CPAP Refill

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Contact Information

Please allow 24 hours to process your order, or 2 days if order is placed on Sunday.

If your insurance has changed since the last time you received supplies, please contact a home medical representative from your respective location.

Insurance Replacement Guidelines
The replacement frequency and quantities for supplies are based on established insurance guidelines. The recommended timeframes for each item are listed below in parentheses and reflect how supplies are dispensed.

Medicare Requirements
Medicare requires an initial visit with your physician or qualified medical practitioner, as well as an updated prescription at least once per year. During these visits, your provider must document that you are using and benefit from your PAP therapy. This documentation must be maintained on file with our company in order to continue receiving supplies under Medicare coverage.

All insurance plans: You will be responsible for any deductible or co-pay before we can bill your insurance.

Additional Information

This form is for current HealthPartners and Park Nicollet CPAP patients only.

Please select the CPAP supplies you'd like to refill. We'll refill items based on what you've received in the past. Unless noted below, insurance-approved 90-day amounts of disposable filters, cushions, and pillows will be provided.

*Note: Medica and Medical Assistance guidelines limit supply orders to 30-day quantities.

Other Concerns