The Surprising Benefits of Embracing New Beginnings

As the calendar year ticks over, many of us are starting fresh with your health insurance cover.

Lets face it - we pay a lot of money, every year to be covered. So, make sure you are claiming what you are entitled to every year.

It's always best to phone your health insurance provider and clarify what you are personally entitled to, but here are a few things to keep in mind.

 

Can I claim the purchase of my CPAP device on Private Health?

Yes, most private health funds do offer a rebate on the purchase of your CPAP machine although this amount varies considerably between insurance providers and level of cover. Some funds will cover CPAP device rental and purchase, some device purchase only. Health insurance providers often require a letter of diagnosis clearly identifying you have Sleep Apnea from your Doctor or Sleep Physician. You will also need a tax invoice, paid in full to make a claim. You can not claim CPAP device purchase on HICAPS. It requires full payment, up-front. 

Check with your health fund to get an accurate and up to date quote for the amount they will cover.

How much rebate can I expect?

Although, as we mentioned, this varies considerably and is best to check directly with your health insurance provider, it can average between $500-$750

How often can I claim on my private health insurance?

Most insurers will let you claim the purchase of a CPAP device once every 5 years. So if you purchased and claimed a device in 2019 you may be eligible to claim a new device purchase in 2024. As always, check with you provider for details specific to you. 

Will Medicare cover my CPAP device or therapy?

Sir Charles Gairdner Hospital and Fiona Stanley Hospital are the public hospitals in WA providing government funded CPAP devices only for patients with health care cards or pension card holders, if they qualify as follows:

1. diagnosed by polysomnography (sleep study) with, at least, moderately severe OSA (AHI>15/hr); and
2. has demonstrated satisfactory use (average at least 4 hours per night), at their own expense; and
3. demonstrated a benefit (either a reduction in Epworth or clinician indicating clinical benefit was obtained) during a CPAP trial.

To access a Medicare supported device in WA you need your Sleep and Respiratory Physician to lodge an application on your behalf. This will only happen after you have completed the sleep study and CPAP trial to ensure you are meeting the criteria. There is a limited amount and variety of CPAP devices Medicare is able to fund, so the wait list and time is long. This process is not 100% free. You will have the expense of the visits to your specialist, the cost to complete the CPAP trial and Medical will request a nominal fee. People need to consider their personal needs and circumstance during this process. There are a number of different payment plans and options available that may be a better option that public funding. The team at Place of Dreams will be able to discuss your personal circumstance and help make any recommendations you qualify for.

Another thing to consider is the Essential Equipment Payment from Centrelink. This is a once a year payment granted to qualifying applications to help with the expense of supplying power to medical devices. It is specific to your power supplier (Western Power - Synergy) and requires your Sleep Physician to sign the Centrelink document. Click Here

Do any other government or support services cover CPAP?

Yes, but this varies greatly depending on each service.

My Home Help, Silverchain, NDIS, Dept of Veteran's Affairs (DVA),  Moorditj Koort Aboriginal Corporation, are all providers that may be able to subsidies the purchase of CPAP device and equipment. You need to contact your coordinator directly and discuss your individual circumstance. Then our team at Place of Dreams can help you. 

Can I claim my CPAP device on tax in Australia?

The Australian Tax Office has a specific page about this. We’re sorry, but no, you can’t claim your sleep apnoea machine as a deduction on your tax return. Medical expenses are classed as a private expense. It is always best to talk to your tax agent about your specific situation or you can read more about deductions you can claim and work-related expenses on the ATO website.

Can I claim for my CPAP consumable components like mask or filters?

No.
These are not covered by private health insurers or Medicare.
There is a recommended schedule of replacement for consumable components to ensure you maintain good CPAP therapy. If you are unsure, talk to your CPAP therapist or have a CPAP therapy review with one of our team at Place of Dreams. We will check you therapy is meeting medical requirements and ensure your device and components are in tip-top working order. 

This blog is of general nature only and is not intended to replace direct advice given by any medical provider. All information is correct at the time of publishing but individuals should do their one diligence to ensure this information is correct for them.