OHIP coverage for CPAP machine?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
thebaj
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OHIP coverage for CPAP machine?

Post by thebaj » Mon Nov 13, 2023 10:01 am

Hello,

First post here, recently diagnosed with mild sleep apnea. My report said AHI of 12.4 with oxygen between 88 - 96% and longest occurrence of 45 seconds.

I lost about 12lb weight before the test and really cleaned up diet drastically along with exercise. I think that helped and feeling less and less symptoms but doctor wants me to try cpap for 6 months. Prior to weight loss I was having quite a bit more difficulty with mid-afternoon fatigue, it’s still there of course but not as bad.

Anyways, I am unsure how this works in regards to getting a machine. I visited/called a couple of vendors locally and they have admin fees + higher costs than what I see online.

Trying to determine if I can purchase the cpap machine and then submit to OHIP for refund myself? I’m told OHIP can cover 75% of the machine cost. A bit concerned to try set it all up myself, but the vendor options were very limited, they only had resmed machines and nothing else

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LSAT
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Re: OHIP coverage for CPAP machine?

Post by LSAT » Mon Nov 13, 2023 11:14 am

Resmed machines are top of the line. I wouldn't buy any other brand.

thebaj
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Re: OHIP coverage for CPAP machine?

Post by thebaj » Mon Nov 13, 2023 11:20 am

LSAT wrote:
Mon Nov 13, 2023 11:14 am
Resmed machines are top of the line. I wouldn't buy any other brand.
There’s so many reviews in YouTube, it’s hard to know what’s correct. I found this https://m.youtube.com/watch?v=v6_NHkXgSRU , which has a lot of negative to say about resmed … don’t know if there’s any truth to it

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Julie
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Re: OHIP coverage for CPAP machine?

Post by Julie » Mon Nov 13, 2023 11:46 am

Why don't you just call OHIP?

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LSAT
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Re: OHIP coverage for CPAP machine?

Post by LSAT » Mon Nov 13, 2023 12:04 pm

thebaj wrote:
Mon Nov 13, 2023 11:20 am
LSAT wrote:
Mon Nov 13, 2023 11:14 am
Resmed machines are top of the line. I wouldn't buy any other brand.
There’s so many reviews in YouTube, it’s hard to know what’s correct. I found this https://m.youtube.com/watch?v=v6_NHkXgSRU , which has a lot of negative to say about resmed … don’t know if there’s any truth to it
No truth...Go through this board and look at the machines that the members use. It is listed on the bottom of posts. I think you will find that about 90% are Resmed machines.

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zonker
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Re: OHIP coverage for CPAP machine?

Post by zonker » Mon Nov 13, 2023 6:54 pm

LSAT wrote:
Mon Nov 13, 2023 12:04 pm
thebaj wrote:
Mon Nov 13, 2023 11:20 am
LSAT wrote:
Mon Nov 13, 2023 11:14 am
Resmed machines are top of the line. I wouldn't buy any other brand.
There’s so many reviews in YouTube, it’s hard to know what’s correct. I found this https://m.youtube.com/watch?v=v6_NHkXgSRU , which has a lot of negative to say about resmed … don’t know if there’s any truth to it
No truth...Go through this board and look at the machines that the members use. It is listed on the bottom of posts. I think you will find that about 90% are Resmed machines.
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Dog Slobber
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Re: OHIP coverage for CPAP machine?

Post by Dog Slobber » Tue Nov 14, 2023 9:25 am

Here is OHIP's ADP program's website. including a list of venders supported by ADP.

https://www.ontario.ca/page/respiratory ... d-supplies

No online vendors are supported.

Be aware you can't just buy any machine, you have to medically qualify for certain classes of machines (CPAP, APAP, BPAP). If you only qualify for CPAP (which a mild case suggests) they won't pay for an APAP.

And ResMeds are the machine to go with, don't even consider anything else.

D.H.
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Re: OHIP coverage for CPAP machine?

Post by D.H. » Tue Nov 14, 2023 10:54 am

LSAT wrote:
Mon Nov 13, 2023 11:14 am
Resmed machines are top of the line. I wouldn't buy any other brand.
I certainly don't recommend Philips Respironcs (Remed's main competitor). While my personal experience with their machines has been satisfactory, their handling of the recall (and cover-up prior) has been abysmal!

I did have a Fisher and Paykel in 2005, and that was a good machine (in fact, I used it during the recall in 2021 until my new machine came). It was a plain old "box" and had only an hours used meter. That was even less that an "odometer" is it measured machine on time, not actual usage.

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thebaj
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Re: OHIP coverage for CPAP machine?

Post by thebaj » Wed Nov 15, 2023 8:29 am

Julie wrote:
Mon Nov 13, 2023 11:46 am
Why don't you just call OHIP?
Thanks, I called them today, confirmed that patients must go through a vendor in the Assistive Devices Program for coverage.

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chunkyfrog
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Re: OHIP coverage for CPAP machine?

Post by chunkyfrog » Fri Nov 17, 2023 5:46 pm

Just remember: Resmed--no substitutes!

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