- Daily therapy tracking
Additionally, all standard CPAP machines these days are compatible with all popular masks. But keep in mind that travel machines may only be compatible with certain masks.ย
When choosing your CPAP machine consider:
๐ธWhether you were prescribed standard CPAP, auto-CPAP, or Bi-PAP
๐ธMachine cost
๐ธDial navigation versus touch screen
๐ธApp design and features
๐ธTherapy support features and troubleshooting help
๐ธSize
๐ธNoise level
๐ธWarrantee
๐ธPower usage
๐ธDishwasher-safe cleaning versus handwash only
๐ธTravel machine versus standard
๐ธCost of replacement supplies
What comes with a standard CPAP machine purchase?
โย CPAP machine
โย Hose
โย Filter
โย Wall outlet power supply
โย Carrying case
What CPAP equipment do you need to buy separately?
โ CPAP mask
โ Gentle cleaning soap
โ Distilled water
โ Tube cleaning brush
โ Replacement supplies
โ Extra comfort accessories
Step 6. Submit your CPAP prescription
Once you're ready to purchase your CPAP machine, you'll be asked to hand over proof of a prescription. This can be a physical copy or a digital script. Your purchase cannot be completed until you have provided a valid prescription.
While you'll be able to hand over a physical prescription in person, if you're buying online you will probably be asked to turn in your prescription by:ย
- Upload
- Fax
- Submit doctor's contact info
Lost your CPAP prescription?
Renewing your CPAP prescription is easy! Our CPAP renewal process connects you with a licensed physician who will evaluate your current CPAP needs and determine whether or not you qualify for a renewed prescription.
Step 7. Finalize your payment
You're finally ready to finalize the purchase of your new CPAP machine! If you are using insurance, you will be asked to submit your policy information at this point.ย
Many online sellers offer a variety of purchasing options and discounts:ย
- FSA/HSA funds
- Financing programs
- Apple, Google, or Shopify Pay
- Discount codes for email or text sign-ups
- Manufacturer rebates
Preparing for CPAP therapy
Once you've purchased your CPAP machine, you'll need to know some basics about ongoing care to protect your investment and ensure effective therapy.
Understanding these basic maintenance requirements can help you make more informed decisions when selecting your machine and accessories.ย
For comprehensive cleaning and maintenance instructions specific to your device, you'll want to consult your manufacturer's guidelines.
Replacement supplies: Budget for regular replacement of wearable parts like masks (every 3-6 months), filters (monthly for disposable ones), and tubing (every 6-12 months).
Cleaning routine: Plan for simple daily and weekly cleaning of your mask and accessories using mild soap and warm water.
Water supply:ย If your machine has a humidifier, you'll need distilled water to prevent mineral buildup and extend the life of your device.
Frequently asked questions
Can I buy a CPAP machine without a prescription?
No, you cannot legally purchase a CPAP machine without a prescription in the United States. As FDA-regulated Class II medical devices, CPAP machines require a prescription from a licensed healthcare provider. There are no legitimate "prescription-free" options, and websites claiming to sell CPAP machines without prescriptions are operating illegally.ย
Using a CPAP when you don't need one, or using someone else's settings, could be ineffective or even harmful. Skipping the prescription step isn't just a legal issue; it carries health risks. Using a CPAP machine set to the wrong pressure or without proper fitting can fail to treat your apnea or even cause new problems.ย
If you suspect you have sleep apnea but haven't been diagnosed, the proper path is to consult with a doctor who can order a sleep study and provide a prescription if needed. Some online retailers offer sleep testing services that connect you with physicians who can prescribe therapy if appropriate.
Is renting a CPAP machine better than buying?
The choice between renting and buying depends on your financial situation and how long you'll need therapy.ย
Renting offers lower upfront costs and a chance to try different machines, but typically costs more over time. Buying provides full ownership, privacy from compliance monitoring, and usually costs less long-term, though it requires a larger initial investment.ย
With insurance, you often don't have a choiceโmany insurers use a rent-to-own model for 10-13 months before transferring ownership to you. For most people with long-term therapy needs, purchasing is the more economical option, while short-term rentals make sense for temporary needs or when testing different machines.ย
Where can I buy a CPAP machine without insurance?
Online discount retailers:ย Specialized CPAP websites often offer lower prices than brick-and-mortar stores.
Refurbished machines: Certified refurbished CPAP machines typically come with warranties and can cost 30-50% less than new models.
Manufacturerย assistance programs: Some CPAP manufacturers offer payment plans or assistance programs for those without insurance coverage.
Payment plans: Many retailers offer financing options with low or no interest.
Assistance programs:ย The American Sleep Apnea Association's CPAP Assistance Program (CAP) provides CPAP equipment to qualifying individuals for a nominal fee (about $100). Patients need to demonstrate financial hardship and have a valid prescription.
Government programs: If you are low-income, check if you're eligible for Medicaid in your state. For U.S. veterans, enrolling in VA healthcare can get you a CPAP at no cost.
Final thoughts
Getting a CPAP machine involves several key stepsโfrom obtaining a sleep study diagnosis and prescription to determining your insurance coverage and selecting where to purchase your equipment. Whether you choose to buy through insurance, from a local supplier, or online, understanding the process helps ensure you get the right machine for your specific needs.
The journey to better sleep through CPAP therapy starts with informed decisions about your equipment. While the process might seem complex initially, breaking it down into these manageable steps makes it more approachable. Remember that the initial investment in time and resources pays dividends in improved sleep quality and better long-term health.
For personalized advice about your specific situation, consult with your healthcare provider or sleep specialist, who can provide guidance tailored to your diagnosis and treatment needs.
Need help? Contact us!
- Call: 1-800-356-5221
- Email: support@cpap.com
- Chat: Connectwith a CPAP Guide through our website or app