Medical Equipment - Breathing Devices
Overview
The least expensive, appropriate breathing devices may be provided to specific recipients to assist with a medically essential need. There must be no other resources available to the client to provide the breathing device requested.
The ministry provides breathing devices under the Employment and Assistance Regulation and the Employment and Assistance for Persons with Disabilities Regulation.
Policy
Effective: February 5, 2019
Breathing devices include only the following types of items:
- positive airway pressure devices
- apnea monitors
- suction units
- percussors
- nebulizers
- medical humidifiers
- inhaler accessory devices
Effective: February 5, 2019
Breathing devices are available to clients who are eligible for general health supplements or meet the Life Threatening Health Need criteria. [For information on eligibility for general health supplements, see Related Links - Health Supplement Summary.]
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
A client requesting a breathing device must meet general requirements that apply to all breathing devices:
- there are no resources available to the family unit to pay the cost of or obtain the breathing device;
- the item is the least expensive, appropriate breathing device;
- must be prescribed by a medical practitioner or nurse practitioner; and
- if a Positive Airway Pressure Device, the medical need must be confirmed by the assessment of a respiratory therapist; or
- if another item, the medical need must be confirmed by the assessment of a relevant therapist (respiratory, occupational, or physical); and
- the request must be pre-approved by the ministry prior to purchase.
Note: the ministry will not accept payment responsibility, except in cases of a life-threatening emergency, for breathing devices purchased without prior approval.
|
Type of Item |
Specific Requirements |
|---|---|
|
Positive Airway Pressure Devices |
|
|
Apnea Monitor |
|
|
Suction Unit |
|
|
Percussor |
|
|
Nebulizer |
|
|
Medical Humidifier |
|
|
Inhaler Accessory Device (e.g. spacer) |
|
When clients no longer require the breathing device and it cannot be exchanged or traded to meet a current need, they should be encouraged to donate the item to an agency that would benefit from that item.
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. For income assistance and disability assistance clients, 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, the individual is not 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, exempt assets are not considered. When assessing other resources for persons with a life-threatening health need, persons who are medical services only or transitional health services, see Related Links – Life-Threatening Health Need, Medical Services Only, or Transitional Health Services.
Effective: February 5, 2019
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 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 [see Additional Resources – HealthLinkBC – Stages of Sleep Apnea].
Effective: February 5, 2019
The ministry has a contract with Positive Airway Pressure Device service providers throughout the province.
Contracted service providers are the supplier of choice when purchasing Positive Airway Pressure Devices, accessories and supplies. However, when an item is not available or a contracted Service Provider is not available in your area, non-contracted service providers may be considered.
The contracted Positive Airway Pressure Device service providers provide the following service as part of their contract:
- Fitting and trial of Positive Airway Pressure Devices;
- Provide training for set up and use of Positive Airway Pressure Devices;
- Repair and service of Positive Airway Pressure Devices;
- Administer any warranties.
- Free suitable loaner Positive Airway Pressures devices while the Positive Airway Pressure device is being repaired or serviced during the coverage period.
(Note: If the service provider did not supply the original Positive Airway Pressure Device, then the cost of the loaner, while it is being repaired, may be covered by the ministry.)
Contracted Positive Airway Pressure Device service providers are located in the following areas:
|
Name |
Locations |
Toll Free / Phone / Email |
|
Vancouver Island / Sunshine Coast |
||
|
AvantSleep |
Langford |
778-265-3109 |
|
CanSleep (Westshore) |
Victoria |
1-888-512REST |
|
Clinical Sleep Solutions |
Sechelt Gibson |
1-800-732-7985 |
|
Coastal Sleep |
Nanaimo |
1-877-241-9066 |
|
Independent Respiratory Services |
Duncan Nanaimo Port Alberni Qualicum Beach Sooke Sydney Victoria |
1-877-965-6204 |
|
Island CPAP |
Campbell River Courtenay Nanaimo Powell River |
250-287-5296 250-897-5296 250-390-0787 604-344-1555 |
|
Island Sleep Health Services (Can Sleep Services) |
Victoria |
250-592-7378 |
|
MedPro |
Colwood Duncan Nanaimo Victoria |
1-888-310-1444 info@medprorespiratory.com |
|
Pacific Sleep Care |
Campbell River Courtenay Duncan Nanaimo |
1-866-210-6585 |
|
Provincial Sleep Group |
Victoria |
250-370-9332 |
|
Respiratory Homecare Solutions |
Duncan Nanaimo Port Alberni Victoria |
1-877-701-0424 |
|
Sleep Easy Respiratory Services |
Cobble Hill |
1-844-887-5337 |
|
VitalAire |
Courtenay Nanaimo Powell River (appt only) Qualicum Beach Victoria |
1-800-637-0202 |
|
Mainland / Southwest |
||
|
AvantSleep |
Burnaby Maple Ridge North Vancouver Vancouver |
1-800-209-2841 ext 7 778-379-4779 778-379-4779 778-379-4779 |
|
Bayside Sleep Solutions |
Delta
|
1-877-483-3607 |
|
CanSleep |
Burnaby Coquitlam Delta New Westminster Surrey (Guilford) Surrey (Newton) |
1-844-SLEEP40 |
|
Clinical Sleep Solutions |
Abbotsford Burnaby Chilliwack Mission North Vancouver Richmond Squamish Surrey/White Rock Vancouver West Vancouver Whistler |
1-800-732-7985 |
|
Coastal Sleep |
Abbotsford Coquitlam Langley Richmond Surrey Vancouver White Rock |
1-877-241-9066 |
|
Custom Sleep Care |
Mobile |
1-844-278-9260 |
|
Independent Respiratory Services |
Abbotsford Chilliwack Delta/Ladner Gibsons/Sechelt Hope Maple Ridge Mission Richmond Surrey/Langley Vancouver |
1-877-965-6204
|
|
Inspire Sleep |
Surrey |
604-536-4353 |
|
Lower Mainland Sleep Aid Respiratory Inc. “Sleep Aid” |
Burnaby Langley Surrey |
604-262-0829 |
|
Mainland Sleep Diagnostics |
Abbotsford Burnaby Coquitlam Langley Richmond Surrey Vancouver Whistler |
604-370-6775 |
|
MedPro |
Abbotsford Langley Surrey Vancouver |
1-888-310-1444 |
|
Oxylife |
Chilliwack |
604-391-0050 |
|
Provincial Sleep Group |
Burnaby Langley |
604-298-5944 |
|
Respiratory Homecare Solutions |
Abbotsford Burnaby Coquitlam Langley Maple Ridge North Vancouver Richmond Surrey Vancouver West Vancouver |
604-630-1212 |
|
Respiratory Therapy Care Consultants |
Langley (Weekend clinics: Surrey) |
604-539-9098 |
|
Sleepworks Medical |
Burnaby (2) Coquitlam North Vancouver Pemberton Richmond Surrey (9) South Surrey Vancouver (4) |
604-372-4000
|
|
Vancouver Sleep Solutions |
Vancouver Mobile: North Vancouver, West Vancouver, Burnaby |
604-558-0055 |
|
VitalAire |
Abbotsford Chilliwack Langley Maple Ridge Surrey Vancouver |
1-800-637-0202 |
|
West Care Medical Ltd. |
Abbotsford Burnaby Chilliwack Coquitlam Port Coquitlam Vancouver |
1-888-540-8288 |
|
Thompson Okanagan |
||
|
AvantSleep |
Penticton |
236-422-3131 |
|
CanSleep |
Penticton |
1-844-SLEEP40 |
|
Good Sleep Health |
Kelowna Penticton Vernon |
250-862-3062 info@goodsleephealth.com 250-541-0078 250-493-1836
|
|
Independent Respiratory Services |
Kamloops Kelowna Oliver/Osoyoos Penticton Revelstoke Salmon Arm Vernon West Kelowna |
1-877-965-6204 |
|
MedPro |
Kamloops Kelowna Penticton |
1-888-310-1444 info@medprorespiratory.com |
|
OkanaMed |
Vernon Mobile throughout Okanagan |
250-306-6759 |
|
Oxylife |
Kamloops |
250-828-6726 |
|
Respiratory Homecare Solutions |
Kamloops Kelowna Merrit Vernon West Kelowna |
1-888-534-5024 |
|
VitalAire |
Kamloops Kelowna Penticton |
1-800-637-0202 |
|
Kootenay |
||
|
Columbia Respiratory |
Trail (Clinic locations in: Nelson, Grand Forks, Nakusp, New Denver) |
250-364-0277 |
|
Independent Respiratory Services |
Castlegar Cranbrook Creston Fernie Grand Forks Golden Invermere Nakusp Nelson Trail |
1-877-965-6204 |
|
Kootenay Respiratory |
Cranbrook (Clinic locations in: Boswell, Crawford Bay, Creston, Elkford, Fernie, Golden, Invermere, Jaffray, Kimberley, Sparwood) |
1-778-517-5600 |
|
MedPro |
Castlegar Cranbrook |
1-888-310-1444 info@medprorespiratory.com
|
|
OkanaMed |
Fauquier Golden Nakusp |
250-306-6729 |
|
VitalAire |
Cranbrook Trail |
1-800-637-0202 |
|
Cariboo |
||
|
Independent Respiratory Services |
100 Mile House Quesnel Williams Lake |
1-877-965-6204 |
|
Nechako |
||
|
AvantSleep |
Prince George |
236-601-1091 |
|
Independent Respiratory Services |
Prince George Vanderhoof |
1-877-965-6204 |
|
MedPro |
Prince George |
1-888-310-1444 info@medprorespiratory.com |
|
Oxylife |
Prince George |
250-563-1887 |
|
VitalAire |
Prince George |
1-800-637-0202 |
|
North Coast |
||
|
Independent Respiratory Services |
Kitimat Prince Rupert Smithers Terrace |
1-877-965-6204 |
|
North East |
||
|
Independent Respiratory Services |
Dawson Creek Fort St. John |
1-877-965-6204 |
|
Island CPAP |
Dawson Creek |
250-784-6608 |
|
MedPro |
Fort St. John |
1-888-310-1444 info@medprorespiratory.com |
|
VitalAire |
Grande Prairie |
1-800-637-0202 |
Effective: February 5, 2019
Recipients are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.
Effective: February 5, 2019
The ministry may consider repairing or replacing breathing devices due to the medical equipment being damaged, worn out, or not functioning.
Repairs may be considered if all of the following are met:
- It is more economical to repair, rather than replace, the breathing device;
- The breathing device has not been damaged by misuse;
- If the device was not previously provided by the ministry, all other eligibility requirements must be met (e.g., prescription, assessment).
Note: Repairs are not considered for breathing devices that are under warranty. Upon the end of the warranty, the ministry may consider funding repairs.
Replacement may be considered if all of the following are met:
- It is more economical to replace, rather than repair, the breathing device;
- The breathing device has not been damaged by misuse;
- The time period, if any, set out in the table below has passed.
Note: The replacement time period does not apply when an item is required due to changes 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 |
|
Apnea monitors, suction units, percussors, 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, nebulizer, or medical humidifier |
1 year |
Procedures
Effective: February 5, 2019
Persons who are income assistance or disability assistance recipients requesting breathing devices must first be determined to be eligible for general health supplements. If eligible, the following procedures must then be completed to assess eligibility for breathing devices.
Persons who are not income assistance or disability assistance recipients but require medical equipment for a direct and imminent life-threatening health need must meet the eligibility criteria for Life-Threatening Health Needs before being assessed eligibility for medical equipment and devices [see Related Link – Life Threatening Health Needs].
The ministry requires that all other available resources must first be considered before funding any requests. If there are other resources available, the individual is not eligible for breathing devices from the ministry. Co-funding may be considered when other resources cannot pay the entire cost [see Policy – No Other Resources].
Effective: February 5, 2019
All requests for positive airway pressure equipment must be assessed by Health Assistance (HA). To assess eligibility for positive airway pressure equipment, follow these steps:
|
POC
|
1. |
Confirm that the recipient is eligible for general health supplements or are making an application under life-threatening health needs [see Policy]. |
|
2. |
Provide client with list of Contracted Positive Airway Pressure Device Service Providers and advise the client what information is required to complete the application. Note: The Medical Equipment Request and Justification form (HR2138) is available through Contracted Service Provider The assessment should include a current baseline overnight oximetry (completed within the past six months) or polysomnogram (completed without CPAP or BIPAP) to demonstrate severity of obstructive sleep apnea (OSA). The ministry only funds CPAP or BIPAP for moderate to severe OSA. |
|
|
3. |
Contracted Service Provider to submit completed HR2138 including client signature (Section 1), medical practitioner or nurse practitioner prescription (Section 2), and assessment of respiratory therapist (Section 3), quote and other required documentation as outlined above, to HA for adjudication. |
|
|
HA
|
1. |
Assess application and ensure that eligibility criteria are met. |
|
2. |
If approved, a purchase authorization will be sent to the service provider and client. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial. |
|
|
3. |
Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider. |
Effective: February 5, 2019
Clients requesting breathing devices must first be determined to be eligible for general health supplements or approved under life-threatening health needs. All other resources must first be considered before the ministry funds any payment of breathing devices.
Health Assistance (HA) will assess a client’s eligibility for the purchase of breathing devices, follow these steps:
|
POC
|
1. |
Confirm that the recipient is eligible for general health supplements or are making an application under life-threatening health needs [see Policy]. |
|
2. |
Verify that there are no other resources available [see Policy]. |
|
|
3. |
Provide client with the Medical Equipment and Devices Request and Justification form (HR2138) and advise the client what information is required to complete the application. |
|
|
4. |
For all eligible breathing devices except positive airway pressure devices (for positive airway pressure devices – see separate procedures above), advise the client to take the HR2138 to their medical practitioner or nurse practitioner for completion of Section 2 and to their respiratory therapist, occupational therapist or physical therapist for an assessment and quote which is completion of Section 3. |
|
|
5. |
Forward the Service Request and all documentation to HA for adjudication. |
|
|
HA
|
1. |
Assess application and refer to policy to ensure eligibility criteria are met. |
|
2. |
If application is approved, an approval letter will be issued to the client and a purchase authorization will be sent to the service provider. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial. |
|
|
3. |
Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider. |
Note: If a diagnosis and prescription from a medical practitioner, or nurse practitioner and/or the assessment from the respiratory therapist are received before the HR2138 is completed, Section 1 must still be completed by the client and forwarded with the supplemental documentation to HA.
Effective: February 5, 2019
Note: All requests for repairs for Breathing Devices must be assessed by Health Assistance (HA).
For repairs of breathing devices, follow these steps:
|
POC |
|
Forward the Service Request and documentation outlining the repairs needed and the estimated cost to HA for review. |
|
HA
|
1. |
Assess the application and ensure that eligibility criteria are met. |
|
2. |
If approved, a letter will be issued to the client and a purchase authorization will be sent to the service provider. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial. |
|
|
3. |
Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider. |
Authorities and Responsibilities
Effective: February 2019
|
Breathing Devices |
|
|---|---|
|
Health Assistance |
|
