PAP Resupply

Whether it's a new mask or accessories for your CPAP or BiPAP device, these supplies need to be replenished regularly to ensure your sleep therapy is as effective as possible in treating your sleep disorder. You must have an active prescription on file with United Health Systems in order to have your PAP supplies replenished. If you have a prescription on file, please fill out the form below to begin the resupply process.

Information

Please fill out and submit the form below to refill your CPAP online.


  • Please allow 24 hours to process your order, or 2 days if order is placed on Saturday.

  • If your insurance has changed since the last time you received supplies, please contact a home medical representative from your respective location.

  • For those with Medicare insurance:
    Medicare determines the frequency that you can receive certain items. Those time periods are shown below in parenthesis.
  • Customers with commercial insurance plans:
    We can bill most insurance carriers and they typically will cover these items every 6 months. Your home medical representative will determine what you are eligible for under your plan.
  • All insurance plans: You will be responsible for any deductible or co-pay before we can bill your insurance.

  • Please select the supplies that you would like to have refilled:

    • Nasal Cusion
  • Additional Information


  • Other Concerns



  • Note or Special Instructions: