What’s the difference between device purchase and rental?
Whether you are getting ready to use your first CPAP machine or you’re a seasoned user about to get the latest CPAP model (have you checked out the new machines with wireless modems??) it’s important to understand these options.
Who determines if I pay for my CPAP as a purchase or rental?
If you are using health insurance to pay for your CPAP, your insurance company will determine whether they pay as a purchase or rental. Most insurance companies are paying on a rental basis, typically for about 10 months. Many insurance companies follow Medicare guidelines for CPAP equipment.
The rental rates are usually base on the purchase price. For example, if the purchase price for the CPAP machine is $800, the monthly rental fee is $80/month for 10 months. The supplies, like your mask, tubing, cushions and even the heated humidifier, are typically purchased and the rental terms only apply to the CPAP machine (aka flow generator). Read more about how much a CPAP machine and supplies cost.
Watch out for compliance requirements
After the rental period is over, you own the device. However, these insurance companies are often requiring proof that you are using the equipment and meeting their usage requirements (at least 4 hours per night for 70% of nights) in order to continue payment. If you don’t meet the compliance requirements, they will not pay. You will either have to pay cash for your equipment or return it to your equipment provider. Read more about what to do if your insurance company won’t pay because you’re not compliant.
Your insurance may require another face-to-face visit with your doctor
Another Medicare guideline that other insurance companies are starting to follow is requiring another face-to-face visit with your physician in the first months of therapy. Medicare and United Healthcare both require that patients have a clinical re-evaluation between the 31st and 91st day after starting therapy, to include:
- Treating physician documents that the patient is benefiting from therapy; and
- Objective evidence of usage (compliance data) is reviewed by the treating physician
Do I have to use my insurance to pay for my CPAP and supplies?
Of course, you don’t have to use your insurance to pay for your CPAP machine or supplies. In fact, if you don’t want to go through the hassle of proving compliance and dealing with a 10 month (or longer) rental period, you may prefer to pay out of pocket for your equipment.
For some patients who have high insurance deductibles, they end up paying out-of-pocket even WITH insurance.
If you pay cash, you can still elect to rent your CPAP machine (you’ll always purchase the supplies like mask and tubing), but it usually makes more financial sense to pay out right for the purchase. You may even end up paying less than if you used your insurance and went out-of-network. Read about the top reasons why people decide to pay cash for CPAP and supplies.
If this is your second CPAP machine (for travel or a second home) you will need to pay cash. Insurance usually won’t cover more than one CPAP machine every five years.
If you’re interested in learning more about getting a new CPAP machine, check out our online store or call us to speak to a customer service representative (877) 775-3377 option 607. We offer face-to-face set-ups or we can ship to you.
Other posts you may find interesting:
- What is CPAP Rainout and How Can it be Prevented?
- I’m a CPAP User; How Often Do I Need a New Sleep Study?
- How to Keep Using CPAP When You Have Nasal Congestion
- Finding the Right Tubing (Hose) for Your CPAP
- How Often Should You Replace Your CPAP Supplies?
- SoClean Makes Daily Cleaning of Your CPAP Equipment So Easy
Comments
James Smith
Posted on April 25, 2018I need to rent one
Seeid
Posted on May 17, 2023want to purchase
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Posted on February 21, 2024So if someone refers to themselves as an agonist are they really trying to say that, if needed , they are flexible or able to change into something which they are not in order to satisfy someone’s needs , wants etc
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Posted on December 11, 2018want to purchase
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Posted on January 28, 2024Good Article
Noreen LaVallo
Posted on January 02, 2019My doctor ordered a new Auto pap machine. I was told my payments for “rental” were $100 a month for 13 months, totally $1300. Medicare was billed $950 and paid $357.66 with a “write off” allowance of 493.80…..SOOOOO WHY am I paying $1300 dollars PLUS the cost of supplies???? This does not make any sense to me…. I am on a fixed income and they don’t even offer financial aid….
L B
Posted on January 25, 2019I am new at this myself but I did find a web site under hel i can’t afford my cpcp device. It has several organizations that help people get devices. look into it.
Melissa Arroyo
Posted on January 07, 2021Hi do you have the information for the organizations that help. If you do can you send it to me please
Kara
Posted on April 10, 2019I discovered yesterday that my CPAP provider has been billing my insurance $2700 PER MONTH for rental, leaving me on the hook for over $2000 in fees out-of-pocket–as of now. Their bills continue to be sent each month. I am in shock.
Deborah Reilly
Posted on May 05, 2019I would like to rent a CPAP machine The doctor has recommended the requirements which I will send to you.
BW
Posted on September 06, 2019I found out that Aerocare, my supplies provider sends me supplies every 3 months, whether or not I need them because the “Dr. Sleep” filled out the prescription that way. My “old” tubes and masks are still fine and I don’t feel I need supplies until they are worn. I called Dr. Sleep and he wrote a different prescription that is on an “as-needed” basis. Now I am going to find out if I own my CPAP or not after renting it for 12 months now.
C. Quica
Posted on January 17, 2020BW, the mask and tubes may seem fine but the mask can wear and not seal as well over time, making it less effective. Same for tubing – it can develop small cracks/leaks, and there is also a risk of virus/fungus/bacteria finding place grow, which puts you at risk for illness. It probably seems wasteful but better to replace it as scheduled.
Nancy Quintano
Posted on May 01, 2020Why I have to start all over after 9 months of rental just because I change insurance?
Nancy Quintano
Posted on May 01, 2020Why I have to start all over with 10 months rental , after 9 months of rental just because I change insurance?
Brad
Posted on August 25, 2020I just got a quote that it’s going to cost me about $350 per month with an initial payment of $443! Why not just buy the damn thing?
Barun Kumar
Posted on June 11, 2021I want to hire a CPAP machine
Joanne Alfuso
Posted on January 15, 2023I have a CPAP machine that I wasn’t able to use most of the time I had it because of illnesses trouble with the mask trouble with the tubing trouble with the machine itself I need the direction on how to use it and I didn’t have a way of going to the manufacturer to get that direction I have no car I have no way of getting to Hudson which is way out of my area I need the CPAP machine because I’m suffering with very severe sleep apnea and it’s affecting my heart and my blood pressure and is detrimental to my health I need to get this straightened out and I have a hard time going through all the bureaucracies of Medicare and the manufacturer and everything else can somebody help me because this is going to kill me if I don’t get the CPAP machine I have one I haven’t returned it to the manufacturer because it was supposed to be he’s supposed to use it within a certain time frame and I wasn’t able to do so so that bureaucracy has set me up for all kinds of problems
High Rated Gabru
Posted on July 25, 2021Awesome blog post. Keep writing.
Jean
Posted on August 07, 2021I cannot afford to pay X amount of 20 %of Medicare will pay.
I will not pay $1000.00 a month for a gadget that may not work.
Jean L Sprague
Posted on February 22, 2022I have used a bipap x 20 years. It just quit last night. I have a copy of my sleep study from 06. My app to get my scrip isn’t until April. I need a rental until April. Please help me!!
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Posted on May 17, 2023My doctor ordered a new Auto pap machine. I was told my payments for “rental” were $100 a month for 13 months, totally $1300. Medicare was billed $950 and paid $357.66 with a “write off” allowance of 493.80…..SOOOOO WHY am I paying $1300 dollars PLUS the cost of supplies???? This does not make any sense to me…. I am on a fixed income and they don’t even offer financial aid….
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