Ontario Criteria for Prescribing a APAP

[justcaring]

Just got back from my 2nd sleep study where they monitored the pressure and adjusted my pressure based on sleeping positions and rem sleep etc....

The tech said that I had a range of pressure from being on my back which was higher at 12 then on my side at 8 I have been diagnosed with mild to moderate between 6 -12 in REM sleep. Is this enough to get a APAP prescription, or am I wasting my breath, (No pun intended)

Any comments or experience on this would be helpful as I want to get my new machine, but want to be armed with the right knowledge.

[Hawthorne]

In Ontario, it is very unlikely you will get a pescription for an auto with that sleep study result.

You MAY be able to convince the doctor to write a prescription for an auto but, if you look up the Assistive Devices Program information on the Ontario Government webiste, you will see what the criteria is.

I believe you have to "fail" cpap to get it. With a diagnosis of "mild to moderate" I don't think you will get it. Almost eveyone has more events while sleeping on their backs so that won't do it.

If you can't get a prescription for an auto, you can't get one in Ontario, even if you don't want to use the Assisitive Devices Program.

If you can't get a prescription for an auto, make sure you get your prescription physically in your hands. Then, if you want and auto and are willing to pay out of pocket, you can get an auto online with a prescription for a straight cpap. If you have extended insurance, they will probably not pay anything. The Assistive Devices Program will certainly not pay anything.

The good news is that if you buy out of pocket online, it is about 1/4 the price of a machine in Ontario. I got a PR System One Auto from cpap.com for just about $650. The price for an auto is around $2500 in Ontario (if you have a prescription that says "auto"- but if you have insurance coverage and can get the Assistive Devices Program, it will be much cheaper in Ontario.

The other good thing about buying online is that your prescription is good for life. In Ontario, you may not get a new machine, even after 5 years, if your old one is still working. That's even if you are willing to pay for it in total yourself.

If you get a prescription for only a straight cpap and cannot pursuade the doctor to write one for an auto, take it but make sure you have a copy in your hands. That way, you can buy an auto quite a bit cheaper online and keep the one that you got with the help of the Asssitive Devices Program, as a backup machine. This will give you access to a Provider in Ontario, if you want that. Masks are also much cheaper online.

There is also cpapauction.com where you can get good deals on machines and masks (buyer beware).

Go for it though and good luck!

[justcaring]

In Ontario, it is very unlikely you will get a pescription for an auto with that sleep study result.

You MAY be able to convince the doctor to write a prescription for an auto but, if you look up the Assistive Devices Program information on the Ontario Government webiste, you will see what the criteria is.

I believe you have to "fail" cpap to get it. With a diagnosis of "mild to moderate" I don't think you will get it. Almost eveyone has more events while sleeping on their backs so that won't do it.

If you can't get a prescription for an auto, you can't get one in Ontario, even if you don't want to use the Assisitive Devices Program.

If you can't get a prescription for an auto, make sure you get your prescription physically in your hands. Then, if you want and auto and are willing to pay out of pocket, you can get an auto online with a prescription for a straight cpap. If you have extended insurance, they will probably not pay anything. The Assistive Devices Program will certainly not pay anything.

The good news is that if you buy out of pocket online, it is about 1/4 the price of a machine in Ontario. I got a PR System One Auto from cpap.com for just about $650. The price for an auto is around $2500 in Ontario (if you have a prescription that says "auto"- but if you have insurance coverage and can get the Assistive Devices Program, it will be much cheaper in Ontario.

The other good thing about buying online is that your prescription is good for life. In Ontario, you may not get a new machine, even after 5 years, if your old one is still working. That's even if you are willing to pay for it in total yourself.

If you get a prescription for only a straight cpap and cannot pursuade the doctor to write one for an auto, take it but make sure you have a copy in your hands. That way, you can buy an auto quite a bit cheaper online and keep the one that you got with the help of the Asssitive Devices Program, as a backup machine. This will give you access to a Provider in Ontario, if you want that. Masks are also much cheaper online.

There is also cpapauction.com where you can get good deals on machines and masks (buyer beware).

Go for it though and good luck!

Hawthorne--- Thanks for the advice. And I suspected as much. I do plan to do what you suggested. It is a shame that the Ontario DME gouge for mask and stuff. Appreciate the advice.

[Hawthorne]

I know! What we have to pay here is outrageous and the hoops we have to go through to get an auto!

SOME people, in some parts of Ontario, have been able to get their doctor to write a prescription for an auto but not here in London where I live.

I was diagnosed in 2002 and went for another sleep study in 2008. It took a year from the time I saw my GP for a referral to finally seeing the sleep specialist again after the retitration.
With all the improvements in machines in that time, I hoped for AT LEAST exhalation relief. I knew I did not meet the criteris for an auto. I am not sure anymore what the criteria is.

He told me that I only needed my pressure changed on my old classic Remstar and that I would get a prescription for a new machine IF my machine was broken beyond repair.

Since I saw him, I have bought 4 machines online (2 from online suppliers and 2 from cpapauction.com). I spent way less than the cost here. I know I don't need 4 machines but I wanted the newest Respironics that came out earlier this year and then I wanted a backup of the same machine because I liked the machine so much. I got no financial help but I have autos and the software and I'm doing well AND it did not cost me that much.

There is a private sleep clinic in town that is covered bu OHIP. If I ever need another sleep study I will go there. I can self refer and get in within a couple of weeks. My GP doesn't like the private one but I have dealt with the hospital one twice now and it is not a good experience.

If you decide to shop online sometime, with an online supplier or cpapauciton.com, just PM me and I will help you all I can.

[Hose_Head]

In Ontario, it is very unlikely you will get a pescription for an auto with that sleep study result.

You MAY be able to convince the doctor to write a prescription for an auto but, if you look up the Assistive Devices Program information on the Ontario Government webiste, you will see what the criteria is.

I believe you have to "fail" cpap to get it. With a diagnosis of "mild to moderate" I don't think you will get it. Almost eveyone has more events while sleeping on their backs so that won't do it.

If you can't get a prescription for an auto, you can't get one in Ontario, even if you don't want to use the Assisitive Devices Program.

If you can't get a prescription for an auto, make sure you get your prescription physically in your hands. Then, if you want and auto and are willing to pay out of pocket, you can get an auto online with a prescription for a straight cpap. If you have extended insurance, they will probably not pay anything. The Assistive Devices Program will certainly not pay anything.

The good news is that if you buy out of pocket online, it is about 1/4 the price of a machine in Ontario. I got a PR System One Auto from cpap.com for just about $650. The price for an auto is around $2500 in Ontario (if you have a prescription that says "auto"- but if you have insurance coverage and can get the Assistive Devices Program, it will be much cheaper in Ontario.

The other good thing about buying online is that your prescription is good for life. In Ontario, you may not get a new machine, even after 5 years, if your old one is still working. That's even if you are willing to pay for it in total yourself.

If you get a prescription for only a straight cpap and cannot pursuade the doctor to write one for an auto, take it but make sure you have a copy in your hands. That way, you can buy an auto quite a bit cheaper online and keep the one that you got with the help of the Asssitive Devices Program, as a backup machine. This will give you access to a Provider in Ontario, if you want that. Masks are also much cheaper online.

There is also cpapauction.com where you can get good deals on machines and masks (buyer beware).

Go for it though and good luck!

Mostly good advice provided by Hawthorne.

I was able to get my Ontario Doctor to prescribe an APAP after my initial titration. He wanted me to go on CPAP, but agreed to my request for an auto. He said his justification to ADP would be that my titration pressures were all over the place, even when sleeping on my side. My titration study pressures ranged from 8 cm to 12.5 with a 90% level of 9.0

The fact that I had complained to the Doctor about his apparently-too-cosy relationship with the DME may have been a factor in his granting my request for an auto. (Once I got my Rx for an auto, I bought it from a different Ontario DME and ADP paid 75% of the cost.)

For the record, two years ago the ADP price for an APAP was $1585 of which ADP paid 1040. This included a humidifier. I doubt the cost is much different today and certainly is not $2500. (All figures $Can).