This is one of the most frequent questions around CPAP therapy, and the good news is that healthcare coverage can help offset some, if not all, of the CPAP equipment costs. This makes CPAP therapy not only more affordable, but it may allow you to choose a better model for your needs.
If you’re wondering if CPAP equipment is covered under your insurance, the first step is to get confirmation that you do have Sleep Apnea and require CPAP therapy. This is done through a consultation with a sleep specialist and a polysomnogram test. If CPAP therapy is prescribed based off of that, you’ll likely need the following equipment:
- CPAP machine & mask
- Heated humidifier
- CPAP filters & caps
- Optional sanitizing device
As mentioned, CPAP equipment can often be covered under your healthcare insurance, but it depends on both the province you live in and your insurance plan. We’ll dive deeper into the specifics below.
Coverage by Province
Every insurance provider and plan are different, so your best bet is to find out from your private plan directly if CPAP therapy is covered or not. But in many provinces, CPAP therapy is also partially covered under the provincial healthcare plan.
- Ontario: Sleep studies and consultations with sleep specialists are covered under Ontario’s provincial healthcare. Other programs can help offset the costs of CPAP equipment, such as the Assistive Devices Program (ADP), Ontario Disability Support Program (ODSP) and the Ontario Works Program (OW).
- Alberta: Only residents who require social assistance support and that are diagnosed with moderate to severe sleep apnea are eligible for CPAP equipment coverage.
- British Columbia: BC only provides coverage for those who qualify for the Employment and Assistance Regulation or the Employment and Assistance for Persons with Disability Regulation and have been diagnosed through a sleep study.
- Quebec: There is no provincial health coverage for CPAP equipment in Quebec.
- Nova Scotia: There is no provincial health coverage for CPAP equipment, but a local organization (the Sleep Apnea Refurbishment Program by the Lung Association of Nova Scotia) helps offset the costs by collecting and distributing CPAP equipment.
Using both provincial funds available to you combined with your private healthcare coverage can help offset as much of the CPAP equipment costs as possible.