Is a CPAP machine covered by healthcare?

What is CPAP?

Continuous Positive Airway Pressure, often just called CPAP, is a system that uses light pressure to help keep a person’s airways open, particularly at night. It is typically used by those people who have breathing issues, including sleep apnea.

The CPAP machine can include a mask that fits over your mouth and nose to prevent your airways from closing while you sleep. 

Costs of a CPAP machine 

One issue with the machine is that it can be expensive. For Ontario residents however, the Ministry of Health and Long-Term Care has a program called the Assistive Devices Program (ADP) which can offset some of the costs associated with various machines, including CPAP. ADP will pay 75% of their approved price of a machine, and you will need to cover the other 25%.

Other provinces offer their own level of funding. For example, Saskatchewan provides the CPAP systems but users need to buy their own mask, the humidifier and any other accessories needed. In Manitoba, approved CPAP systems, including the unit itself, the mask, and accessories, are provided by the province. Other provinces, such as Alberta, offer funds for CPAP therapy for eligible seniors with specific income thresholds. Other provinces offer a limited amount of funding for CPAP machines.

At a national level, some Veteran Affairs Canada and Non Insured Health Benefits funding may be available for those who are eligible.

Who can apply to CPAP funding programs?

Any resident provincial with a valid health card in their name who has doctor-diagnosed obstructive sleep apnea and who meets all other eligibility criteria can apply to CPAP funding programs.

You may be required to attend a sleep clinic to verify our eligibility. Your sleep physician and clinic staff will determine the type of equipment you need.

Can your personal health insurance company cover the remaining CPAP costs?

Many insurance companies will cover the remaining expenses of obtaining a CPAP machine. Contact your insurance agent for more information.

What equipment and supplies does a person need?

A CPAP system can consist of the some or all of the following items:

• The actual CPAP device
• A heated humidifier
• A mask and related head gear
• Tubing
• Carrying case
• Caps and filters
• Power cord
• Instruction manual

If you need other parts that are not included as part of the system, you may need to pay for those costs yourself or through your insurance.

What happens when you need to replace your CPAP equipment?

Some provinces, such as Ontario, may contribute funds towards replacing your equipment when it no longer works, cannot be repaired, and has past the warranty date. Note that you still need to meet the necessary eligibility requirements.