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.

 

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

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

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, the person is at risk for compromised health.
    • For example:
      • To avoid a significant health risk, a person has been provided with medication by Pharmacare that cannot be delivered without a nebulizer.
      • A person with cystic fibrosis who requires 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

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

Campbell River

778-560-2344

campbellriver@avantsleep.com

Langford

778-265-3109

Victoria@avantsleep.com

CanSleep (Westshore)

Victoria

1-888-512REST

info@cansleep.ca

Careica Health Victoria

250-370-9332

victoriasleep@careicahealth.com

Clinical Sleep Solutions

Sechelt

Gibson

1-800-732-7985

info@clincialsleep.com

Coastal Sleep

Nanaimo

1-877-241-9066

info@coastalsleep.ca

Independent Respiratory Services

Duncan

Nanaimo

Port Alberni

Qualicum Beach

Sooke

Sydney

Victoria

1-877-965-6204

qa@irscanada.ca

Island CPAP

Campbell River

Courtenay

Nanaimo

Powell River

250-287-5296

250-897-5296

250-390-0787

604-344-1555

info@islandcpap.com

Island Sleep Health Services

(Can Sleep Services)

Victoria

250-592-7378

info@cansleep.ca

MedPro

Colwood

Duncan

Nanaimo

Victoria

1-888-310-1444

info@medprorespiratory.com 

Pacific Sleep Care

Campbell River

Courtenay

Duncan

Nanaimo

1-866-210-6585

info@pacificsleep.ca

Respiratory Homecare Solutions

Duncan

Nanaimo

Port Alberni

Victoria

1-877-701-0424

vancouverisland@rhscanada.com

Sleep Easy Respiratory Services

Cobble Hill

1-844-887-5337

Sleepeasy101@yahoo.ca

Sleeptech Qualicum Beach

1-877-597-5030

contactus@sleeptech.ca

VitalAire

Courtenay

Nanaimo

Powell River (appt only)

Victoria

1-800-637-0202

vahomecare.bc@airliquide.com

Mainland / Southwest

AvantSleep

Burnaby

Maple Ridge

North Vancouver

Vancouver

1-800-209-2841 ext 7

778-379-4779

778-379-4779

778-379-4779

Vancouver@avantsleep.com

Bayside Sleep Solutions

Delta

 

1-877-483-3607

info@baysidesleepsolutions.com

CanSleep

Burnaby

Coquitlam

Delta

New Westminster

Surrey (Guilford)

Surrey (Newton)

1-844-SLEEP40

info@cansleep.ca

Careica Health

Burnaby

Langley

604-298-5944

burnabysleep@careicahealth.com

Clinical Sleep Solutions

Abbotsford

Burnaby

Chilliwack

Mission

North Vancouver

Richmond

Squamish

Surrey/White Rock

Vancouver

West Vancouver

Whistler

1-800-732-7985

info@clincialsleep.com

Coastal Sleep

Abbotsford

Coquitlam

Langley

Richmond

Surrey

Vancouver

White Rock

1-877-241-9066

info@coastalsleep.ca

Custom Sleep Care

Mobile

1-844-278-9260

asleep@customsleepcare.ca

Independent Respiratory Services

Abbotsford

Chilliwack

Delta/Ladner

Gibsons/Sechelt

Hope

Maple Ridge

Mission

Richmond

Surrey/Langley

Vancouver

1-877-965-6204

qa@irscanada.ca

 

 

 

Inspire Sleep

Surrey

604-536-4353

contact@inspiresleep.ca

Lower Mainland Sleep Aid Respiratory Inc.

“Sleep Aid”

Burnaby

Langley

Surrey

604-262-0829

info@sleepaidclinics.com

Mainland Sleep Diagnostics

Abbotsford

Burnaby

Coquitlam

Langley

Richmond

Surrey

Vancouver

Whistler

604-370-6775

ministry@mainlandsleep.ca

MedPro

Abbotsford

Langley

Surrey

Vancouver

1-888-310-1444

info@medprorespiratory.com

Oxylife

Chilliwack

604-391-0050

oxylifechilliwack@gmail.com

Respiratory Homecare Solutions

Abbotsford

Burnaby

Coquitlam

Langley

Maple Ridge

North Vancouver

Richmond

Surrey

Vancouver

West Vancouver

604-630-1212

lowermainland@rhs.com

Respiratory Therapy Care Consultants

Surrey

236-988-9007

rtccbc@gmail.com

Sleeptech

Abbotsford

Surrey

Vancouver

1-877-597-5030

contactus@sleeptech.ca

Sleepworks Medical

Burnaby (2)

Coquitlam

North Vancouver

Pemberton

Richmond

Surrey (9)

South Surrey

Vancouver (4)

604-372-4000

info@sleepwm.com

 

Vancouver Sleep Solutions

Vancouver

Mobile: North Vancouver, West Vancouver, Burnaby

604-558-0055

Info@vancouversleepsolutions.com

VitalAire

Chilliwack

Langley

Maple Ridge

Surrey

Vancouver

1-800-637-0202

Vahomecare.bc@airliquide.com

West Care Medical Ltd.

Abbotsford

Burnaby

Chilliwack

Coquitlam

Port Coquitlam

Vancouver

1-888-540-8288

Reception@westcaremedical.com

Thompson Okanagan

AvantSleep

Penticton

236-422-3131

Penticton@avantsleep.com

CanSleep

Penticton

1-844-SLEEP40

info@cansleep.ca

Good Sleep Health

Kelowna

Penticton

Vernon

250-862-3062 info@goodsleephealth.com

250-541-0078

Penticton@goodsleephealth.com

250-493-1836

Vernon@goodsleephealth.com

 

Independent Respiratory Services

Kamloops

Kelowna

Oliver/Osoyoos

Penticton

Revelstoke

Salmon Arm

Vernon

West Kelowna

1-877-965-6204

qa@irscanada.ca

MedPro

Kamloops

Kelowna

Penticton

1-888-310-1444

info@medprorespiratory.com 

OkanaMed

Vernon

Mobile throughout Okanagan

250-306-6759

tracey@okanamed.co

Oxylife

Kamloops

250-828-6726

oxylifebc@gmail.com

Respiratory Homecare Solutions

Kamloops

Merrit

 

Kelowna

Vernon

West Kelowna

1-855-888-0201

rhskamloops@rhs.com

 

 

1-888-534-5024

kelowna@rhs.com

VitalAire

Kamloops

Kelowna

Penticton

1-800-637-0202

vahomecare.bc@airliquide.com

Kootenay

Columbia Respiratory

Trail

(Clinic locations in: Nelson, Grand Forks, Nakusp, New Denver)

250-364-0277

Columbia.respiratory@gmail.com

Independent Respiratory Services

Castlegar

Cranbrook

Creston

Fernie

Grand Forks

Golden

Invermere

Nakusp

Nelson

Trail

1-877-965-6204

qa@irscanada.ca

Kootenay Respiratory

Cranbrook

(Clinic locations in: Boswell, Crawford Bay, Creston, Elkford, Fernie, Golden, Invermere, Jaffray, Kimberley, Sparwood)

1-778-517-5600

doug@kootenayrespiratory.ca

MedPro

Castlegar

Cranbrook

1-888-310-1444

info@medprorespiratory.com 

 

OkanaMed

Fauquier

Golden

Nakusp

250-306-6729

tracey@okanamed.co

VitalAire

Cranbrook

Trail

1-800-637-0202

vahomecare.bc@airliquide.com

Cariboo

Independent Respiratory Services

100 Mile House

Quesnel

Williams Lake

1-877-965-6204

qa@irscanada.ca

Nechako

AvantSleep

Prince George

236-601-1091

Princegeorge@avantsleep.com

Independent Respiratory Services

Prince George

Vanderhoof

1-877-965-6204

qa@irscanada.ca

MedPro

Prince George

1-888-310-1444

info@medprorespiratory.com 

Oxylife

Prince George

250-563-1887

oxylifepg@gmail.com

VitalAire

Prince George

1-800-637-0202

vahomecare.bc@airliquide.com

North Coast

Independent Respiratory Services

Kitimat

Prince Rupert

Smithers

Terrace

1-877-965-6204

hcadmin@irscanada.ca

North East

Independent Respiratory Services

Dawson Creek

Fort St. John

1-877-965-6204

qa@irscanada.ca

Island CPAP

Dawson Creek

250-784-6608

info@islandcpap.com

MedPro

Fort St. John

1-888-310-1444

info@medprorespiratory.com 

VitalAire

Grande Prairie

1-800-637-0202

vahomecare.bc@airliquide.com

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 Breathing Device Request and Justification form (HR3727) 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 HR3727 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 Breathing Device Request and Justification form (HR3727) 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 HR3727 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 HR3727 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 

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