CPAP Services & Resources

• Your PAP device and Humidifier are considered durable medical equipment and as such, most insurance companies will pay on a rental basis.  

• Rentals will be billed monthly to your insurance company for a total of 10 or 13 months. This is at the discretion of your insurance company.  
• Most policies for durable medical equipment apply a co-insurance and/or deductible to each monthly rental and each supply purchase.  

• Supplies such as masks and filters are purchased items. The cost for supplies is separate from the rental of the device under most health insurance policies.   
• Most policies for durable medical equipment apply a co-insurance and/or deductible to each monthly rental and each supply purchase.  

A deductible is the amount you pay for health care services before your health insurance begins to pay. How it works: If your plan's deductible is $1,500, you will pay 100 percent of ALL eligible health care expenses until the bills total $1,500. After that, you share the cost with your plan by paying co-insurance. 

• The co-insurance is the percentage of costs of a covered health care service you pay (50%, for example) after you have paid your deductible.  

Please review your explanation of benefits provided by your insurance. For specific policy information regarding rental billing, co-insurance or deductibles; please call the telephone number on your health insurance ID card. 

Once all rental payments have been satisfied (including insurance payments, your deductibles and co-insurance) you will own the PAP.  No further rental charges will be incurred. There will be charges for any additional supply purchases.  

• Machine replacement varies by insurance. However, if you've had your machine for 5 or more years or your machine is in poor working condition, you may qualify for a replacement.

For a replacement you will need:

1. A new prescription. Your physician and documentation of a face-to-face evaluation stating that you are still using and benefitting from PAP therapy and why you need a replacement at this time.
2. Health System Services will need a copy of your previous sleep studies.
3. Check with your insurance about compliance requirements. Some insurances require documentation that you are compliant with your current PAP machine.

Please note, Health System Services may need to request for authorization from your insurance. This could take up to 15 business days from date of submission.

The delivery ticket you received is an estimate of the amount of co-insurance you are responsible for paying. This does not include any unmet deductible. You will be billed any additional amount once your insurance processes the claim and determines the amount due.  

It is the responsibility of the patient to notify our office regarding any changes in your insurance coverage. Please contact us with updated coverage information: 716-283-2339 or click here to submit this secure form