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Ontario: Provides 1 machine/5 years and no accessories?
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TorontoCPAPguy Offline

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Posts: 143
Joined: May 2012

Machine: S9 Autoset II
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro FFM
Humidifier: H5i; Control III Germicide
CPAP Pressure: 12-20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50EW Oximeter; Everflo Q O2 Concentrator; O2 Analyzer; Climate Control Hose (winter)

Sex: Male
Location: Toronto; Southern USA; etc.

Post: #1
Ontario: Provides 1 machine/5 years and no accessories?
Anyone have a handle on those of us who have no health insurance in Ontario, Canada, asides from OHIP (government) coverage?

Spoke to ADP today and they tell me they will provide one APAP setup on Rx and that is it for FIVE YEARS. No filters, masks, hoses, nothing! Ditto sleep studies under OHIP?

And as a dualie (I am also a US Citizen) I have never had income generated in the USA and gather I am not eligible for ANY stateside benefits.

Ah well.

----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.
05-30-2012 08:37 PM
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PaulaO2 Offline
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Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: Ontario: Provides 1 machine/5 years and no accessories?
US Medicare is dependent on the deductions from your paycheck. So if you've never worked in the US (and paid that deduction), you are not eligible. You would not be eligible for disability income either (SSDI). Medicaid is state funds for those with very low income. You're probably not eligible for that, either, as you'd have to establish residency in a US state.

I know nothing about Canadian health care so I can't help with that avenue. There are a lot of online dealers who sell for very low prices. The suppliers list has a Canadian supplier listed. #20.
http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List

I poked around a little via Google and couldn't find much. Couldn't find any kind of schedule like there are for Medicare.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-30-2012 09:20 PM
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kitley Offline

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Posts: 104
Joined: Mar 2012

Machine: resmed s9 elite
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: resmed s9 elite
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Ontario, Canada

Post: #3
RE: Ontario: Provides 1 machine/5 years and no accessories?
Hi there...I am from Ontario as well, and just purchased my machine today. My insurance coverage booklet from work says I have extra coverage there, but my predetermination was sent back as I am not eligable. I will need to contact my union rep to sort out whether or not I should be covered for the rest. So, at this point I bought mine as though I had no extra insurance coverage. Here is what I got and what I had to pay after Ontario paid their share......

The machine I purchased is a Resmed S9 Elite, and I purchased only what I had to have at this point...no extras.

Mask...(Mirage FX Nasal..they gave me 2 of these).........$275.00
Resmed S8 Elite CPAP machine, humififier included.........$1040.00

Sobtotal................................................................$1315.00​
Tax.......................................................................$0.00
Patient pays............................................................$535.00

Also included all I needed...ie...machine, humidifier, mask, hose, nasal pillows, and case. Also OHIP paid for my sleep study, and the sleep study for titration. My nasal pillows are good for 6 to 12 months and cost about $40.00 each to replace. Not sure how much a new filter is...I need to buy a new one every 6 months. I did not buy extended warranty nor maintenance coverage. Any Drs appointments are covered by OHIP...and billed directly, as is the CPAP...ie...I did not need to pay first and then submit to receive their share. Hope this info helps. Also if I want to purchase a different mask, ie nasal it runs about $300.00. Also, I thought OHIP covered a new machine every 3 or 4 years, rather then every 5, but I might just be mistaken on that....I don't have the best memory..lol
05-30-2012 09:24 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: Ontario: Provides 1 machine/5 years and no accessories?
Spare a thought for us here down under we have to pay for everything out pocket and no subsidy from government and insurance doesn't cover masks or supplies just one off rebate approx $500 for the machine which is cheaper to buy 0n-line and forfeit the rebate.

I've this link from "Ontario Ministry of Health and Long-Term Care" bookmark might be helpful for someone
http://www.health.gov.on.ca/english/public/pub/adp/cpap.html
05-30-2012 09:46 PM
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EyesWideOpen Offline

Preferred Members-2

Posts: 87
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed H5i
CPAP Pressure: 6 - 14
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: Ontario, Canada

Post: #5
RE: Ontario: Provides 1 machine/5 years and no accessories?
My understanding is that the Assisted Devices Program (ADP) of OHIP will pay for one machine (limited in value) which will be a CPAP machine unless the doctor really believes that you need an Autoset (must be written specifically in prescription) a standard hose and a mask. The rest is up to you. Replacement hoses and masks are better off purchased from the US on-line. I have used supplier number one many times, and have been happy. You will save almost 50% on most things. The Ontario prices are horrible, and the only reason that I buy my stuff here is because of my insurance company, even though I could save the tax payers a ton of money.

ADP will no longer automatically replace your CPAP machine after 5 years unless it's defective. That was a change implemented last November.

Good luck!
06-02-2012 07:57 AM
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