Why do I Need a Prescription to Get CPAP and Supplies?

Why do I need a prescription for CPAP?

The Food and Drug Administration (FDA) in the US classifies CPAP devices as Class II medical devices with possible risks. Therefore, their sale requires a medical prescription.

While the process for obtaining a prescription (not to mention insurance approval) for CPAP and supplies can be burdensome, working with a healthcare provider to start and maintain CPAP therapy is crucial. Diagnosing and treating sleep apnea can be challenging. To be successful with CPAP therapy, you will need to expertise and support of clinicians.
 

It’s possible to buy the items without a prescription, but buyer beware

There are two popular ways of buying a CPAP or supplies without a prescription:

1. Online selling sites like Craigslist

There are lots of concerns about buying CPAP and supplies on sites like Craigslist (there’s even a JAMA study that researched outcomes of Craigslist CPAP sales). Main concerns are the condition of the device (does it even work), how many hours it’s been used, adjusting the pressure settings of a used device without a therapist/technician and, obviously, sanitary concerns. While these sales are technically illegal since a prescription is not required, they still occur quite frequently.
 

2. Online sellers who sell CPAP mask components individually, instead of fully assembled

Some online resellers will sell separate mask components without a prescription. These resellers are taking advantage of a loophole in the FDA classification of CPAP devices and equipment.
 

How can I get a prescription for CPAP?

You should talk to your doctor. If you’ve already been diagnosed with sleep apnea, your doctor may prescribe CPAP therapy.

If you have not yet been diagnosed, but suspect you have a sleep disorder like sleep apnea, talk to your doctor about assessing your symptoms and possibly having a sleep study.

If you don’t have a doctor, there are several different types of physicians you can speak to about sleep issues, including a primary care physician, pulmonologist, endocrinologist or a sleep specialist.
 

What information is required on a prescription for CPAP?

Medicare requires the following information on a prescription. Many insurance companies follow Medicare guidelines.

  1. Beneficiary/patient’s name
  2. Treating physician’s name
  3. Date of order
  4. Detailed description of items (type of device and supplies, pressure setting for machine)
  5. Physician signature and signature date
  6. Physician’s NPI
  7. Length of need
  8. Diagnosis

How often do I need a new prescription for CPAP or supplies?

You will only need a prescription for CPAP if you want to get a new device. Typically, insurance will cover a new CPAP machine every 5 years or so.

It is recommended that you replace some of the CPAP equipment on a regular basis, such as filters, cushions, tubing and your mask. Your equipment provider may ship these items to you on a regular basis, like every 90 days. Your insurance company may require a new prescription for ongoing replacement supplies every year.
 

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.

Shop for CPAPs and supplies
 

Sources:
https://www.fda.gov/RegulatoryInformation/Guidances/ucm072728.htm

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Comments

  1. Leonard Webster Reply

    Greetings:

    I just discovered that one can purchase a CPAP machine from Amazon without a prescription? How should I go about reporting this matter?

    • John Ryder Reply

      Why would you do that? It’s hard enough for people to survive in this credential-inflation mess of red tape. Do you like having bureaucrats tell you what you can have or not have?

    • joe d pearson Reply

      you must have been a little tattle tail

    • Tom Reply

      What an asshole. My machine is 8 years old and my puppy just ate my mask. I can’t get an appointment to get a new prescription, and no one local will sell the mask without it.
      If you have and can keep friends do they think your a jerk?

      • Dan Koziolek Reply

        One time when my employer changed health insurance the new company wouldn’t cover the sleep doctor I was seeing. Even though my prescription said 99 months and I thought that would mean it was still good, I eventually found and saw a new sleep doctor. A couple of nights later my mask broke. I took my broken mask to the DME that had my old prescription and my new prescription. They told me they couldn’t help me because my old prescription was too old and my new prescription hadn’t yet been entered into their system. So I just sat down in their waiting room. Eventually someone came over to ask why I was still there. I told them I wasn’t leaving without a mask I could use that night. The person walked away. As closing time came closer another person came and told me I needed to leave. I said I wasn’t leaving without a working mask. I was afraid they would call the police, but they actually brought me a new mask.

  2. Jane Reply

    Leonard Webster,

    Maybe you shouldn’t. Maybe you should mind your own business. Why? Take my situation, for example:

    My husband just lost his third job (in a row) before the 90 day mark in early December. I lost my 3+ year job on Christmas eve. He keeps losing jobs because he literally falls asleep at work and can barely concentrate. He snores like a monster truck all night and stops breathing sometimes up to 30 times an hour for at least 15 seconds (yes, I’ve watched and timed). He’s irritable and anxious and depressed and wakes up feeling worse than when he went to bed. We cannot afford insurance and sleep studies. I do, however, have Amazon credit, an internet connection, and a keen, critical, and analytical mind. I just bought him a new Auto CPAP on Amazon with credit, after a month of reading up on asleep apnea, because our family needs him to get good enough sleep such that he can function again and keep a job.

    Your reporting-happy self should consider that not everyone who really needs relief from OSA (which he very likely has, if not also CSA) is fortunate enough to be in a position to be able to see a doctor. In our present, imperfect system, some really do need to be able to get around the medical monopoly to get treatment as we cannot go through it. Our children need to eat and my husband needs to sleep. Sorry if this offends you.

  3. Albert Reply

    Leonard you RAT! Mind your own business!

  4. Dearest Love Reply

    Thanks Leonard. Now I can go get one from Amazon that my insurance failed to approve…although I’ve been using CPAP ongoing for years. This new insurance company through my job is not working for me.

  5. Donna Reply

    I wonder how much one can save by paying privately vs using insurance where I have a 20% copay? I know DME providers charge insurance a huge amount.

  6. Tracy Trogdon Reply

    I have a lightly used ResMed AirStart 10 APAP CPAP with warmer humidifier for your consideration. It has been used approximately 80 hours over a period of two months. It is in “like new” condition complete with carrying case and hoses.

    • Kiesha Reply

      Hello Tracy! Is that machine still available? I’m totally interested if so!

    • Dennie Reply

      How much are you asking?

  7. Live Free or Die Reply

    Leonard,
    Your comment is so frustrating. How can you be such an authoritarian? CPAP’s shoud be 100% free of bondage, not prescription only. This causes extreme price gouging and leaves many of us suffering. We are adults and can make our own decisions concering our sleep of all things. If you want someone to hold your hand, fine, but don’t mess with my rights to make my own choice. Liberty is making a comeback in this country and on this planet. It shows in this very thread. Thank you, my fellow independent humans, don’t let the Leonards and their nanny state win.

  8. High Rated Gabru Reply

    AWESOME INFO!!! Thanks a ton.

  9. Barry Reply

    Just a tip for everyone: bnccreations.com has a wall mounted shelf that holds your cpap machine and has a decorative hook to hang your mask when not in use. This shelf gives your nightstand back to you. My wife loves it! Go to their website and click on creations then click on cpap “charlie” shelf. They are also available on amazon.

  10. Psi Reply

    I don’t understand why can’t we buy it without prescription. What are they afraid us doing with it? Inflating ourselves into a balloon?
    The medical system in the US is so frustratingly broken.

    • Jim Reply

      Maybe because they have to be programmed to your prescription. It’s not like buying a microwave and you can start using it no problem. If you don’t program the CPAP machine to the specifics of the user, you’re not helping them and can actually make it worse.

  11. Tirzah Reply

    Leonard, I’m sorry people have been unkind in their responses to you. I suspect I’ll get some of the same from my defending you. I understand that it’s hard to get a CPAP so that can make people upset, I feel for you all. When I got my own and then found out my insurance doesn’t even cover it, it was super frustrating. But I can understand why there are laws in place and safeguards. The FDA has decided to make it prescription because the pressure from the CPAP if not adjusted correctly can be a safety issue. Imagine going deaf because you didn’t have the CPAP calibrated correctly, no thanks!

  12. Ross Santana Reply

    I have done the sleep study and they said I need it. I have the machine and I been using it for the last 8 years. I just want to buy my equipment locally. Equipment like the hose , mask, headgear and filters. The company I got the machine and equipment from is expensive and I can get it cheaper from supply stores locally but they have the prescription on their file.

  13. John Fields Reply

    2. Online sellers who sell CPAP mask components individually, instead of fully assembled
    Some online resellers will sell separate mask components without a prescription. These resellers are taking advantage of a loophole in the FDA classification of CPAP devices and equipment.

  14. Jason Reply

    The implication that a patient cannot be told how to set pressure settings on a simple device is insulting as well as indicative of how the US has the BEST GOVERNMENT MONEY CAN BUY.

    The medical industry has written its own laws for a long time now, and this is a prime example of how they carve out markets for themselves and keep costs high.

    Shame.

  15. Christchurch Reply

    Some internet retailers provide non-prescription sales of individual mask parts.

  16. Dan Koziolek Reply

    I am so tired of articles claiming that it’s crucial to work with a healthcare provider but nothing about how crucial it is for healthcare providers to work with their patients, especially with CPAP where compliance is low. When I was first prescribed CPAP 10 years ago I was allowed no input into the machine and mask I was given. When I woke up after the first morning the machine said I had spent 60% of the night in periodic breathing. After googling the term, I called the sleep doctor in a panic. He told me I wasn’t diagnosed with that and not to worry. I saw a different sleep doctor who told me the same thing. Six weeks later I was hospitalized with congestive heart failure. I spent that Christmas in the hospital, which likely could have been avoided had one of the sleep doctors referred me to a cardiologist. How could they not know? How can my working with doctors like this be so crucial?

  17. uno online Reply

    I think that prescription is very important.

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