Trying CPAP for the First Time? Tips to Understanding Machine Use and Insurance

If you or someone you know suffers from sleep apnea, you are likely familiar with the CPAP machine, a medical device that helps patients breathe easy through the night. Dr. Friedman and his team of expert ENTs, allergists, head and neck surgeons, board-certified sleep specialists, as well as dental sleep specialists now treat snoring and sleep apnea with a number of non-invasive and minimally invasive treatment options. One of many treatment options is a CPAP machine. 

“At ChicagoENT, we encourage every patient to try CPAP before considering other forms of therapy,” said world-renowned sleep specialist Dr. Michael Friedman of Chicago ENT. “Although CPAP is a miracle cure for some patients, it is intolerable for others. Although patients with severe Obstructive Sleep Apnea will have a high compliance rate, patients with mild apnea are unlikely to accept CPAP as a permanent solution.”

Because a CPAP machine can be uncomfortable when patients first try it, Dr. Friedman recommends a light-use approach to begin. “Often if patients try and use CPAP all night when first obtaining the unit, and they cannot sleep. They then become frustrated with the treatment and give it up forever,” said Dr. Friedman. “I achieve much better results with patients if I tell them to try it for five to ten minutes for the first week. Psychologically, it’s easy to accept anything for five minutes. Often if they relax during those few minutes; they fall asleep and awaken in the morning with the CPAP on and feel refreshed.” 

Photo by Matheus Vinicius on Unsplash

If you are directed to use a CPAP machine to treat your sleep apnea, it’s important to understand your insurance and the associated costs of the device. In the digital age, it’s no surprise that some CPAP machines track patient use. This helps doctors understand patient usage and assess the progress a patient is making with the machine. Some CPAP machines can upload the information directly to your doctor’s office from the device. 

However, do be aware of data and privacy concerns. According to a recent NPR article, “You Snooze, You Lose: How Insurers Dodge The Costs Of Popular Sleep Apnea Devices,” in newer connected devices, some insurance companies may be tracking patient use to ensure proper use and compliance. They then may be denying payment if the device isn’t used properly for the correct amount of time each night. If you are concerned about privacy, consider a CPAP machine that allows you to use a removable data card that you bring to your doctor to report treatment.  

Dr. Friedman offers the following advice regarding CPAP suppliers: 

• Be sure to discuss the out-of-pocket cost of the CPAP with the CPAP supplier.

• Check “in network” vs. “out of network” suppliers. If a patient goes to an “out of network” supplier, they often find that they now have a new outrageous deductible which is often far more than the cost of the machine. 

• Patients are often misinformed by the CPAP suppliers and are told that they “must” use CPAP every night for at least four hours to have coverage. If they cannot use CPAP, insurance still has to pay for the first month (beyond deductible) whether the patient used it or not. 

• It is true that if patients want to keep the unit, they will have to prove use. They do have the right to try it and return it if they feel it is not for them.

So a CPAP machine might be just the device you need to treat your sleep apnea. Just be sure that, as with any medical treatment, you are fully informed of how insurance will work and the associated costs. The expert team at Chicago ENT will work with you to answer questions from our end as you explore your treatment options.  

Over 50 million Americans suffer from from snoring and some form of Obstructive Sleep Apnea. And the disease has far worse consequences than just making you a loud sleeper—people with sleep apnea are at more serious risk for strokes, high blood pressure, heart attacks, and more. 

If you suspect you have sleep apnea, make an appointment to visit today to find out the best treatment option for you. 

Make an appointment to visit today! 

 Header Photo by Jason Blackeye on Unsplash