How to Buy a CPAP Machine: From Prescriptions to Replacement Parts (2024)

Sleep apnea, particularly obstructive sleep apnea (OSA), is a common but serious sleep condition in which breathing repeatedly stops and starts during sleep.

If it goes untreated, OSA can lead to daytime fatigue, lack of concentration, mood changes, increased risk of accidents — even high blood pressure and heart problems. So it's important to seek a diagnosis if you suspect you or someone you love suffers from symptoms.

Fortunately, continuous positive airway pressure machines, known as CPAP machines, offer an effective solution for many people. They deliver steady air pressure to keep the airways open, leading to restful sleep. Choosing the right CPAP machine is an important step toward better overall health and well-being for those diagnosed with OSA.

We’ve put together this guide to take the guesswork out of purchasing the best CPAP machine and equipment for you. Whether you're overwhelmed by the options or unsure where to even start, we'll walk you through the process — from understanding the types of machines and masks available to navigating costs and insurance coverage.

First Off: You'll Need a Prescription for Obstructive Sleep Apnea

If you have obstructive sleep apnea, you'll need a diagnosis and a prescription before you get access to a CPAP machine (or other therapeutic devices that can help, such as custom-made oral appliances, medications, or even surgical procedures).

Do You Have Obstructive Sleep Apnea?

These common signs and symptoms may indicate you have obstructive sleep apnea:

• Loud snoring (typically noticed by a bed partner)
• Pauses in breathing during sleep (sometimes accompanied by gasping or choking)
• Excessive daytime sleepiness (even after a full night of sleep)
• Memory problems or difficulty concentrating
• Morning headaches
• Changes to mood or libido
• Dry mouth or sore throat on waking up

In children, OSA might also show up as bedwetting or night sweating, poor school performance or learning challenges, behavioral issues like hyperactivity, or unusual sleeping positions.

If you experience any of these symptoms or observe them in someone you love, consult a doctor or sleep specialist to get checked out for possible apnea.

In addition to a physical exam and health history, you will likely need to undergo a sleep study, either at home or in the lab.

• To do an at-home sleep study, you'll receive a portable monitoring device and follow directions to attach the sensors that will collect data while you sleep (usually a chest strap to monitor breathing, a finger clip to measure oxygen, and a nasal cannula to track airflow). You'll sleep in your own bed with the device and then return it for your doctor to analyze. This type of study is more convenient and comfortable.
• For an in-lab sleep study, you'll go to a sleep center or hospital and get connected to the sensors. You'll sleep in a private room while the sensors collect data, which will then go to the doctor to be analyzed. This type of study provides more comprehensive data.

If you receive a diagnosis of OSA and a prescription, follow your doctor or specialist's recommendations when it comes to shopping for a machine. Based on your needs, they may recommend different types of PAP machines, pressure settings, or models.

Next: Check With Your Insurance

Most insurance plans, including Medicare and private insurance, typically cover CPAP machines and equipment, with a diagnosis of OSA confirmed through a sleep study. (Your plan should cover the sleep study, too.)

Many plans initially cover CPAP machines as a rental, along with supplies like masks, hoses, and filters. And many insurers will want to see proof you are using your machine regularly to keep covering it.

If you're shopping with insurance, you'll need to source your machine from a durable medical equipment (DME) supplier approved by your plan. Depending on the specifics of your plan's deductible and copay, you may have upfront and out-of-pocket costs before insurance kicks in. Always verify coverage in advance to avoid any expensive surprises.

HSAs and similar funds can also typically be used for CPAP costs, accessories, and repair costs as long as the machine is medically necessary and prescribed.

Can I Buy a CPAP Machine Without Insurance?

As long as you have a prescription for your CPAP device, you can purchase a CPAP machine without using insurance. As with many insurance-related tasks, the process of approvals can feel onerous. Instead, you might choose to purchase your CPAP machine out of pocket to avoid the restrictions and delays that may come with purchasing through insurance. And if you're willing to pay out of pocket, you might find better deals online and more options.

Here’s a quick comparison of the pros and cons of buying CPAP devices with and without insurance:

Will Medicare Cover the Cost of a CPAP Machine?

Note that Medicare covers CPAP machines and related supplies under some conditions. You must have a diagnosis of OSA through a Medicare-approved sleep study, as well as a doctor's prescription for the device. Medicare then covers CPAP therapy for a 12-week trial period, during which you must use the machine regularly to keep your coverage. (That is, at least four hours per night on 70 percent of nights over 30 days in a row).

You'll also need a follow-up appointment with your doctor to confirm it's working and keep coverage going. And you have to get the machine and all supplies from a Medicare-enrolled supplier. Medicare Part B typically covers 80 percent of the cost after you meet your deductible; you're responsible for the remaining 20 percent.

Find a Store: Where Can You Buy a CPAP Machine?

You can typically shop for a CPAP machine either from an online retailer or in person at a local medical supply store. Some CPAP retailers partner with medical professionals to streamline the process from diagnosis to treatment.

Here's a quick breakdown of the benefits of shopping for a CPAP machine online vs. in-store:

How to Shop: What Do You Need From Your CPAP Machine?

Your doctor will recommend a device that aligns with your diagnosis and prescription. First and foremost, follow your doctor or specialist's recommendations to make sure you buy a model that has the right settings to work for your prescribed treatment.

There are many choices available among CPAP machines, with three primary device types:

• CPAP (Continuous positive airway pressure): delivers fixed, constant pressure
• APAP (Auto-adjusting): auto adjusts pressure based on your needs
• BiPAP (Bilevel pressure): Provides two pressure levels, one for inhaling and one for exhaling (typically used for more complex cases)

Your doctor will recommend the type of device you need based on the results of your sleep study. Once you know what type of machine you need, you'll look for one that fits your specific needs and preferences. Ideally, you'll select a machine with many of these key features:

• Acceptably quiet, especially if you or your bedmate are light sleepers
• Portable and lightweight, especially if you travel often
• Easy to use
• Durable and reliable
• Comes with a good warranty
• Has a built-in humidifier
• Covered by your insurance or suits your out-of-pocket budget
• Has favorable ratings or reviews
• Has no open recalls

Many machines also come with smart features that track your sleep data so you and your doctor can monitor your progress.

Last Step: Don't Forget to Buy CPAP Parts

The CPAP device itself is only part of the necessary equipment, and you'll need a few extra items for their CPAP therapy to work: the mask, hose, and filters.

Most insurance plans will cover CPAP masks and hoses, but they may have specific guidelines regarding how frequently you can replace them. (Typically, new masks and hoses are covered every three to six months, but this can vary by plan and provider.) Filters are typically covered, too (usually every one to three months).

These additional parts must all be compatible with one another — and with the machine itself. Many modern CPAP machines offer customizable settings, like ramping (gradually increasing air pressure as you fall asleep) or automatic pressure adjustments (APAP). So it's important to select accessories that will work with these features. As well, some require specific masks or hoses that are designed to handle the increased pressure settings or heated air. (Check with your provider or the manual to make sure everything is compatible.)

CPAP Mask: Finding the Right Fit

The mask is the part of the CPAP system that sits right on your face, and choosing the right CPAP mask is key to a successful and comfortable therapy experience. CPAP masks come in three main styles:

• Nasal masks: This type of mask covers your nose and is a popular option for those who can breathe through their nose comfortably.
• Nasal pillow masks: These masks are smaller and cover only the nostrils. They work well for people who feel claustrophobic with larger masks.
• Full-face masks: These cover both the nose and mouth, which can be helpful for people who breathe through their mouth during sleep or have nasal congestion.

CPAP Hoses: Connecting the Mask and the Machine

The hose connects your CPAP machine to your mask, delivering the pressurized air that helps keep the airway open. The most common hose materials are flexible and durable, but like all parts of the CPAP system, hoses can wear out over time. A damaged hose can affect the efficiency of the air delivery, so it's important to regularly check it for cracks or leaks.

Hoses generally come in standard sizes (usually six feet long). Some newer models of CPAP machines offer heated hoses that help maintain a consistent air temperature and prevent moisture buildup. If you live in a cold or humid environment, a heated hose might be right for you.

CPAP Filters: Keeping Air Clean

Filters are essential for making sure the air you breathe through your CPAP machine is clean and free of dust, allergens, and other irritants. Most CPAP machines come with a filter that needs to be replaced periodically, and most retailers sell packs of filters so you can stay stocked up. There are two main types of filters:

• Disposable filters: typically made of fine mesh and need to be replaced every one to three months, depending on your usage and environment.
• Reusable filters: typically made from foam and can be washed, but they still need to be replaced periodically, generally every six to 12 months.

Nice-to-Have CPAP Machine Parts and Upgrades

While the mask, hose, and filters are all essential components of a CPAP machine — and are critical for effective therapy — there are some additional accessories and upgrades that can enhance the overall experience. These additional nice-to-have features include:

• Heated hoses: Helps maintain a consistent temperature for the air as it travels from the machine to the mask, preventing moisture from accumulating and causing discomfort. By keeping the air warm, the hose also minimizes dryness in the throat and nasal passages.

  (These may not be covered by insurance or may only be covered with a required medical reason.)

• Humidifiers: Many CPAP machines come with the option to add a humidifier, which adds moisture to the air that's delivered through the mask. This is helpful for people who experience dry mouth, dry nasal passages, or throat.

  (These may be covered by insurance; some plans include the humidifier as part of the CPAP machine package, while others may require additional documentation or pre-authorization.)

• Mask liners: These are soft, disposable cushions that fit between the CPAP mask and your face. They help improve the mask's seal and reduce irritation and pressure.

  (Mask liners are typically not covered by insurance, as they are considered a comfort accessory — but they are relatively inexpensive.)

• Portable CPAP batteries: These are a must-have accessory for people who travel often or experience power outages. These batteries allow you to use your CPAP machine without relying on a wall outlet.

  (Portable CPAP batteries are generally not covered by insurance unless you can demonstrate a medical necessity.)

Maintaining and Replacing CPAP Parts

To keep your CPAP therapy working well, it's essential to maintain and regularly replace all components of your setup. Over time, parts can wear out, become dirty, or lose their effectiveness, which can impact the quality of your sleep and therapy. While maintenance and replacement schedules may vary by brand, here are some general rules of thumb on how often to maintain each piece:

By maintaining a regular replacement schedule for all parts, you ensure that your CPAP therapy stays comfortable and as effective as possible.