Do you know that 22 million Americans suffer from moderate to severe sleep apnea? Sleep Apnea is a condition where you stop breathing for short periods during the night. Most people who have sleep apnea are not aware of it until they go to their doctor for another reason, like an irregular heartbeat or snoring that has disrupted their partner's sleep.
Sleep apnea can be dangerous because lack of oxygen at night can cause serious health problems over time such as heart disease and high blood pressure. The good news is that there are tools that are affordable and effective in helping people get more restful sleep.
One of these tools is the CPAP machine. CPAP machines provide air pressure through a mask worn on your face while you're sleeping so that you breathe properly all night long. The masks come in different sizes and shapes to fit every type of nose comfortably.
But how much do these machines cost? What is the cost of a CPAP machine? Is it affordable? We’ll give you answers to these common questions. So read on to find out more!
Cost Breakdown: How Much Does a CPAP Machine Cost?
If you need a CPAP machine, you are probably wondering how much money you need to shell out to get one. Is it expensive? What are the other costs involved when buying a CPAP machine?
The cost of a CPAP machine can range from $300 to $1,000. However, you may find premium models that cost higher than this. Typically, you can find a good quality CPAP machine at an average price of $500 to $800.
It's also important to note that aside from the cost of the CPAP machine, you also have to pay for other accessories and supplies such as CPAP masks, CPAP hose, and CPAP filters.
If your machine does not come with a humidifier, you have to buy this as well. You also need to purchase cleaning supplies to maintain your machine. Cleaning supplies include mask wipes, mask and hose soap, tube brushes, and disinfectants.
To give you an idea of how much money you may need, here is a cost breakdown of CPAP machines and accessories. Note that the prices below are just average prices and depending on the brand you choose, these costs can be higher or lower.
- CPAP Machine – $300 – $800
- CPAP Mask – $50 – $200
- CPAP Hose – $10 – $20
- CPAP Humidifier – $150 – $200
- CPAP Filters – $10 – $20
- CPAP Cleaning Supplies – $50 – $70
This means, you need to pay a total of $500 to $1,000 for everything – not including the sleep test and doctor’s fees.
Costs of sleep tests:
- At-home sleep tests – $200 – $500
- Sleep tests in labs – $500 – $3,000
What to look out for when buying a CPAP machine?
There are many different brands of CPAP machines. Some of the more popular brands of CPAP machines include ResMed, Philips Respironics, Human Design Medical (HDM), Fisher & Paykel, and Somnetics.
Depending on the brand there are different features integrated with CPAP machines available in the market today. So how do you choose the best CPAP machine for sleep apnea? It is recommended to consult your doctor and at the same time read user reviews on which of the latest machines are good options.
To make your search easier, we listed down some factors that you can look for when choosing a CPAP machine:
- Built-in humidifier – Having a machine with a built-in humidifier makes it more convenient so you don't need to purchase that separately.
- Ramp up feature – The CPAP machine can start off at a lower pressure and can ramp up to the recommended pressure while you sleep. This can make it easier for you to adjust to the machine.
- Low noise level – Since you will have to sleep while the machine is on, it helps if your CPAP machine emits minimal noise to let you sleep well. You can check this online or based on CPAP machine reviews.
- Portability – A CPAP machine home unit will be bigger than a travel unit, but it's still convenient if your home unit is not too bulky.
- Ease of use – Look for a CPAP machine that is easy to operate. You can read reviews and watch videos online to check this out.
- Smart features – There are CPAP machines with additional features such as Bluetooth connectivity, Wi-Fi, software for data tracking, pressure relief, and collection of other sleep information. Having these features can be very helpful as they can help you monitor your sleep quality.
Does Insurance Cover CPAP?
Yes, insurance covers CPAP machines. Most insurance plans cover devices for sleep apnea and accessories. Most insurance will also cover the cost of doctor consultations, prescriptions, as well as sleep studies that can typically cost around $1,000 to $2,000 per night.
How much does insurance cover? It's important to note that how much your insurance will cover depends on your insurance plans. For example, some insurance providers will only cover your CPAP machine if you've already met your annual deductible. While some insurance companies follow the rent-to-own guidelines set by Medicare when it comes to CPAP equipment.
Your insurance provider will usually consider your AHI or apnea-hypopnea index to determine whether you are eligible for CPAP coverage.
- Mild Sleep Apnea – AHI between 5 to 14
- Moderate Sleep Apnea – AHI between 15 to 30
- Severe Sleep Apnea – AHI of 30 and above
Usually, most insurance providers will cover moderate and severe sleep apnea. If your sleep apnea is only mild, it may still be covered if you have a comorbidity like hypertension, heart disease, insomnia, etc.
Does Medicare cover the cost of CPAP machines?
Yes, Medicare will cover 80% of the cost of the CPAP machine and supplies including face masks, tubing, and filters.
You will have to pay 20% of the approved amount plus a $203 deductible fee (2021) or $233 (2022). This is the Medicare Part B deductible which applies because the CPAP machine and its supplies are covered as durable medical equipment.
Before Medicare will cover the cost of the CPAP machine, you will have to meet the following requirements:
- You must have a doctor's prescription for a CPAP machine.
- You must undergo a sleep test in a lab setting or using an approved at-home test. Medicare will cover this cost as long as it is recommended by a Medicare-approved doctor.
- You must have a diagnosis of obstructive sleep apnea.
- Your AHI is 15 or higher (moderate sleep apnea), or if your AHI is between 5 and 14, you have a related comorbid condition such as heart disease, history of stroke, hypertension, insomnia, etc.
- The CPAP machine must be rented or bought from a Medicare-approved supplier. You cannot choose from outside the brands Medicare recommends.
If you meet the above requirements, Medicare will cover the first 3 months. Additionally, you must be using CPAP for at least 4 hours each night for at least 70% of the period. If your condition improves using the CPAP machine, coverage will continue.
If Medicare agrees to pay for CPAP long-term therapy, you will be placed in a rent-to-own payment plan where you pay the 20% coinsurance plus the deductible fee. As long as you are using the machine with no interruption, Medicare will continue to cover 80% of the costs. After 13 months, you will own the CPAP machine.
Cost of other machines that help with sleep apnea
APAP or Auto-adjusting CPAP machine – This machine has a sensor to alert it when an apnea is taking place. It can automatically adjust the pressure settings on a breath-to-breath basis. APAP machines typically start at $500.
BiPAP machines – A Bi-level Positive Airway Pressure machine delivers an inhale pressure and exhale pressure, unlike CPAP that only delivers a single pressure. If your condition does not improve using a CPAP machine, your doctor may recommend this device. This is a more sophisticated machine that's why it is also typically more expensive with prices starting at $1,000.
How to get a CPAP machine more affordably if you don't have insurance?
If you do not have insurance, there are options that you can explore to get the device without paying full price. You have to take note, however, that you still need a doctor's prescription before you can purchase a device. You cannot purchase a CPAP machine without a prescription.
You also have to be careful about buying used machines online from unverified companies or sources. If you are not sure of the source, the machine may not function well or could be unsanitary.
Below is a list of organizations that provide affordable CPAP machines to those who cannot afford one:
- Second Wind CPAP – CPAP machines start at $95
- The Reggie White Foundation – new or donated CPAP machines at $25
- Breathe California – Donation amount from $55 to $105 depending on the machine
- American Sleep Apnea Association – $100 program fee is required
Other (possibly cheaper) ways to treat sleep apnea
If you have mild sleep apnea or if a CPAP machine is not working for you, you can also try other methods to manage your condition. Some experts suggest these alternative methods if CPAP is not an option for you, if you have tried CPAP but were unable to use it during the night, or if CPAP does not help control your symptoms.
The following are other ways that can help manage sleep apnea without CPAP:
- Oral Appliance Therapy – This therapy involves wearing an oral appliance (mouthpiece) during sleep that repositions the teeth, jaw, and tongue to open the airways. A mouthpiece can cost between $20 to $200.
- Nasal patches – This is a device that can help keep your nostrils open while sleeping. You will need a prescription for this device and some insurance providers do cover the cost. This can cost around $60 to $80 a month.
- Sleep apnea pillow – This is a pillow to help you sleep on your side if your condition is caused by your sleeping position. You can buy these pillows online that can cost you $40 to $200 depending on the brand.
- Lifestyle changes – Making healthy lifestyle changes can help relieve our sleep apnea. Changes such as losing weight, avoiding alcohol and cigarettes, and regular exercise are recommended. The best part? These cost you zero dollars and could even save you money!
Getting the best CPAP machine for you
CPAP machines can be expensive, but there are ways to get CPAP more affordably. You can check with your insurance provider so they can help cover the cost of the machine.
Before choosing a CPAP machine, make sure to consult your doctor and read user reviews to find the best fit for you. If you cannot afford the cost, you can also check out organizations that provide affordable machines to low-income individuals.