How to claim for CPAP devices

Q: Can I claim for a replacement machine if it's still under warranty?

You can’t claim for a replacement machine if it’s still under warranty. In this case, contact the manufacturer.

We cover Continuous Positive Airway Pressure (CPAP), Bi-level Positive Airway Pressure (BiPAP), and similar devices. To keep things simple, we refer to them as “CPAP machines”.

If your cover includes benefits for a CPAP-type device, you can claim for it as a Hospital claim. You can claim for it online using My Medibank app or My Medibank on the web by following the instructions on this page: How to make a Hospital claim. You can also claim for it offline using the steps below.

Please note that if you want to claim for a breathing appliance like a nebuliser, spacing device, or peak flow meter, this is an Extras claim. Click here to claim for a breathing appliance.

Before you start your claim for a CPAP machine, make sure that:

- You’ve served any relevant waiting periods. If you’re not sure, you can check whether you’ve served your waiting period under "Limits" in My Medibank.
- You’ve undergone an overnight sleep study for sleep apnoea that’s covered or partially covered by Medicare.
- You purchased or hired the machine within 12 months after the sleep study.
- You purchased or hired the machine in Australia.
- If you purchased a machine, it's new (rather than second-hand).
- You have the required documents – see below for details.

If you're not sure whether you're eligible to claim, you can check your cover summary, as well as limits and waiting periods, on My Medibank online, or the My Medibank app.

Required documents

You'll need to provide some documents to support your claim. The documents you need will depend on whether you've successfully claimed for a CPAP machine before. For more information, select from the options below:

You have received benefits from Medibank for a CPAP machine before

You have received benefits from another health fund for a CPAP machine before

You have never received benefits for a CPAP machine before

You’ll need proof that you’ve undergone a sleep study sometime in the 12 months before getting the machine. This proof can be a previous sleep study claim that you’ve made via Medibank (you won’t need to provide proof of this as this information is already available to us), your sleep study results, or a letter from your Doctor. You’ll also need an invoice or receipt for the hire or purchase of a CPAP machine.

Note: The receipt or invoice needs to shows the provider ID and the item number for your treatment, and be dated within the last two years

Claim instructions

1. Download claim form
  
  Download this Claim Form, ready to fill in with your details.
2. Fill in member and claim information
  
  Fill in the member information (either for yourself or the person on the policy you’re claiming for) and requested claim information. Under “Claim Type” select “Hospital”.
3. Sign and date
  
  Sign and date the declaration, at the bottom of the page.
4. Attach documents
  
  Include the required documents (outlined in checklist above) to support your claim.
5. Submit
  
  Post your completed claim form and documents to: Medibank, Medical and Extras Claims, Reply Paid 2984, GPO BOX 2984, Melbourne VIC 3001.
  
  Alternatively, submit your completed claim form and documents in person at a Medibank store.

Download the My Medibank app

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Frequently Asked Questions

Can I claim for a replacement machine if it's still under warranty?

Can I claim for someone else?

You can claim for someone else on your policy, but you can’t submit a single claim form for more than one person at a time. You’ll need to do a separate claim form for each person. Please keep in mind that unless we have the other person’s consent, we won’t be able to discuss the details of the claim once it has been submitted.

To authorise someone else to act on your behalf when dealing with Medibank, apply using this Authority form.

Can't find the answers you are looking for? We're here to help.

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Things you should know:

If you’re on Overseas Student Health Cover (OSHC), please visit OSHC Help & Support to find out more about claiming for a CPAP machine, or call our OSHC 24/7 Student Health and Support Line on 1800 887 283.

Claims submitted in store will be processed separately (at a later date) and pay benefits to you, the hospital or the provider, as appropriate.

Some claims, like paper based, may take longer to update.

Following the government changes on 1 April 2019, all private health insurers are no longer permitted to pay benefits towards some natural therapy services. Read more about the changes to some natural therapies.