CPAP Machine Cost: Are Prices Lower Without Insurance?

As most know, getting a great night’s sleep is one of the most important things in the world. It’s the difference between having a great day and needing to drink way too much coffee to simply get through it. For millions of people with sleep apnea across the United States, this much-needed great night of sleep can be difficult to get. However, there’s a solution: CPAP therapy! CPAPs help keep your airways open while you’re sleeping and ensure you get the rest you deserve.

But, whether you’re new to CPAP (and haven’t had a sleep study yet) or you’re a CPAP veteran, there’s another thing holding some people back from getting the therapy they need: the cost. If your insurance is willing to cover everything, that’s great, but that’s rarely the reality. Sometimes getting a CPAP without insurance is the cheaper option.

In this article, we’ll go through the cost of CPAP equipment and discuss options to pay for it, including insurance and alternative payment options.

What Supplies Do You Need for CPAP Therapy?

Overall, there are only a few basic supplies you’ll need to get started with CPAP therapy:

1. CPAP Machine

CPAP machines generate pressurized airflow, and it controls how your therapy will be set-up and controlled. Depending on your sleep apnea diagnosis, you will either be prescribed a CPAP or BiPAP device. Through the machine’s menus, you can adjust settings such as pressure level, humidification, mask type, and more.

2. CPAP Mask:

The mask allows air pressure to be delivered to your lungs. By forming a strong seal with your face, the mask keeps a closed circuit to prevent air from escaping. There are different mask types (full-face, nasal, and nasal pillow) for you to consider when picking out the best one for your needs.

3. Tubing:

The tubing connects the mask to your machine. When choosing tubing, you can consider standard (unheated) tubing or heated tubing, which can provide additional comfort during therapy. If you’re feeling adventurous, Easy Breathe offers Colored CPAP Tubing to make your experience more personalized and enjoyable.

There are also additional supplies you can get to enhance your CPAP therapy experience, making it easier and more comfortable.

CPAP Cleaning Machine: A CPAP Cleaning device allows you to sanitize your CPAP equipment regularly and protect yourself from germs. These cleaners kill 99% of bacteria and pathogens that can be found on your supplies. We have a CPAP Cleaners Review article to help you decide which cleaner is best for your needs.
Back-Up Battery: All of our CPAP machines can be run off of a rechargeable back-up battery. Whether you’re concerned about power outages or you’re an avid camper, a back-up battery might be a good additional product for you.
Mask Liner: A mask liner goes between your mask and your face to improve the seal and reduce potential for mask irritations. These are compatible with most mask types and will provide additional comfort during therapy.

All CPAP equipment and supplies should be replaced on a semi-regular schedule to ensure you’re getting adequate CPAP therapy. To learn more about how often you should change out your CPAP machine, tubing, mask, etc., check out our article on replacing your supplies.

How Much Do CPAP Supplies Cost?

Investing in your health and well-being is very important. We want to provide you with accurate cost estimates to help you determine what’s best for you. Rest assured if these prices feel a bit high, we do have payment plan options for all of our machines, which we’ll discuss later on in this article.

1. CPAP Machines:

A quality, auto-titrating CPAP machine generally costs $800-$950 before any coupons or promotional codes are applied. The AirSense 10 CPAP, for example, comes with the machine itself, tubing, and the filter.

2. CPAP Masks:

Mask pricing depends on the type of mask you choose (full-face, nasal, or nasal pillow) and the features it has. They generally cost $80-$150, depending on the model. If you only need part of the mask and not the full system, you can oftentimes purchase individual parts.

3. CPAP Accessories:

Water chambers usually cost $30-$60 depending on your machine model
CPAP tubing usually costs $10-$40 depending on if it’s heated or unheated
Filters are generally less than $10

Are My Supplies Covered by Insurance?

Insurance can be used to cover CPAP products, but coverage amount does depend on your exact policy. Some items, however, are not billable to insurance and therefore, would have to be paid for out-of-pocket. Below we outline which products can be covered by insurance and which are not eligible.

What’s Covered?

CPAP/BiPAP Machines
Masks
Chinstraps
CPAP Filters
CPAP Tubing
Water Chambers

For eligible CPAP supplies, insurance companies usually reimburse on a set schedule. For example, CPAP and BiPAP machines can be replaced every 5 years, whereas disposable filters can be replaced far more frequently. In general, you can plan on:

CPAP/BiPAP Machine: eligible every 5 years
Headgear and Humidifier Chamber: eligible every 6 months
Mask Frame and Tube: eligible every 3 months
Mask Cushion and Machine Filter: eligible every 2 weeks

What’s Ineligible Under Insurance?

Cleaning Supplies: CPAP Cleaning Machines, CPAP Wipes, Tube Brushes, etc.
Comfort Products: Mask Liners, Mask Strap Covers, Creams, etc.
Power Supplies: CPAP Power Cords, Batteries, etc.
Travel CPAPs: Insurance won’t cover a secondary travel CPAP.

What Does My Policy Cover?

Fortunately, all of the CPAP essentials can be covered by insurance. But, you’re probably wondering what and how much your personal insurance policy covers. With Easy Breathe’s Insurance Check you can check what your insurance plan covers quickly and easily.

To request a free, no-obligation insurance check follow these steps:

Once we have received your information, we’ll do the work for you! Our goal is to make the process as easy as possible. Here’s what we do for you:

Interpreting the Results

Deductible: The amount you have to pay before your insurance will kick in to cover CPAP supplies.

Co-Payment: The percentage of the total that you’re responsible for paying (could be 0%, depending on the policy!).

Once your coverage has been determined, you will be ready to place an order. To make things better, Easy Breathe guarantees your price at checkout. We will never balance bill you if your insurance can no longer cover their portion. It’s important to do your due diligence, because sometimes it’s actually cheaper to buy a CPAP without insurance.

What Are the Drawbacks of Using Insurance?

While it’s great if you have an excellent insurance policy and they’ll cover 100% of your equipment, this is rarely the case. Sometimes getting a CPAP without insurance is the cheaper option. Some common downsides of insurance we often hear about…

High Deductibles: Many insurance plans have extremely high deductibles where your insurance company won’t kick in until you’ve spent a certain amount. Fortunately, we are often able to apply your purchases towards your deductible.
Pressure to Maintain Compliance: Some insurance companies will stop paying for your CPAP equipment if you can’t show that you’re using your CPAP adequately. They often bill for machines as rentals and may require that you submit sleep data reports on a regular basis to prove you’re using your machine.
Not Always Cheaper: Due to continuously decreasing insurance reimbursement rates, CPAP companies generally have to bill insurance at the MSRP (manufacturer’s suggested retail price), instead of the MAP (minimum advertised price). Even with insurance, some people have copayments that end up being at or above the MAP. If this is the case, it’s cheaper to purchase a CPAP without insurance.
Worse Quality Equipment: Oftentimes, the insurance company dictates what machine and supplies you get. Unfortunately, this may be keeping you from getting the highest-performing machine or equipment on the market.

Can I Get a CPAP Without Insurance?

Many people with sleep apnea either don’t want to use their insurance due to the reasons listed above or don’t have an insurance policy. Rest assured, we have some options for you!

Fortunately, we do not require insurance to order CPAP products. If you would like to make an out-of-pocket purchase just note some of our products do require a prescription. You can learn more about which items require a Rx by reading our Prescriptions Article.

FSA/HSA Spending

You can also use FSA or HSA accounts to purchase CPAP machines and equipment from us. You have more flexibility with using FSA/HSA since they don’t have the same restrictions as insurance.

Payment Plan Options ($99 Down)

If you don’t have insurance and/or you’re tight on cash, we still have options for you! You can get a CPAP machine at an affordable price through one of our payment plans.

Check out the following CPAP payment plan deals:

There are many benefits of choosing a payment plan, including…

Bundle Your Supplies: You can get the machine and other equipment (mask, CPAP cleaner, etc) bundled into a single down payment plan. For as little as $99 down, you can get started on CPAP therapy.
Control Your CPAP Therapy: Not only do our payment plans make therapy more affordable, but they’ll allow you to choose the equipment you want. You’ll be able to pick out the equipment that’s best for you that you might not have had access to through your insurance company.
No More Renting: With our CPAP payment plans, you’ll pay a fixed amount every month for a predetermined number of months. Once you pay out your plan, you’ll own your equipment and never have to make another payment for it again.

What If I Still Have Questions?

If you have any questions, want to check your insurance coverage, or want help placing an order, give us a call at (866) 564-2252 or chat in on our website. One of our customer service representatives would be happy to help!