Confused re: CPAP Prescription in Canada

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
teleute
Posts: 117
Joined: Thu Dec 05, 2013 12:32 am
Location: Calgary, AB, Canada

Confused re: CPAP Prescription in Canada

Post by teleute » Thu Dec 05, 2013 12:37 am

My husband has had two different sleep studies (from different places), and both places recommended a CPAP machine. However, they're saying they don't give prescriptions - that he's supposed to just take the sleep studies into a local place and get the equipment there. From everything I've read about needing prescriptions for CPAP machines, this seems really odd. And if they're not prescribing anything, who's to say whether he'd be best with a CPC, APAP, BiPAP, etc...? And what about pressure levels? Is the supplier supposed to say that? Because that seems like a conflict of interest, not to mention it keeping us from being able to purchase it cheaper online (which I feel is likely the game being played here). I'd assume going to his GP with the study wouldn't be the best option; they're not specialists, after all.

We're quite new to researching this, so I'd appreciate any thoughts/advice people have.

_________________
Machine: DreamStation Pro CPAP Machine
Mask: DreamWear Gel Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Pressure 10.5-14

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Confused re: CPAP Prescription in Canada

Post by Julie » Thu Dec 05, 2013 5:18 am

Uhhh - where is the Doctor in all of that? There should be a doctor referring your husband for the sleep study, then (having been told of the results by the lab) writing a prescription for Cpap, and giving it to the DME and (a copy to) yourself, etc. etc. The lab cannot write scripts for anyone, only a doctor can, and from what you say about what he's been told by the DME, something is very wrong or else you've misunderstood something badly.

User avatar
hueyville
Posts: 255
Joined: Sun Sep 01, 2013 8:37 pm
Location: Foothills of Blue Ridge Mountains
Contact:

Re: Confused re: CPAP Prescription in Canada

Post by hueyville » Thu Dec 05, 2013 6:30 am

Way it worked for me (and how I have been told is it is supposed to) is a doctor sends the patient to the lab. Without the doctors orders you are not supposed to have a study. After doctor writes a script for the study the lab sends the results back fo the doctor who writes the prescription for the appropriate equipment. Sometimes the doctor does refer with a sleep specialist and the DME in this process. Once the patient gets the perscription they take it to the DME of their choice unless their insurance company has different rules. Without the doctor in the mix neither the lab nor the equipment company does any testing or issue of equipment.
For the time will come when they will not endure sound doctrine, but according to their own desires, because they have itching ears, they will heap up for themselves teachers; and they will turn their ears away from the truth

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Confused re: CPAP Prescription in Canada

Post by Julie » Thu Dec 05, 2013 6:31 am

Hueyville - they're in Canada - whole different system.

purple
Posts: 837
Joined: Sat Feb 28, 2009 9:06 pm

Re: Confused re: CPAP Prescription in Canada

Post by purple » Thu Dec 05, 2013 7:46 am

Sorry to repeat what you already know, but, just to be complete.

The machine, hoses, filters, masks are sold by a Durable Medical Equipment company (DME). Not the Doctor or Sleep Clinic.

In the US. Usually two sleep studies. The first is an all night study to verify that the patient has sleep apnea. Then a second study to to a "Titration Study," which determines the exact settings that are needed for the machine. Sometimes this is done as a split night study in which the two parts are done in the same night.

Then someone reads the sleep study report, which is a fairly complicated thing. Usually the report is read in like, I think thirty second segments, by at least two different people, which takes, I have been told, like two hours to read the study.

Then from this a doctor will write a prescription for the exact machine, and air pressures to be used for the patient.

In some places this is now all cut down to confirm the patient has Apnea. Give him a sleep apnea machine that does what is called Auto mode, which detects that the pressure needs to be increased to stop Apneas. Let the patient do an "auto" Titration at home, which adds frustration for the patient. Here in the US, about fifty percent of the patients quit even if they had have the best help, for whatever reason they can find.

The machine, hoses, filters, masks are sold by a Durable Medical Equipment company. Not the Doctor or Sleep Clinic. Depending on your location in Canada, insurance might pay for part or all of that cost. I have heard that in the French Province, public health care will pay for Sleep Study, but not the machine.

Because manufacturers have gotten the Canadian government to allow sales of their machines to only be from Canadian suppliers, inside the country, the machines, masks cost more than in the US. (or So I have been told). To buy a machine from a reputable online company, one must have a prescription, which makes it very difficult to purchase a machine on the internet (actually based in the US) and have it shipped into Canada. The US companies will not mail/ship into Canada. There are a few companies who exist to get a a shipment, then reship it into Canada.

Perhaps someone will PM you about how this can be done. Also beware that some US shippers, like UPS have this onerous fee regarding Canadian Customs. Medical Equipment is supposed to be exempt from a crossing the border tax, or whatever it is called.

That is some explanation of types of Equipment and what a DME is from the blog. While ignoring much of the description of the US insurance industry.

http://maskarrayed.wordpress.com/what-y ... me-part-i/

CRMW
Posts: 106
Joined: Sun Mar 19, 2006 7:17 pm
Location: Calgary, Alberta

Re: Confused re: CPAP Prescription in Canada

Post by CRMW » Thu Dec 05, 2013 8:45 am

In Canada, the regulation change from Provence to Provence. In Alberta, I just found out that a prescription is not needed to purchase a cpap machine, however the Respiratory Technologists are covered by a code of conduct that ensures they only can give machines out to patients that need them.

In my case, my doctor referred me to a sleep clinic at the local hospital and the Sleep Doc wrote me a prescription that I took to a DME that supplied the equipment, that was about 6 years ago. Recently my Sister and Father were referred to the DME directly, the DME performed a home sleep study and provided the equipment after consulting with the doctor.

I have gotten prescriptions from my GP when needed to purchase equipment online or to provider to my insurance provider. My insurance covers me for a new machine every 5 years with nothing in between. As a result I usually purchase the insurance covered machine from the local DME and the masks and supplies from our host.


Chris

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Confused re: CPAP Prescription in Canada

Post by Julie » Thu Dec 05, 2013 9:03 am

We DO need a script to buy a machine... don't know who told you otherwise. However, it is also NOT true that we can't buy e.g. Resmed (or other) machines here, but it must be done directly through a Canadian dealer who's imported them, most of which will cost more, but there are places like Clinicalsleep.com or coastalsleep.com that sell almost at par. And e.g. Cpap.com (the U.S. sponsor of this forum we're on) has had my prescription (as have 1-2 U.S. DME's) for years and I buy what products they're free to sell me and in the past submitted the invoices to my local insurance once they've said I could do that.

It's not as hard as these posters have led you to believe, but you do have to follow procedures.

And btw Purple, the 'French Province' is Quebec ("Kwehbek'), not difficult to remember as there are only 10 provinces (and 3 territories), vs your 51, and I bet most Canadians can name all your states, whereas I've found so many Americans barely know we're a separate country, let alone know the name of our Prime Minister (whose been in office a long time), or know what form of government we have (parliamentary). Your schools are very sad - teach no geography to speak of and so little about other places in this world. You should get on them to do better .

nanwilson
Posts: 3464
Joined: Tue Apr 13, 2010 10:35 am
Location: Southern Alberta

Re: Confused re: CPAP Prescription in Canada

Post by nanwilson » Thu Dec 05, 2013 9:41 am

CRMW
We do need a prescription to buy our equipment in Alberta... the doctor must have just given it over to the supplier without your knowledge Mine did that and I thought the same thing until I got a bit more knowledge on the subject. I just went to the supplier and asked for a copy. You can buy on line anywhere but Resmed and PR now won't allow you to buy from the US and have it shipped here... but.. we can get what we want here in Canada. A good online retailer is clinicalsleep.com in Vancouver. I buy most of my supplies at cpap.com in the states, but if its a Resmed or PR product I just go to clinicalsleep.
Started cpap in 2010.. still at it with great results.

ReadyforRest
Posts: 136
Joined: Thu Jul 26, 2012 12:43 pm
Location: Ontario, Canada

Re: Confused re: CPAP Prescription in Canada

Post by ReadyforRest » Thu Dec 05, 2013 10:06 am

teleute wrote:My husband has had two different sleep studies (from different places), and both places recommended a CPAP machine. However, they're saying they don't give prescriptions - that he's supposed to just take the sleep studies into a local place and get the equipment there. From everything I've read about needing prescriptions for CPAP machines, this seems really odd. And if they're not prescribing anything, who's to say whether he'd be best with a CPC, APAP, BiPAP, etc...? And what about pressure levels? Is the supplier supposed to say that? Because that seems like a conflict of interest, not to mention it keeping us from being able to purchase it cheaper online (which I feel is likely the game being played here). I'd assume going to his GP with the study wouldn't be the best option; they're not specialists, after all.

We're quite new to researching this, so I'd appreciate any thoughts/advice people have.
You said, "they're saying they don't give prescriptions". Maybe they meant, they don't give prescriptions out to the patient. That's quite normal here in Canada. They ask you to choose a DME (medical device supplier) ... or they choose the DME ... and they fax or email the prescription to that DME. You are expected to go there and deal with that DME and order your machine there. I think it's because we have ADP (Assisted Device Program) where the DME sends in the proper forms and ADP pays for 75% of your machine. You need to call that specific DME that they've sent the prescription to, and set up an appointment. Ask them if they received your prescription, and for which machine it's for. Because we have ADP, we don't have the same problems that Americans have of being given lower quality machines. Because there's no advantage for the DME to sell you a lower quality blower. We have a much better system. However, it does vary from province to province. Where are you located?

Now all that being said, you CAN and SHOULD ask the DME for a copy of your prescription. They have to give you a copy. After all, it's yours. Then, if you have any problems with that DME, you can change to another one. After one week at my first DME, I changed to another one. I called the sleep clinic and asked them to send my prescription to the DME I selected. They did it right away. And then I asked for, and got, a copy of my prescription from the new DME. That is because I want to purchase masks at a lower price online. I've done that many times.

We also have the one month trial program (free), at least here in Ontario, where you can use a machine from the DME for one month to see how you do, and to find out if that machine or those settings are working for you or not. During this time, if you have any problems, you should consult with both the DME and your sleep doc, to see if you need a different machine or new settings. You will follow this up with your one month follow-up appointment with the sleep doc, who will assess your treatment and see if you need your settings changed. You'll also have a titration study, where your husband goes in with his mask, sleeps overnight using their machine at your settings, and see if the treatment is working at it's best. If not, then they adjust his settings during the titration. THEN you purchase the machine, but ADP pays 75%, and you pay the rest, or if you have private insurance then it will pay most of the remainder.

_________________
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: SleepyHead v0.9.1, Pressure: 9 - 14

User avatar
Hawthorne
Posts: 3973
Joined: Tue Oct 19, 2004 4:46 am
Location: London Ontario -Canada

Re: Confused re: CPAP Prescription in Canada

Post by Hawthorne » Thu Dec 05, 2013 10:18 am

As far as I know, the Assistive Devices Program is only in Ontario. There MAY be forms of it in other Provinces but, as Julie said, Health Care in Canada is a Provincial matter so every Province is different.

_________________
Machine: DreamStation Auto CPAP Machine
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments:  Backups- FX Nano masks. Backup machine- Airmini auto travel cpap

teleute
Posts: 117
Joined: Thu Dec 05, 2013 12:32 am
Location: Calgary, AB, Canada

Re: Confused re: CPAP Prescription in Canada

Post by teleute » Thu Dec 05, 2013 10:19 am

Sorry...to clarify. GP referred to a sleep clinic (Merrell, btw), doc at Merrell ordered sleep study, reviewed results, and recommended CPAP. But they're the ones saying a Rx is not needed - that we should just take the sleep study results into the local suppliers. And they didn't give us any particular place to go, just a longish list of suggestions.

We're in Alberta, btw.

Thanks for the info - I'll call some of the DMEs today and quiz them further. ..

_________________
Machine: DreamStation Pro CPAP Machine
Mask: DreamWear Gel Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Pressure 10.5-14

ReadyforRest
Posts: 136
Joined: Thu Jul 26, 2012 12:43 pm
Location: Ontario, Canada

Re: Confused re: CPAP Prescription in Canada

Post by ReadyforRest » Thu Dec 05, 2013 10:33 am

OOOOOHHH ... now it makes more sense. I just visited their website. They appear to specialize in dental devices!

http://www.merrellclinic.com/index.html

Their FAQ page is full of dental information ONLY: http://www.merrellclinic.com/faq.html

This is not a proper sleep clinic. You need to find one.

_________________
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: SleepyHead v0.9.1, Pressure: 9 - 14

ReadyforRest
Posts: 136
Joined: Thu Jul 26, 2012 12:43 pm
Location: Ontario, Canada

Re: Confused re: CPAP Prescription in Canada

Post by ReadyforRest » Thu Dec 05, 2013 10:58 am

You need to call your GP and ask him why he referred your husband to Merrell, which doesn't write out prescriptions, and mostly deals with dental appliances. AND you need to go online, or ask other Albertans who are on this forum, and get a list of GOOD sleep clinics in your area. Here's a list from my quick web search: http://www.ab.lung.ca/sitewyze/files/Al ... ontent.pdf But it would be better if you had a recommendation from someone here, and I know there are several Alberta people on this forum.

You didn't say what town or city you live in. That would help a lot.

Then once you have found accredited sleep clinics that you know are good, then tell your GP that you want a referral to that particular sleep clinic. But you also need to call the new sleep clinic BEFORE that referral and ask a lot of questions. Like, after the sleep study, do you send a RX to a medical supplier? Tell them your husband has already had two sleep studies, but you can't seem to get a RX, even though Merrell said he needs cpap. Ask them if you can bring the results of your husband's past two sleep studies to a consult with one of their sleep docs, and could the doc then write out an RX for equipment? If they say YES, ask what is the follow-up schedule? What DME do they deal with or recommend? And any other questions you have. IF their responses are to your liking, THEN get your GP to refer you.

_________________
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: SleepyHead v0.9.1, Pressure: 9 - 14

Ducky2
Posts: 31
Joined: Sun Nov 24, 2013 9:58 am
Location: Saskatchewan, Canada

Re: Confused re: CPAP Prescription in Canada

Post by Ducky2 » Thu Dec 05, 2013 11:23 am

interesting....all I got in Sask. is a HOME sleep study...with my Gp ordering it, than I was told its an 18month wait period to get a LAB sleep study done. since my apnea was mod/severe I was urged NOT to wait but to go ahead and go to Vitalaire and purchase the cpap machine and pay for out of pocket!!!

there I was given a machine and mask for a 2 week trial. Than I had to buy the machine out $2400.00, small city they only have 3 loaner masks to trial. so far I am on #2 having tried the quattro FX and the F&P Simplus, both have leaks and the later hurts the bridge of my nose. tomorrow I get the quattro MIRAGE to trial. than I'm on my own, if none of the 3 trial ones work out I would have to purchase any of the next ones in order to try...WITH NO RETURN OR EXCHANGE.

I am at my wits end with this small outlet and NO help from girl there....and NO doctor follow up as my GP only refered me for the home study he really knows nothing abt apnea...so my only help is this forum.
NO sleep study doctor!!!

guess I'm just venting, the lack of choices for trial...the lack of outlet support not to mention NO doctor support....I'm on my own with a machine and hopefully one day a mask that will fit.

my question to all of you Canadians...
Do I need a prescription to order a mask from these on line suppliers?

also does anyone use or tried the QUATTRO AIR? my local outlet has one for sale for $340, but none for a trial, so I would have to buy it in order to try it
how does it compare with the quattro fx or the F&P Simplus????....what a business this is!!!

_________________
MaskHumidifier

User avatar
BlackSpinner
Posts: 9745
Joined: Sat Apr 25, 2009 5:44 pm
Location: Edmonton Alberta
Contact:

Re: Confused re: CPAP Prescription in Canada

Post by BlackSpinner » Thu Dec 05, 2013 11:34 am

Yes you need a prescription for online purchases because they don't care where you order from. Just get your GP to write you another one - basically it should say something like"Cpap 7-15 cm H2O and mask of patients choice" that will allow you to buy anything anywhere. It is what mine says - in French. Scan it into your computer and email it to the supplier you want The costs are MUCH cheaper online.
You can get a lot off different masks from our host cpap.com and they offer fitting insurance. If you want to buy Resmed gear go to clinicalsleep.com from Vancouver and sign up. The Canadian sites work a bit different then our host here and you have to log in to get the real prices.

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Additional Comments: Quatro mask for colds & flus S8 elite for back up
71. The lame can ride on horseback, the one-handed drive cattle. The deaf, fight and be useful. To be blind is better than to be burnt on the pyre. No one gets good from a corpse. The Havamal