CPAP Insurance Pre-Approval in Ontario. We Handle the Paperwork, You Get Funded
Paying full price for a CPAP machine in Ontario is almost never necessary. The provincial Assistive Devices Program (ADP) covers about 75% of an eligible machine, and private or workplace insurance may cover part of the rest, but only if the pre-approval is filed correctly and in the right order.
That’s what we do. CPAP Central Inc. is a registered Ontario ADP vendor, which means we don’t just sell you a machine and hand you a receipt to chase reimbursement. We submit your ADP application, apply the ~75% provincial funding at the counter, and coordinate the rest with your private plan so your out-of-pocket is as low as possible. Fill out the form below to start your pre-approval, or call the location nearest you and one of our CPAP specialists will walk you through it.
We serve patients in person across four Ontario communities, Hamilton, Georgetown, Kanata (West Ottawa) and Whitchurch-Stouffville. All four stores are open Monday to Friday, 9:00 AM to 5:00 PM, and Saturday, 10:00 AM to 3:00 PM, with fittings by appointment.
Serving Hamilton, Georgetown, Kanata (West Ottawa) and Whitchurch-Stouffville, plus the surrounding communities across southern and eastern Ontario.
Related reading: Get Your CPAP Covered in Ontario and CPAP Machine Cost in Canada
Insurance Pre-Approval
Fill out the form below and we will send an estimate to your Insurance company
Ontario ADP: How the ~75% CPAP Funding Works
The Assistive Devices Program (ADP) is Ontario government funding that covers approximately 75% of the cost of a CPAP or BiPAP machine for eligible residents. You pay the remaining ~25%, and if you have private insurance, that share may be covered too, which may further reduce your out-of-pocket cost depending on your plan.
Are you eligible? You generally qualify for ADP CPAP funding if you:
- Are an Ontario resident with a valid health card (OHIP),
- Have a documented diagnosis of obstructive sleep apnea from a qualified sleep physician, and
- Have a completed ADP application authorized by a registered ADP CPAP prescriber.
We’re a registered ADP vendor and we bill the funding directly. This is the part that trips people up when they buy from a general medical-supply store or online. Because CPAP Central is registered with ADP, we apply the ~75% grant at the point of sale. You don’t pay full price upfront and wait months for a cheque. We complete the vendor portion of the paperwork, submit it, and discount your invoice by the ADP amount then and there.
ADP replacement cycles and eligibility are set by ADP, so getting the pre-approval right the first time matters. Ask us, or check the current ADP criteria. Bring your paperwork to any of our four Ontario storefronts and we’ll verify eligibility before you commit to anything.
Related reading: Get Your CPAP Covered in Ontario and How to Choose a CPAP Machine (Ontario)
On ODSP or Ontario Works? You May Have Additional Coverage
If you receive Ontario Disability Support Program (ODSP) or Ontario Works (OW) benefits, your remaining CPAP cost after ADP, and in some cases related supplies, may be covered through your caseworker’s discretionary or mandatory health benefits.
The process here is order-sensitive: ADP is applied first, and the balance is what’s submitted to ODSP/OW. Because we file the ADP portion in-house, we can give you an accurate written breakdown of the remaining amount to take to your caseworker, so there are no surprises and no back-and-forth. Bring your member ID and we’ll prepare the documentation you need.
Related reading: Get Your CPAP Covered in Ontario
Private & Workplace Insurance
Most private extended-health plans cover part or all of the ~25% left after ADP, and many also cover replacement masks and supplies on a recurring basis. Workplace/group benefit plans frequently do the same.
Coverage varies plan to plan, so as part of your pre-approval we’ll help you confirm your device and supply benefits before you buy, and we give you the itemized documentation to submit to your insurer. If your injury or sleep condition is tied to a workplace claim (WSIB) or a motor-vehicle accident, let us know on the form. Those are handled through separate funding streams and we can point you in the right direction.
Bring your policy number and group number to your appointment and our fitting team will verify what’s covered.
Related reading: CPAP Supplies Near Me and CPAP Mask Types
How CPAP Pre-Approval Works, Step by Step
- Get tested and diagnosed. You’ll need a sleep study, either an at-home test or an in-clinic overnight study, resulting in an obstructive sleep apnea diagnosis and a CPAP prescription from a sleep physician. Not there yet? Start with the blog below.
- Submit this form (or call us). Tell us your location, your coverage (ADP, ODSP/OW, private/workplace), and upload or bring your prescription and sleep study results.
- We confirm your eligibility. Our specialists review your documents, verify OHIP/ADP eligibility, and check your private plan’s device and supply benefits.
- We file your ADP application. As a registered ADP vendor, we complete and submit the vendor portion so your ~75% funding is applied to your invoice.
- Come in for your fitting. Visit your local storefront (by appointment) to try masks and machines in person and get properly fitted, one of the biggest factors in whether therapy sticks.
- Walk out funded. We apply ADP at the counter and give you a clear written breakdown of any remaining balance to submit to your insurer.
Related reading: Sleep Apnea Test (Home vs Clinic) and CPAP vs BiPAP
Documents Checklist, What to Bring
Have these ready to make your pre-approval fast:
- Valid Ontario health card (OHIP)
- Your CPAP/BiPAP prescription from a sleep physician
- Your sleep study results (home or in-clinic report showing your OSA diagnosis)
- Private insurance details, insurer name, policy/certificate number and group number
- ODSP/OW member ID and caseworker contact, if applicable
- WSIB or motor-vehicle claim number, if your therapy relates to one
Don’t have everything yet? Bring what you have and we’ll tell you exactly what’s still needed and how to get it.
Frequently Asked Questions About CPAP Insurance Pre-Approval
Is CPAP Central a registered ADP vendor?
Yes. We’re registered with Ontario’s Assistive Devices Program and bill the ~75% ADP funding directly on your invoice, so you don’t pay full price and wait for reimbursement.
How much does ADP actually cover?
ADP covers approximately 75% of the machine cost for eligible Ontario residents. The remaining ~25% is often covered by private insurance, ODSP/OW, or paid out of pocket.
Do I need a prescription and sleep study before pre-approval?
Yes. ADP and most insurers require a diagnosis of obstructive sleep apnea and a CPAP prescription from a sleep physician. If you haven’t been tested, read our guide on home vs. clinic sleep testing.
How often can I get ADP funding for a machine?
ADP replacement cycles and eligibility are set by ADP. Ask us, or check the current ADP criteria. Supplies and masks are handled separately and may be covered more frequently by private plans.
Can you bill my private insurance directly?
We bill ADP directly. For private insurance, we confirm your coverage and give you the itemized paperwork to submit to your plan. Bring your policy and group numbers.
Do you offer weekend appointments?
Yes. All four storefronts are open Saturday, 10:00 AM to 3:00 PM, as well as Monday to Friday, 9:00 AM to 5:00 PM. Fittings are by appointment, so call your nearest location to arrange a time that works for you.
What if my coverage is through WSIB or a car accident claim?
Those are funded through separate streams. Note it on your form and we’ll guide you through the right process.
Related reading: Sleep Apnea Test (Home vs Clinic), Get Your CPAP Covered in Ontario and CPAP Machine Cost in Canada
Start Your Pre-Approval at the Location Nearest You
Prefer to talk it through? Call the storefront closest to you and our fitting team will start your pre-approval over the phone. All locations are open Monday to Friday, 9:00 AM to 5:00 PM, and Saturday, 10:00 AM to 3:00 PM. Fittings are by appointment, and all four stores offer home visits if getting to us is difficult.
Hamilton
754 Queenston Road, Unit 5A, Hamilton, ON L8G 1A4
Serving Stoney Creek, Ancaster, Dundas, Waterdown, Binbrook, Grimsby, Winona & Haldimand. Near the Queenston Traffic Circle and Red Hill Valley Pkwy, minutes from the QEW and Eastgate Square.
Call (289) 389-1730 or email info@cpapcentralinc.ca
Georgetown
251 Guelph St, Unit 201, Georgetown, ON L7G 4B1
Serving Halton Hills, Acton, Norval, Glen Williams, Limehouse, Terra Cotta, Stewarttown, Milton & Erin. On Guelph St (Hwy 7) near Georgetown Marketplace, minutes from Georgetown GO.
Call (905) 877-1991 or email georgetown@cpapcentralinc.ca
Kanata (West Ottawa)
99 Kakulu Rd, #112, Kanata, ON K2L 3C8
Serving Kanata, Nepean, Stittsville, Barrhaven, Bells Corners, Carp, Almonte, Arnprior & Carleton Place. Off Hwy 417 (Eagleson exit) in the Kanata Centrum/Hazeldean corridor. Bilingual EN/FR service.
Call (613) 595-0660 or email kanata@cpapcentralinc.ca
Whitchurch-Stouffville
28 Sandiford Drive, Unit 207, Whitchurch-Stouffville, ON L4A 3V9
Serving Markham, Uxbridge, Aurora, Newmarket, Ballantrae, Gormley, Goodwood & Vandorf. Off Hwy 48 near Hoover Park, minutes from Stouffville GO.
Call (905) 642-2222 or email stouffville@cpapcentralinc.ca
You can also read our Google reviews to see what Ontario patients say about their fittings, then book the appointment that works for you.
Related reading: CPAP Store Near Me / Clinic in Ontario and CPAP Supplies Near Me