5 years later - rules changed? Gov't subsidies.

Hi, Its been 5 years since i have been using my CPAP machine.

Have the rules changed with regards to gov't replacement of CPAP machine? In Ontario, they used to cover a certain percentage of the machine, up to $700. I have been informed that you can't just get a new machine after 5 years. If the machine is still in good working order they will not replace it. Is this true? is there any way I can get a new machine?

I have booked a follow up sleep study and been told this is the case.

Thanks

There is no limit. The subsidy is just 75 percent, and the prices are regulated. Registered suppliers cannot charge you more. If it has only been five years, you will not be getting a new machine if the old one still works. This has always been the rule. I have heard of people replacing a functional machine after 10 year. The quieter machines became available more than 5 years ago, so a new machine won't make a lot of difference.

If you need a different type of machine, you can get one, but they require confirmed titration results showing the need. If your AHI is low with your current configuration, I wouldn't even bother with the study.

I would want a new machine if I had an Escape which provides no efficacy data. He doesn't state which model he has.

I have the Resmed S9 Elite CPAP. I wanted to get the new Resmed Air Sense A10. I was hoping that i could replace the machine every 5 years and the gov't would cover 75% for the new machine. If this is not the case, really wondering now if I need the sleep study...

If your therapy is working well currently and you feel well, there would be little reason for a new study.
If you want a new A10, you can get one any time you like. Just write a check.

I don't know anything about the rules in Ontario that I didn't read here.

My initial thought is after 5 years a sleep study may be beneficial but If you have to pay 25% for it that would be a good chunk to apply to the Autoset. Just make sure any machine you get is full data capable. Grayghost4 has lightly used and sometines o hours machines I would PM him. Buying that way you do not have a warranty but I got a very good deal from Grayghost4. You can also look at prices with http://www.secondwindcpap.com/.
i'm not sure about the cost to ship to Canada but if you call them, they will let you know.

As I said, if you are doing well with your regular CPAP, and you weren't prescribed Autoset 5 years ago, you won't get one paid for now. The requirement is that you need at least 10 cmH20 as a minimum pressure, and that your pressure needs vary by at least 4cmH2O from either REM to NREM sleep or from sleeping on your side to sleeping on your back. The ADP program requires that this be documented in a titration study.

Also, if your machine breaks, I don't think you even need to have another study to get it replaced. Most DME's , from what I have heard, will report a severely outdated CPAP as broken. However, as the S9 Elite is still in production, and still being offered as an option to new patients, that is not going to happen here.

The only thing the A10 Elite gives you over the S9 Elite (aside from Cheyne Stokes detection which is related to a very specific diagnosis) is autoramp. I think autoramp is awesome, but after five years of not having it, you are unlikely to use it anyway.

bono1 wrote:Hi, Its been 5 years since i have been using my CPAP machine.

Have the rules changed with regards to gov't replacement of CPAP machine? In Ontario, they used to cover a certain percentage of the machine, up to $700. I have been informed that you can't just get a new machine after 5 years. If the machine is still in good working order they will not replace it. Is this true? is there any way I can get a new machine?

I have booked a follow up sleep study and been told this is the case.

Thanks

Google Ontario Assistive Devices Program to get the latest government policies about cpap machines. Reading them will tell you everything you need to know, and a lot more than most DME's will tell you.

Things have changed in the ADP program, but not much. One catch that I can think of is that your old machine might have to be broken and unrepairable before you will qualify for the ADP subsidy. I'm not sure how strict they are with that rule.

BTW, who told you that a new sleep study is needed to replace your machine? I'm about to replace my 8 year old M Series and was told by the clinic that did my original sleep study that a new study is not required - I just have to meet with my sleep doctor and get him to submit the papers for it. [Note that I'm only reporting on what I was told and haven't actually gone through with it yet. I would like to hear some first hand experience!].