Download it here . Complete the claim form above and submit it along with your CPAP.com itemized receipt and prescription to the address listed on the back of your Health Plan ID Card. The US Expediters, Inc. dba CPAP.com Federal Tax ID is 760521364.
Note: Receipts for masks with headgear and machines with humidifiers do not break down the cost separately because they are a packaged item. If your insurance provider has questions, please do not hesitate to reach out to us!
After submitting your claim, you'll typically be reimbursed within 2-3 weeks. (Depending on your provider, it can be faster or slower.)
If this page doesn't show your insurance provider, click the button below to return to a menu to select the right provider. Claim forms are often specific to each company. You don't want to fill out the wrong one!Back to Providers