Medical Equipment - Breathing Devices

Effective:  September 1, 2024

Breathing devices include only the following types of items:

• Positive airway pressure devices
• Mandibular advancement devices (MAD)
• Apnea monitors
• Suction units
• Percussors
• Cough assist devices
• Nebulizers
• Medical humidifiers
• Inhaler accessory devices

Effective:  September 1, 2024

Breathing devices are available to recipients who are eligible for general health supplements or meet the life threatening health needs criteria. Learn more about the eligibility for general health supplements by reviewing the health supplement summary section.

A requested item must meet the following:

• General requirements for all breathing devices

and

• Specific requirements for each individual type of breathing device

General requirements for all breathing devices

To receive help to get a breathing device, you must meet these conditions: 

• There are no resources available to the family unit to pay the cost of or obtain the breathing device
• The item must be the least expensive, appropriate breathing device
• The item must be prescribed by a medical practitioner or nurse practitioner

and

• If a Positive Airway Pressure Device or a Mandibular Advancement Device (MAD), a respiratory therapist must confirm the medical need  

or

• If it’s a different device, a relevant therapist (respiratory, occupational, or physical) must confirm the medical need

and

• The ministry must approve the request before the device is bought

Note: The ministry will not pay for breathing devices that are bought without approval – unless it’s a life-threatening emergency.

Specific requirements for each individual type of breathing device

Type of Item	Specific Requirements
Positive Airway Pressure Devices	The ministry is satisfied that the positive airway pressure device or supply or accessory to operate the device is medically essential for the treatment of moderate to severe sleep apnea
Apnea Monitor	The ministry is satisfied that the apnea monitor, accessory, or supply is medically essential to monitor breathing
Mandibular Advancement Device (MAD)	The ministry is satisfied that you are intolerant to positive airway pressure devices and that the mandibular advancement device (MAD) is medically essential for the treatment of moderate to severe sleep apnea
Suction Unit	The ministry is satisfied that the suction unit, accessory, or supply is medically essential for clearing respiratory airways
Percussor	The ministry is satisfied that the percussor, accessory, or supply is medically essential for clearing respiratory airways
Cough Assist Device	The ministry is satisfied that the cough assist device, accessory, or supply is medically essential for clearing respiratory airways
Nebulizer	The ministry is satisfied that the nebulizer, accessory, or supply is medically essential to avoid an imminent and substantial danger to health Medically essential to avoid an imminent and substantial danger to health refers an immediate need for a nebulizer where, without the nebulizer, you are at risk for compromised health For example: To avoid a significant health risk, you have been provided with medication by Pharmacare that cannot be delivered without a nebulizer If you have cystic fibrosis and require hypertonic saline delivered by a nebulizer to avoid a significant health risk
Medical Humidifier	The ministry is satisfied that the medical humidifier, accessory, or supply is medically essential to moisturize air in order to allow a tracheostomy patient to breathe
Inhaler Accessory Device (e.g. spacer)	The ministry is satisfied that the inhaler accessory device, accessory, or supply is medically essential to deliver medication

If you no longer need your breathing device and it cannot be exchanged or traded to meet a current need, you can choose to donate it to an organization that could use it.

Effective:  February 5, 2019

The ministry does not provide medical equipment and devices that do not meet the eligibility criteria above. For example:

• Ventilators

Effective:  February 5, 2019

By regulation, the ministry requires that all other available resources must first be considered before requesting funding. If you are receiving income assistance or disability assistance, other resources include (but are not limited to) accessing breathing devices or funding through:
 

• Other government programs or funding sources (e.g., Fair PharmaCare, Health Authorities, ICBC, WorkSafeBC, Veterans Affairs Canada)
• Private insurance

If there are other resources available, you would not be eligible for breathing devices from the ministry.

Co-funding may be considered when other resources cannot pay the entire cost. For example, if an insurance company will pay $500 for an item that costs $1000, the ministry may consider funding the remaining $500 if all other eligibility criteria are met.

Note: When assessing breathing device eligibility for income or disability assistance clients, the ministry does not consider exempt assets. Review the related topics for more information when assessing other resources for persons with a life-threatening health need, persons who are eligible for Medical Services Only or Transitional Health Services.

Effective: September 1, 2024

Sleep apnea occurs when a person regularly stops breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, based on the number of times an hour that the person stops breathing (apnea) or that airflow to the lungs is reduced.

The ministry will consider funding positive airway pressure devices or mandibular advancement device (MAD) when medically essential for treatment of moderate to severe sleep apnea based on information provided by the Respiratory Therapist. 

To determine whether sleep apnea is moderate to severe, ministry staff use guidelines determined by Ministry of Health. Learn more about the stages of sleep apnea through HealthLinkBC.

Effective:  February 5, 2019

You are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.

Effective:  September 1, 2024

The ministry may help repair or replace a breathing device if it is damaged, worn out, or no longer working. 

Repairs may be considered if all of the following are met:

• It costs less to repair the device than to replace it
• The damage was not caused by misuse
• If the device was not originally provided by the ministry, the client must still meet all eligibility requirements (e.g., having a prescription and assessment)

Note: The ministry does not cover repairs for devices that are still under warranty. Once the warranty ends, repairs may be considered.

Replacement may be considered if all of the following are met:

• It costs less to replace the device that to repair it
• The damage was not caused by misuse
• Any required time period for replacement, (listed in the table below) has passed

Note: The replacement time period does not apply if the device is needed due to a change in a person’s medical condition.

Breathing Device	Replacement Time Period
Positive Airway Pressure Devices	5 years
Accessories or supplies required to operate a positive airway pressure device	1 year
Mandibular Advancement Device (MAD)	5 years
Apnea monitors, suction units, percussors, cough assist devices, nebulizers, medical humidifiers	5 years
Inhaler Accessory Device (e.g. spacer)	1 year
Accessories or supplies required to operate an apnea monitor, suction unit, percussor, cough assist devices, nebulizer, or medical humidifier	1 year

Effective:  February 5, 2019

If you are receiving income assistance or disability assistance, you must first be approved for general health supplements. If approved, the ministry will then assess whether you qualify for a breathing device.

If you are not receiving income assistance or disability assistance, you may still qualify if you have a direct and imminent life-threatening health need. You must meet the eligibility criteria for life-threatening health needs before being assessed for medical equipment and devices.

The ministry requires that all other available resources must first be considered before funding any requests. If there are other resources available, you would not be eligible for breathing devices from the ministry. Co-funding may be considered when other resources cannot pay the entire cost. For more information, review the no other resources section.

Effective: August 1, 2025

The ministry may cover the cost of CPAP or BIPAP devices for moderate to severe obstructive sleep apnea (OSA).

If an you cannot use a CPAP or BIPAP machine, the ministry may fund a Mandibular Advancement Devices (MAD) instead – if an assessment shows you are unable to tolerate other devices.

How to request a new device:

1. Get a quote from a service provider.
2. Complete the Breathing Device Request and Justification form (HR3727).
3. Make sure the form includes:

• Section 1: Client’s signature
• Section 2: A recommendation from a doctor or nurse practitioner, or a copy of the prescription
• Section 3: An assessment from a respiratory therapist

You can submit the form and any other documents to the ministry in person, by mail, or by fax. The ministry will review your request and make a decision.

Effective:  September 1, 2024

To ask for a repair, you need to provide documents that explain what needs to be fixed and how much it will cost.

If the repair is approved:

• The ministry will send you a letter
• A purchase authorization will be sent directly to the service provider

If the repair is denied:

• You will receive a letter explaining why
• You will be offered the right to request a reconsideration 

Note: For detailed instructions and required documents, please see page 2 of the Breathing Device Request and Justification form (HR3727).

Effective:  February 2019

Breathing Devices
Health Assistance	Assessing eligibility for all Medical Equipment - Breathing Devices purchases and repairs