Insurance companies cover PAP devices only if they’re used consistently. Since less than 50% of patients stick with therapy, insurers require proof of regular usage.

How Insurance Covers PAP Devices
Many insurers rent devices for 2 to 12 months before ownership transfers to the patient. If the device isn’t used regularly, insurance may stop covering it.
Regular use improves:

• Daytime alertness
• Cognitive function
• Overall quality of life

Manufacturers provide multiple ways to record and transmit compliance data:

1. Smart Card

• Memory card stores up to one year of data
• Patients must mail or bring it in for reporting

2. Attachable Modem

• Uses cellular networks to send data
• Can be temporary or permanent
• Sends data about an hour after the device turns off

3. Wireless-Enabled PAP Devices

• Built-in Wi-Fi, Bluetooth, or cellular modems
• Automatically transmits data within an hour if a wireless signal is available
• Stores data for later download if needed

• Usage time: At least four hours per day on 22 out of 30 days
• Sleep duration and apnea events
• Leak rate: Measures mask fit and effectiveness
• Remote troubleshooting: Some devices allow pressure adjustments based on a doctor’s prescription

Patients can request copies of their data at any time.

• Medical Equipment Provider: Stores and sends reports
• Insurance Company: Verifies compliance for coverage
• Your Physician: Uses data to optimize treatment

The frequency of compliance verification depends on your insurance plan. Medicare and many insurers require:

• Ongoing proof to continue coverage
• Annual reports to approve replacement supplies (masks, cushions, filters, tubing)

PAP data tracking helps ensure better care and insurance coverage, but it also raises privacy questions since usage is monitored from home.

Each patient must decide whether the benefits of personalized therapy outweigh privacy concerns.