If buy your own cpap, does insurance cover hose, mask, etc?

[tmiker]

I am on Tricare with supplemental to cover the difference.

[Pugsy]

It should cover the same things it would cover if you had a DME supply the machine.
Since the mask has a RX requirement the insurance company may need similar verification of the need though. I don't know what might be needed though. I don't know if a simple diagnosis code for OSA is sufficient or if they need a copy of the sleep study or whatever is used when someone gets a machine using their insurance.

I bought my machine privately but I do have a DME that I use my insurance and get masks and supplies from so that the insurance gets to pay their portion. I don't know what may have been needed the first time to establish the diagnosis.

If you used a DME and bought your machine and then 6 months later moved across the company and you found a new local DME for masks and supplies they would pay. So it really shouldn't matter where you get the machine. Heck, you could tell the DME that a family member gave the machine to you.

[ems]

I don't know why they wouldn't. But I think the smartest thing you can do is to call your insurance company. When you have insurance related questions, it's always best to speak with the insurance company directly.

[edm_msu]

The best thing is to call your insurance and ask. Make sure your insurance will pay the supplier that you use. My insurance will only pay for approved suppliers. That means that they will not pay for any internet sales, including cpap.com.

[Julie]

My insurance did pay for equipment, though not as often as apparently US companies do for masks and cushions, etc... but machines every 5 yrs (same as yours). The company was a U.S. one but with Canadian modifications.

[greatunclebill]

i use tricare prime. the in network dme you pick is going to have to get a copy of your sleep study for their files and will require a prescription from the doc for every item you want, every time you want it. most good dme's do this behind the scenes. you go in and ask for the mask and they ask the doc for a fax prescription. the first time, they will ask the doc for the sleep study.

[TalonNYC]

I can only speak to my own experience. I went to the Sleep Doc, got an Rx, and my DME (Apria) got me my first machine and supplies.

About a half-year in, I bought my own machine to get some extra features.

Apria continued to supply supplies, and my insurer continued to pay for them.

So, while you need to call your insurance company to be certain, I can say that my own DME/insurance plan didn't seem to care.

[chunkyfrog]

I was told that in network supplies are covered, regardless of where you get the machine;
even on Medicare; but additional documentation may be needed from your doctor.