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CPAP Insurance Coverage
CPAP Insurance Coverage and Funding Options in Canada
CPAP coverage may be available through private insurance, provincial assistance or federal benefit programs. Learn what to confirm before purchasing equipment and which documents may be required.
Already have a prescription? MedPro can help prepare an equipment quote and identify the information your plan may request.
Coverage at a Glance
Four Things to Confirm Before Ordering
- Which equipment and supplies are eligible
- Whether preapproval is required
- How much the plan will reimburse
- Which documents must be submitted
Coverage varies by province and plan. MedPro cannot guarantee approval or reimbursement.
Understanding Your Benefits
“Covered” Does Not Always Mean the Full Cost Is Paid
A plan may pay a percentage of an approved amount, set a maximum, apply a deductible or coinsurance, restrict replacement frequency, cover only basic equipment or require an approved provider and preauthorization.
Confirm the benefit amount, approved price and remaining patient cost before purchasing equipment.
Coverage information last reviewed: July 2026. Program and insurer rules can change, so verify current requirements before ordering.
The Coverage Process
A Practical Way to Review CPAP Funding
Confirm requirements before committing to a major equipment purchase.
01
Confirm Your Prescription
Ensure the prescribed therapy and equipment type are documented.
02
Contact the Plan
Ask about equipment eligibility, limits, required forms and preapproval.
03
Obtain a Quote
Request an itemized quote showing the machine, mask, accessories and services.
04
Submit Required Documents
Provide the prescription, quote, forms and supporting clinical information.
05
Confirm Approval Before Ordering
Understand the approved amount and your remaining responsibility.
Ways CPAP May Be Funded
Coverage May Come From More Than One Source
Private plans, provincial assistance and federal programs use different eligibility and documentation rules.
Private Insurance
Employer or individual extended-health plans may cover some CPAP equipment and supplies.
Provincial Programs
Provincial coverage differs substantially among British Columbia, Alberta and Ontario.
Federal and Special Programs
Some patients may qualify through federal, veteran or other case-specific programs.
Private Insurance
Review the Details of Your Extended-Health Plan
Ask the insurer to explain both the covered benefit and the claim process.
Equipment Maximum
The plan may set a maximum amount for a machine or complete system.
Eligible Frequency
A machine, mask or accessory may be eligible only after a defined period.
Prescription Requirement
The plan may require a current prescription or medical authorization.
Preapproval
Written approval may be required before purchase.
Provider Requirements
Some plans may require a recognized or approved equipment provider.
Coordination of Benefits
Patients with two plans may be able to submit remaining eligible costs to a second plan.
Ask whether the plan’s maximum applies to the complete system or separately to the machine, mask and accessories.
British Columbia
Coverage Depends on the Specific Program
Standard BC PharmaCare does not cover CPAP machines. Separate assistance pathways may be available for eligible income- or disability-assistance recipients when program and medical criteria are met.
Potential pathways may include private extended-health insurance, income or disability-assistance health supplements, federal benefit programs, employer benefits and other case-specific funding.
Questions for a BC Coverage Review
- Which program may apply?
- Is prior authorization required?
- What medical criteria must be documented?
- Is an equipment quote required?
- Are masks and supplies covered?
- Must other insurance be used first?
Eligibility must be confirmed through the applicable program before purchase.
Alberta
Alberta Health Care Insurance Does Not Generally Cover CPAP Equipment
Other private or public assistance pathways may apply depending on the patient’s eligibility.
Private Insurance
Review employer or individual coverage for:
- CPAP or APAP equipment
- Mask and headgear
- Tubing and humidification
- Replacement supplies
- Professional support services
Alberta Assistance Programs
Eligibility may exist through programs such as:
- Assured Income for the Severely Handicapped (AISH)
- Special Needs Assistance for Seniors
- Alberta Income Support
- Other qualifying benefit programs
Do not assume Alberta AHCIP or AADL will pay for standard CPAP equipment. Confirm the exact program and eligibility pathway.
Ontario
Eligible Patients May Receive Funding Through ADP
Ontario’s Assistive Devices Program generally pays 75% of the ADP-approved price for eligible positive airway pressure systems. The patient normally pays the remaining 25% plus optional accessories or services outside the approved package.
Clinical eligibility, authorization, approved equipment and registered-vendor requirements apply.
Clinical Eligibility
Required diagnosis and clinical assessment must be documented
Approved Price
Funding is based on the ADP-approved price
Patient Portion
The patient may remain responsible for the unfunded amount and optional upgrades
Registered Vendor
The equipment must be supplied through the appropriate ADP process
Additional Assistance
Other benefit programs may help some eligible patients with the remaining contribution
Confirm the current ADP process and approved equipment before placing an order.
Other Funding Pathways
Some Patients May Qualify Through Federal Programs
Each program has its own eligibility, authorization, supplier and documentation requirements.
Non-Insured Health Benefits
Eligible First Nations and Inuit clients may have access to medical supplies and equipment through the applicable NIHB process.
Veterans Affairs Canada
Eligible clients may have access to respiratory equipment benefits, subject to authorization and program rules.
Other Programs
Coverage may also be available through workplace injury, automobile insurance, disability benefits or other case-specific programs.
Covered Equipment
Confirm Every Component Separately
An itemized quote helps the payer identify each product and service.
CPAP or APAP Machine
The prescribed therapy device.
Heated Humidifier
May be included in the approved system or treated separately.
Mask and Headgear
Coverage may be limited to a basic mask or approved amount.
Tubing
Standard and heated tubing coverage may differ.
Filters and Accessories
Routine components may be included, limited or excluded.
Setup and Support
Professional services may not be reimbursed in the same way as equipment.
Ask for an itemized quote so the insurer can identify each product and service.
Understand the Remaining Cost
Some Products or Services May Not Be Covered
Confirm what the plan excludes and what remains the patient’s responsibility.
Commonly Limited or Excluded
- Optional equipment upgrades
- Premium masks
- Extra batteries
- Travel CPAP machines
- Cleaning accessories
- Additional tubing or filters
- Shipping or delivery charges
- Services above the approved allowance
Costs the Patient May Pay
- Deductible
- Coinsurance
- Amount above the plan maximum
- Non-covered accessories
- Replacement before eligibility
- Difference between approved and retail pricing
Obtain written confirmation whenever a major purchase depends on insurance reimbursement.
Prepare Your Claim
Collect the Required Information Before Submission
Incomplete documentation can delay a preapproval or reimbursement request.
01
Prescription
Confirm the prescribed therapy type and any insurer requirements.
02
Clinical Documentation
A sleep-study report, diagnosis, trial information or authorization form may be requested.
03
Itemized Equipment Quote
Show the machine, mask, tubing, accessories and professional services separately.
04
Claim or Preapproval Form
Complete all patient, provider and prescriber sections.
Keep copies of all prescriptions, approvals, quotes, invoices and receipts.
Before Purchasing
Confirm How the Claim Must Be Submitted
The process may involve preapproval, direct billing, assignment of benefits, patient-paid reimbursement, coordination of benefits or provincial-program authorization.
Direct billing is not available for every insurer, program, product or clinic. Confirm the applicable process before ordering.
Questions to Ask MedPro and Your Insurer
- Can this claim be billed directly?
- Must I pay first and seek reimbursement?
- Is preapproval required?
- What documents are needed?
- How long is approval valid?
- What amount remains my responsibility?
Ongoing Supply Coverage
Replacement Rules May Differ From Machine Coverage
Manufacturer replacement guidance and insurer eligibility schedules are not necessarily the same.
Masks and Cushions
Plans may limit eligible frequency, approved amounts or mask categories.
Tubing, Filters and Chambers
These may have separate limits or be grouped under a yearly supply maximum.
Early Replacement
Damage or wear does not automatically guarantee early reimbursement.
Specialized Therapy Equipment
Bilevel Equipment May Follow Different Funding Rules
Confirm coverage before ordering a bilevel, travel or backup device.
BiPAP/Bilevel Devices
Coverage may require:
- A bilevel prescription
- Additional clinical documentation
- Prior authorization
- Confirmation of the prescribed mode
- An approved equipment category
Travel and Backup Machines
Travel CPAP machines and secondary devices are often treated differently from the primary prescribed system and may not be eligible.
Confirm coverage before ordering a bilevel, travel or backup device.
Keep Your Receipts
Some Unreimbursed CPAP Costs May Be Eligible Medical Expenses
CRA guidance lists prescribed assisted-breathing devices such as CPAP among eligible medical expenses, subject to the applicable tax rules and documentation.
Keep Documentation
Retain prescriptions, invoices, receipts and insurance statements.
Claim Only Eligible Amounts
Do not claim costs already reimbursed by insurance or another program.
Obtain Tax Advice
MedPro can provide purchase documentation but cannot provide personal tax advice.
Tax eligibility depends on CRA rules and the patient’s circumstances. Consult CRA or a qualified tax professional.
Coverage Support
MedPro Can Help You Prepare—The Payer Makes the Decision
MedPro can provide available equipment and purchase information for a claim.
Equipment Quote
An itemized estimate for the prescribed equipment and selected components.
Product Information
Manufacturer, model, component and compatibility information.
Claim Documentation
Available invoices, receipts and provider information needed for submission.
MedPro cannot interpret every policy, determine final eligibility or guarantee payment by an insurer or funding program.
CPAP Insurance Coverage FAQ
Common Questions About Coverage and Funding
Verify current program and insurer requirements before purchasing equipment.
Is CPAP covered by provincial healthcare?
Coverage differs by province and program. Ontario may fund eligible positive airway pressure systems through ADP, while standard BC PharmaCare and Alberta Health Care Insurance do not generally cover standard CPAP equipment.
Does private insurance cover CPAP equipment?
Many extended-health plans provide some coverage, but maximums, eligible equipment, preapproval rules, replacement frequency and patient costs vary.
Is CPAP covered in British Columbia?
Standard BC PharmaCare does not cover CPAP machines. Private insurance or separate assistance programs may apply for eligible patients.
Is CPAP covered in Alberta?
Alberta Health Care Insurance does not generally cover CPAP equipment. Private insurance and qualifying assistance programs may be available.
How much does Ontario ADP cover?
For eligible respiratory equipment, ADP generally pays 75% of the approved price. The patient normally pays the remaining 25% plus optional items outside the approved package.
Is BiPAP or bilevel equipment covered?
It may be covered under some plans or programs, but additional prescription, clinical documentation and authorization requirements may apply.
Are CPAP masks and replacement supplies covered?
Some plans cover masks and supplies separately, place them under a yearly maximum or restrict eligible replacement frequency.
Is a prescription required?
Many insurers and public programs require a prescription or clinical authorization. Confirm the exact requirements before submitting a claim.
Do I need insurance preapproval?
Some plans require written preapproval before purchase. Buying first can affect reimbursement when preauthorization was required.
Can MedPro direct bill my insurer?
Direct billing may be available in some situations, but not for every insurer, program, product or clinic. Confirm the claim process directly.
What is an approved equipment price?
A program may base payment on a fixed or approved amount rather than the full unrestricted retail price.
What happens if insurance covers only part of the cost?
The patient may be responsible for a deductible, coinsurance, the amount above the plan maximum, optional upgrades or other non-covered costs.
Are travel CPAP machines covered?
Travel or backup machines are often treated differently from the primary prescribed device and may be excluded. Obtain written confirmation before ordering.
Can I coordinate two insurance plans?
Coordination may be possible when a patient has two eligible plans. Each insurer sets its submission order and documentation rules.
Can CPAP expenses be claimed on my tax return?
CRA lists prescribed assisted-breathing devices such as CPAP among eligible medical expenses, subject to current tax rules and unreimbursed amounts.
What documents should I keep?
Keep prescriptions, clinical forms, approvals, itemized quotes, invoices, receipts and insurer payment statements.
Can MedPro provide an equipment quote?
MedPro can help prepare an itemized quote for the prescribed equipment and selected components.
How do I contact MedPro for coverage support?
Call 1-888-310-1444 or contact a MedPro clinic. Bring your prescription, insurer information and any required forms.
Related CPAP Resources
Continue Your CPAP Journey
Direct links to practical CPAP education and support.
Coverage Support
Need Help Preparing a CPAP Insurance Claim?
MedPro’s respiratory care team can help you identify the prescribed equipment, prepare an itemized quote and provide available purchase documentation.