Why do I Need a Prescription to Get CPAP and Supplies?

Why do I need a prescription for CPAP?

The Food and Drug Administration (FDA) in the US classifies CPAP devices as Class II medical devices with possible risks. Therefore, their sale requires a medical prescription.

While the process for obtaining a prescription (not to mention insurance approval) for CPAP and supplies can be burdensome, working with a healthcare provider to start and maintain CPAP therapy is crucial. Diagnosing and treating sleep apnea can be challenging. To be successful with CPAP therapy, you will need to expertise and support of clinicians.
 

It’s possible to buy the items without a prescription, but buyer beware

There are two popular ways of buying a CPAP or supplies without a prescription:

1. Online selling sites like Craigslist

There are lots of concerns about buying CPAP and supplies on sites like Craigslist (there’s even a JAMA study that researched outcomes of Craigslist CPAP sales). Main concerns are the condition of the device (does it even work), how many hours it’s been used, adjusting the pressure settings of a used device without a therapist/technician and, obviously, sanitary concerns. While these sales are technically illegal since a prescription is not required, they still occur quite frequently.
 

2. Online sellers who sell CPAP mask components individually, instead of fully assembled

Some online resellers will sell separate mask components without a prescription. These resellers are taking advantage of a loophole in the FDA classification of CPAP devices and equipment.
 

How can I get a prescription for CPAP?

You should talk to your doctor. If you’ve already been diagnosed with sleep apnea, your doctor may prescribe CPAP therapy.

If you have not yet been diagnosed, but suspect you have a sleep disorder like sleep apnea, talk to your doctor about assessing your symptoms and possibly having a sleep study.

If you don’t have a doctor, there are several different types of physicians you can speak to about sleep issues, including a primary care physician, pulmonologist, endocrinologist or a sleep specialist.
 

What information is required on a prescription for CPAP?

Medicare requires the following information on a prescription. Many insurance companies follow Medicare guidelines.

1. Beneficiary/patient’s name
2. Treating physician’s name
3. Date of order
4. Detailed description of items (type of device and supplies, pressure setting for machine)
5. Physician signature and signature date
6. Physician’s NPI
7. Length of need
8. Diagnosis

How often do I need a new prescription for CPAP or supplies?

You will only need a prescription for CPAP if you want to get a new device. Typically, insurance will cover a new CPAP machine every 5 years or so.

It is recommended that you replace some of the CPAP equipment on a regular basis, such as filters, cushions, tubing and your mask. Your equipment provider may ship these items to you on a regular basis, like every 90 days. Your insurance company may require a new prescription for ongoing replacement supplies every year.
 

If you’re interested in learning more about getting a new CPAP machine, check out our online store or call us to speak to a customer service representative (877) 775-3377 option 607. We offer face-to-face set-ups or we can ship to you.

Shop for CPAPs and supplies
 

Sources:
https://www.fda.gov/RegulatoryInformation/Guidances/ucm072728.htm

Other posts you may find interesting:

• I’m a CPAP User; How Often Do I Need a New Sleep Study?
• SoClean Makes Daily Cleaning of Your CPAP Equipment So Easy
• Why Won’t My Insurance Company Pay for the CPAP Supplies I Need?
• Medicare Coverage for CPAP & Supplies
• Should you rent or purchase your next CPAP machine?