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If you’ve been diagnosed with sleep apnea in Ontario, one of your first questions might be: “Does OHIP cover CPAP Machines?”
Short answer: the Ontario Health Insurance Plan (OHIP) does not pay for CPAP, APAP, or BiPAP the “traditional” way (you can’t buy Sleep Apnea machines on Amazon and bill OHIP, and a quick family-doctor visit doesn’t unlock funding).
Coverage comes through Ontario Assistive Devices Program (ADP) in other words, CPAP is supported under ADP, not paid straight by OHIP.
The answer involves two important programs: OHIP and the ADP program (Assistive Devices Program). But they serve different roles, and it’s crucial to understand what each covers.
The Ontario Health Insurance Plan (OHIP) is the provincial public health insurance program. It pays for a wide range of medical services, from doctor visits to hospital stays. However, OHIP itself does not directly cover the cost of CPAP machines. Instead, it supports access through referrals and assessments done by sleep specialists.
The Assistive Devices Program (ADP) is a separate initiative run by the Ontario Ministry of Health. Its goal is to provide financial support for residents who need certain medical devices — including Continuous Positive Airway Pressure (CPAP) machines, which are essential for treating obstructive sleep apnea.
In Ontario, it’s the ADP program, not OHIP, that contributes directly to the cost of a CPAP machine. ADP typically covers 75% of the approved price of the device. The remaining 25% is your responsibility, unless you have private insurance to bridge the gap.
People often conflate OHIP and ADP because both are provincial programs. But here’s the key difference:
In essence, OHIP sets you up with the diagnosis and medical pathway. ADP helps pay for the equipment.
The ADP program includes a few types of sleep apnea devices:
Each device type must meet ADP’s medical necessity criteria, and funding requires a prescription from a qualified sleep physician.
No. If you’re already an OHIP-insured resident of Ontario, you don’t need to submit anything for OHIP support related to sleep studies or medical consultations. For the ADP program, however, there is a separate application process, typically handled in collaboration with your medical provider and a registered vendor (more on that later).
When someone asks, “Does OHIP cover CPAP machines?” — the most accurate answer is:
The Ontario Health Insurance Plan (OHIP) does not pay for CPAP, APAP, or BiPAP the “traditional” way (you can’t buy Sleep Apnea machines on Amazon and bill OHIP, and a quick family-doctor visit doesn’t unlock funding) but it helps set the stage for ADP to fund 75% of the cost, provided you meet eligibility criteria.
Coverage comes through Ontario Assistive Devices Program (ADP) in other words, CPAP is supported under ADP, not paid straight by OHIP.
Understanding these two programs side-by-side is the first step to getting proper sleep apnea treatment without financial surprises.
You’ve just been diagnosed with obstructive sleep apnea, and your doctor recommends a CPAP machine. Naturally, your next thought is: “How soon can I actually get one through the ADP program?” The timeline depends on several moving parts — but let’s break it down into manageable phases so you know what to expect.
This is the part covered under OHIP — you’ll undergo a sleep study in-lab polysomnography. Once your physician reviews the results and determines a medical need for CPAP therapy, they’ll issue a prescription.
The key problem isn’t just ADP paperwork — it’s getting a family doctor to assess you and sign the forms. If you don’t have one, you’ll likely end up at a walk-in clinic, where waits of 3–4 hours are common. And many people are in this boat: according to Canadian Institute for Health information, the latest national data shows roughly 17% of Canadians don’t have a regular primary-care provider (family doctor or NP). Among recent immigrants (in Canada <10 years), about 23% lack a regular provider, making the first appointment — and your ADP timeline — harder to start.
This is the key trigger for ADP eligibility.
At this stage, your doctor or sleep clinic will likely refer you to an ADP-registered vendor to begin the funding application process.
Here’s where timelines can vary. After your referral, you’ll:
The purpose of the trial is to determine which type of positive airway pressure device works best for you (CPAP vs. APAP vs. BiPAP) and what pressure settings you need.
The vendor collects usage data during this period and reports it back to your prescribing physician.
After your trial period ends:
Most vendors handle the paperwork on your behalf, and turnaround times from the Ministry are relatively quick.
Once ADP approves the application:
Some vendors allow you to pay the 25% up front during the trial period, which speeds up final delivery.
Let’s summarize the process:
Total time from diagnosis to device in hand: Typically 8 weeks.
Some common bottlenecks include:
You can speed things up by:
Waiting weeks for a device isn’t just inconvenient — it’s discouraging. The ADP program’s layered approvals, appointments, and vendor scheduling can slow things down, and even with funding, you’re still handling paperwork and a 25% co-pay. The process may ensure the right machine and settings, but it often feels like bureaucracy first, relief later.
Many Ontario residents are surprised to learn that OHIP does not directly pay for CPAP machines, even though it’s the province’s main healthcare program. However, OHIP plays a significant role in the treatment journey. To understand how it works, let’s look at what OHIP actually covers — and how it supports access to CPAP therapy indirectly.
While OHIP doesn’t buy the CPAP machine itself, it does cover the essential diagnostic and consultation services that lead to your CPAP prescription. Specifically:
In other words, OHIP covers the medical side — everything from noticing the problem to confirming the diagnosis and issuing the prescription.
Here’s the important link: you must be covered by OHIP to qualify for ADP. That means:
Only then will the ADP program approve funding for a CPAP machine. Think of OHIP as the gatekeeper that opens access to ADP support.
Despite OHIP’s extensive healthcare coverage, it won’t pay for:
Those fall under either ADP funding (initial machine) or private insurance/personal expense (ongoing costs).
Technically yes, if you want to pay for everything privately.
But without OHIP:
Let’s simplify it:
So while OHIP doesn’t pay for the device, it is still central to your sleep apnea treatment path.
If you’re wondering whether you’re eligible for financial support through Ontario’s ADP program, the good news is that the qualifications are fairly well-defined. However, meeting the criteria involves more than just having sleep apnea — there are residency, medical, and procedural requirements you need to understand.
To qualify for ADP assistance with a CPAP or related device in Ontario, you must meet all of the following:
Your prescribing physician must be licensed in Ontario and approved to participate in the ADP funding stream.
ADP doesn’t fund CPAP machines just because you snore or feel tired. You must undergo a diagnostic sleep study and be shown to have clinically relevant sleep apnea. According to provincial guidelines:
This evidence is included in the physician’s prescription and submitted as part of your ADP paperwork.
The ADP program requires that applicants complete a 2–4 week machine trial before full funding is granted. During this time, you’ll:
Only after demonstrating benefit from therapy will you be eligible for the final funding.
You may not qualify if:
However, in some borderline cases, your doctor may appeal for coverage if there’s significant impact on your health.
To be eligible for the ADP program, you must:
When in doubt, consult with your sleep doctor or a vendor familiar with ADP guidelines — they’re your best allies in navigating this system.
If you’ve reached the stage where a CPAP machine is recommended, you may assume OHIP will foot the bill — but that’s not entirely the case. Understanding exactly what’s covered by OHIP, what isn’t, and what falls under ADP or private insurance is essential to avoid unexpected costs.
Let’s be clear: OHIP covers the clinical pathway to treatment, which includes:
This means the entire diagnostic process — from identifying symptoms to confirming a diagnosis and managing follow-up — is free at the point of use for anyone with valid OHIP coverage.
Where OHIP steps back is in the equipment phase. The following items are not covered by OHIP:
These costs fall under:
Many patients are surprised by these exclusions. Some mistakenly believe OHIP covers the entire process, including the machine and supplies. This confusion arises because OHIP and ADP are often mentioned together, but they are distinct programs.
Here’s a quick comparison:
| Service or Product | Covered by OHIP | Covered by ADP |
|---|---|---|
| Sleep study and diagnosis | Yes | Yes |
| Physician consultation | Yes | Yes |
| CPAP/APAP/BiPAP machine (initial) | No | Yes (only 75%) |
| CPAP mask, hose, filters | No | No |
| Follow-up physician assessments | Yes | No |
Unfortunately, OHIP has strict boundaries when it comes to equipment coverage. You cannot request additional funds for machines or supplies directly through OHIP.
However:
What are the main takeaways? OHIP is crucial for your diagnosis and medical oversight, but you’ll need to rely on ADP or insurance for equipment needs.
If you’ve made it this far, you probably know that Ontario’s Assistive Devices Program (ADP) covers 75% of the cost of a CPAP machine — but what does that really mean in dollars? And what exactly are you responsible for paying?
Let’s walk through a clear breakdown of CPAP-related costs under the ADP program so you know what to expect — and how to plan.
The ADP covers 75% of the approved base price of CPAP devices and related setup services, but only through vendors who are registered with the program.
This includes:
Note: The amount ADP will pay is not based on the market price but on a fixed, government-approved maximum cost for each type of device.
Example (estimates):
If your vendor’s price is higher than the ADP cap, you will be responsible for any extra on top of your 25% share.
Unless you have private or employer-based insurance, you’ll be responsible for the following costs:
Some people opt for enhanced models or premium comfort features not covered by ADP, like heated tubing or automatic humidifiers. These will increase your cost and are not reimbursed.
Most group or extended health insurance plans will cover:
Make sure to:
If you have no insurance, ask your vendor about financing or payment plans — many offer monthly options.
Most vendors allow you to start with a trial machine, and you’re only billed your 25% share after the trial ends and you’ve selected your final machine. Some vendors ask for the 25% portion up front — especially if you’re ordering upgraded features.
Your ADP application will not be processed until the trial period is completed, so budget for the full cost over about 6–8 weeks.
| Expense Category | Covered by ADP | You Pay (if no insurance) |
|---|---|---|
| Machine (base model) | 75% | 25% |
| Sleep study & diagnosis | OHIP | $0 |
| Upgraded model features | No | 100% |
| Masks & accessories | No | 100% |
| Repairs after warranty | No | 100% |
The ADP program significantly reduces the cost of getting a CPAP machine in Ontario — but it’s not entirely free. You’ll still need to budget for supplies and any upgrades beyond the standard coverage. Having private insurance makes a big difference.
Applying to the ADP program in Ontario can feel overwhelming, especially when you’re managing a new diagnosis like sleep apnea. But don’t worry — the process is structured and well-supported by your healthcare team and vendor. Here’s a detailed step-by-step guide to walk you through it.
Before anything can move forward, you need a confirmed diagnosis of obstructive sleep apnea (OSA) from an Ontario-licensed physician. This typically involves:
Once you’ve been diagnosed, your doctor will determine whether you meet the ADP program eligibility based on the severity and your clinical profile.
Your sleep clinic or physician will refer you to an approved ADP-authorized CPAP vendor. This vendor is crucial — they:
Only registered vendors can process ADP claims. You cannot apply directly to the government yourself.
Before you’re eligible for ADP funding, you must complete a 2–4 week trial period using a CPAP, APAP, or BiPAP machine. During this time:
This ensures that CPAP therapy is medically effective for your condition.
After the trial, you return to your doctor with the usage report. If:
Then your physician will complete their section of the ADP application.
The vendor finalizes the ADP forms, attaches your sleep study results, machine trial report, and the physician’s recommendation. They submit everything to the Ministry of Health on your behalf.
There’s no need for you to mail or email anything — your vendor handles the submission.
Once the ADP application is approved:
Some vendors let you prepay this amount during the trial to speed up the process.
Make sure you retain copies of:
You’ll need these if you apply for insurance reimbursement, future upgrades, or additional funding in 5 years.
This step-by-step structure is designed to ensure you receive not just a device, but the right device with appropriate medical supervision.
Getting a CPAP machine through Ontario’s ADP program is a huge help, but it’s only the start. CPAP therapy is ongoing, and the equipment you use needs regular care, occasional repairs, and periodic replacement. Let’s break down what happens after your initial machine is delivered — and what’s covered, what’s not, and what you should expect to maintain your therapy effectively.
The average CPAP machine lifespan is about 5 years — and that’s not a coincidence. It’s the same interval ADP uses for replacement eligibility. After this period, you may:
Even if your device seems to work fine, many users upgrade for better technology, quieter motors, or added features like mobile apps.
Most machines come with a 2 year warranty, BeC CPAP machines have 3 years warranty (depending on the brand and model). If something breaks within this time:
Out-of-warranty repairs are the user’s responsibility. OHIP and ADP do not cover repairs, even if the damage is not your fault.
Pro tip: If your machine fails just after warranty, ask your vendor to appeal to the manufacturer — many will still offer service or discounted upgrades.
Unlike the machine, your CPAP accessories need much more frequent replacement. Here’s a rough guide:
| CPAP Part | Replace Every |
|---|---|
| Mask cushion | 1–3 months |
| Full mask | 6–12 months |
| Filters | 1–3 months |
| Tubing | 6–12 months |
| Headgear | 6–12 months |
These items are not covered by ADP, so you’ll need to:
Many vendors offer supply bundles at a discount or send reminders when it’s time to reorder.
If you have extended health coverage, it likely includes CPAP supplies. Be sure to:
Additionally, CPAP equipment and supplies are eligible for the Medical Expense Tax Credit on your Canadian income tax return. Save your receipts!
Sometimes a CPAP machine fails before the 5-year ADP renewal window. Here’s what to do:
Proper care will save you money and keep your therapy effective.
CPAP therapy is a long-term commitment, and ongoing maintenance is part of the process. While ADP helps you get started, you’ll need to stay proactive about repairs and replacements. Work with a trusted vendor, keep records, and plan ahead for what’s not covered.
Filling out government forms isn’t exactly exciting — but for the ADP program, it’s a crucial part of securing funding for your CPAP machine. Luckily, most of the paperwork is handled by your vendor and physician, but you should still know what’s involved so there are no surprises.
Here’s a complete checklist to keep the process smooth, fast, and stress-free.
This is the official ADP form for respiratory devices, including CPAP and BiPAP machines. It must be:
🛈 This form is not downloadable for public use. Vendors have secure access and will print and prepare it during your visit.
You’ll need to show that you’re eligible for ADP funding, which means:
Your vendor will usually make a copy of your card at your first appointment.
After your 2–4 week trial, your vendor will print a detailed usage and compliance report. This includes:
This report proves that the machine is medically necessary and effective.
Your physician must include your diagnostic sleep test results, showing the severity of your sleep apnea (AHI, RDI, oxygen desaturation, etc.).
These results support your medical eligibility for ADP funding.
You must have an official prescription for a:
This is often written after your trial period ends, based on how your body responded to the treatment.
You’ll need to:
This section also outlines that ADP will pay the vendor directly — you do not receive the money yourself.
If you plan to claim your 25% share through an insurer, keep:
This can speed up any insurance reimbursement process.
| Document | Who Provides It |
|---|---|
| ADP Application Form (1027E) | Vendor & Physician |
| OHIP Card | You |
| CPAP Trial Report | Vendor |
| Sleep Study Results | Sleep Physician |
| Machine Prescription | Sleep Physician |
| Signed Consent | You (with Vendor) |
The paperwork may seem daunting, but remember: your vendor handles most of it. Just be prepared, ask questions, and don’t rush.
It’s easy to assume that once you’ve been diagnosed with sleep apnea, everything else — including getting your machine — will fall neatly into place. But the truth is, funding your CPAP device in Ontario through the ADP program involves a few potential missteps that can cost you time, money, or access to coverage.
Here’s a list of the most common traps — and how to steer clear of them.
This is probably the most frequent mistake.
If you buy a CPAP machine before completing the ADP-approved trial period with a registered vendor, you won’t be eligible for funding. The Ministry of Health will not reimburse purchases made outside of ADP protocol.
Avoid this by:
Only vendors registered with the ADP program are allowed to submit applications and receive funding on your behalf.
If you choose to buy your machine from an unregistered source (like a U.S. supplier or an online seller not linked to ADP), you lose access to the 75% coverage.
Avoid this by:
Some people try to self-diagnose or use third-party sleep testing services that aren’t recognized by OHIP or ADP. This is risky.
ADP funding requires a medical diagnosis from a licensed Ontario sleep specialist based on approved testing methods.
Avoid this by:
Even if everything goes well during your trial, missing a physician signature, outdated OHIP info, or failing to sign consent can cause delays or rejections.
Avoid this by:
Vendors may offer upgraded features, premium masks, or accessories not covered by ADP. If you agree without realizing the difference, you’ll pay more than expected.
Avoid this by:
Many assume that ADP continues to cover masks, hoses, filters, and other parts. But ADP only covers the initial machine, not ongoing supplies.
Avoid this by:
ADP only funds a new machine once every five years. If your machine breaks early and can’t be repaired, you’ll likely need to cover the full cost yourself or through insurance.
Avoid this by:
ADP pays your vendor — not you. If you try to buy privately and get reimbursed, it won’t work.
Avoid this by:
Your best defense against all these traps? Ask questions. A reputable vendor and sleep clinic will guide you through the process and help you avoid costly missteps.
By now, it’s clear that Ontario’s system for funding CPAP therapy involves multiple players — and multiple steps. If you’re feeling a bit overwhelmed, here’s a concise roundup of the most important things to remember when navigating OHIP and the ADP program.
Keep copies of:
It’ll help with warranty issues, reapplications, and insurance reimbursement.
Ontario’s CPAP funding system won’t cover everything, but it makes treatment accessible to most people who follow the steps. Understanding how OHIP, ADP, and insurance work together gives you a powerful edge.
Sleep apnea is not officially classified as a disability in Ontario under most provincial or federal programs. However, in severe cases where it causes significant impairment in daily function or contributes to other health conditions, individuals may qualify for accommodations at work or school — or even federal disability tax credits. Always consult with your healthcare provider and a tax professional if your condition severely affects your quality of life.
If you can’t afford the 25% co-pay after ADP funding:
Yes, most private insurance plans in Ontario cover:
You’ll need to:
Check your specific policy for annual maximums and renewal limits.
OHIP does not cover the machine itself. It pays for:
The machine is covered through ADP, which pays 75% of the approved base cost. You pay the rest.
For example:
There are no age restrictions for adults applying for CPAP coverage through ADP. However, pediatric patients (under 18) may have slightly different evaluation criteria and device recommendations. A pediatric sleep specialist must be involved in those cases.
Yes. CPAP machines are portable and safe for travel. If you’re going abroad:
Some airlines allow you to use a CPAP during flights — but you must check in advance.
No, but if you discontinue use during the trial period, your ADP application may be denied. After you own the machine, you’re not obligated to continue therapy — but stopping without medical advice can harm your health.
Once ADP funding has been applied to a machine, it’s considered a completed transaction. If you want to upgrade later, you’ll pay the full cost out of pocket — ADP will not fund a second machine within the 5-year window.
Don’t throw it in the trash. Instead:
If you’ve been diagnosed with sleep apnea in Ontario, one of your first questions might be: “Who pays for the machine that helps me breathe at night?” The answer involves two important programs: OHIP and the ADP program (Assistive Devices Program). But they serve different roles, and it’s crucial to understand what each covers.
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