For the many people who suffer from obstructive sleep apnea, using a cpap unit is a necessity. However, a very real factor in obtaining one is the price of the unit itself.
If you are one of the lucky ones who has health insurance, the final cost is ultimately decided on your actual insurance plan and not the price set by your DME provider. Many people often criticize DME providers because they think they are being ripped off after they see the invoice. Keep in mind that the amount an insurance company pays is up to the insurance company, not your DME provider. This is where it is very important to be familiar with your insurance plan and know you coverage whether it be hospital coverage, prescription drug coverage, durable medical equipment…etc. The only real choice the DME company has is which model of sleep apnea machine they provide you with.
One of the more frequent coverage plans is the 80/20 plan. In this plan, your insurance covers 80% of the cost and you pay the remaining balance. It really is difficult to give an exact number on cost as each insurance has a different contracted price. It is safe to assume that under an 80/20 plan most co-pays will cost between the $50- $100 range.
Another factor that has an impact of cost is whether your insurance will rent the machine or purchase the unit. Believe it or not, many insurance companies will not purchase the cpap unit outright until months later. The obvious downside to this is that the individual will also pay a monthly copay aside from what the insurance company is paying. There are benefits to both plans, but the point I’m trying to make is that you should know exactly what your insurance covers and how much you will have to pay out of your own pocket.
For those who are unfortunate not to have health insurance coverage, they are responsible for the full purchase of their sleep apnea machine. The good news is that the prices vary greatly from manufacture and functions. The most basic cpaps usually run around $200 and the more “top of the line” unit will run as high as $1200. Both units do the exact the same thing; which is blow air. However, the more expensive units have built in comfort features and the ability to store usage data.
Whether you have insurance or are paying out of pocket for your unit, make sure to know all your options. Looking up prices online is a great way to get an idea of cost. Also, your durable medical equipment provider can help with answering your questions, and can assist you in choosing the best sleep apnea machine for you.