Your sleep apnea will only improve if you remain compliant with your therapy! 

Listed below are the four steps that MUST be followed for your Medicare insurance to cover your CPAP therapy.

1. Face to face examination with your primary care physician.
2. Sleep study results
3. Compliance during your first 3 months
4. Follow up face to face examination with your physician

1. Face to face visit:

Your first step will be an appointment with your primary care physician. Based on your symptoms of possible sleep apnea, you may be sent to a sleep lab to do an overnight study.

What is Sleep Apnea?

 There are (2) types of sleep apnea:

1. Obstructive sleep apnea - This is the most common. OSA is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.
2. Central sleep apnea - The airway is not blocked but the brain fails to signal the muscles to breathe.

With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality. Therefore, people who suffer from sleep apnea most often have daytime sleepiness, morning headaches, mood swings and feelings of depression.

Untreated, sleep apnea can also cause high blood pressure and other cardiovascular diseases, memory problems and weight gain.

2. Sleep Study

Upon review of your study, if the sleep physician diagnoses you with sleep apnea, he will contact us to start the process of your CPAP therapy. Once we receive your prescription, our respiratory technician will contact you to set up an appointment. At your appointment, he will set you up with your CPAP or Bi-Pap machine, explain how to use it, fit you with correct mask, and advise you how to properly maintain your equipment.

How it works: 

The CPAP machine blows air through a mask placed over your nose and/or mouth at the prescribed pressure. This pressure opens up your airway during sleep just enough to stop the airways from narrowing.

CPAP treatment can be highly effective in treatment of obstructive sleep apnea. For some patients, the improvement in the quality of sleep and quality of life due to CPAP treatment will be noticed after a single night's use.

3. Compliance

Your insurance will cover the rental of your CPAP machine for the first 3 months. However, continued coverage is dependent upon your compliance with your machine. "Compliance" is defined as "using your equipment for are least 4 hours a night for at least 70% of the nights during a consecutive 30 day period during the first 3 months of use".

It is important that you contact us if you are having any difficulties with your equipment so that we may help correct them before the 90 day trial period.

What if I have problems with my CPAP device?

For many patients, compliance may be difficult. The following are some common problems you may have with your CPAP device, and some possible solutions:

• Your nose feels dry and stuffy. You can try using a humidifier to moisten the air from the CPAP device.

• Your nose feels blocked up. Some people who have sleep apnea also have nose problems. Ask your doctor if you have a nose problem that can be treated with a nasal spray. Surgery is sometimes also an option. People who breathe through their mouths don't do as well with CPAP nose masks. In this case, a full-face mask that covers both the nose and the mouth may help.

• The mask bothers your skin and nose. Because the mask must fit firmly over your nose and cheeks, it may irritate your skin. A different size or kind of mask may help. There are also special skin moisturizers made for CPAP device users. Some petroleum-based products can damage the mask, so ask your doctor for more information. Some people also benefit from using nasal pillows that fit into the nostrils and relieve pressure on the bridge of the nose. Using a regular CPAP mask one night and nasal pillows the next night may help you feel more comfortable.

• The mask leaks air. Some people can't keep their jaw closed while wearing the mask. A chin strap can help hold up your jaw to keep the air in.

• You don't like the pressure. You may find that breathing out against the air pressure keeps you from sleeping deeply. Your doctor may ask you to use a bi-level machine that lowers the air pressure when you breathe out. The same mask may be used with CPAP and bi-level machines.

• You take the mask off during your sleep or don't wear it every night. Most people can't wear the mask all night long, every night, right from the start. Keep trying, even if you can only use the mask for an hour a night at first. Once you solve your comfort problems, you should be able to increase the time you wear the mask.

4. Follow up face to face visit:

You are required to have a follow up appointment with your physician to evaluate your therapy. After 30 days of use, we will contact you for a download from your machine. This download will confirm if you are compliant with your insurance requirements as stated above. Once we receive this download, we will forward a copy to your physician. He will discuss this and your therapy at your follow up visit. Once we receive documentation of that visit, we can then submit your continued rentals to your insurance.