CPAP Mask and Headgear: FSA Eligibility

CPAP Mask and Headgear: eligible with a Flexible Savings Account (FSA)
A CPAP mask and headgear are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and a health reimbursement arrangement (HRA). CPAP mask and headgear reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

What is a CPAP mask and headgear?

Continuous positive airway pressure, also known as CPAP, is a series of treatments used to treat breathing problems like sleep apnea by utilizing mild air pressure to keep airways open and alleviate the difficulty that is associated with common respiratory problems. The primary means of treatment for these issues is the CPAP machine, which is a mask that covers the nose and mouth (nose-only devices are called Nasal Continuous Positive Airway Pressure (NCPAP)), and is worn each night to open airways to improve sleep and breathing quality (National Heart, Lung, and Blood Institute).

The CPAP mask and headgear is the piece of equipment most synonymous with the CPAP machine, as this mask will form a seal around the nose or mouth and is connected to the air tube that pumps air from the CPAP machine itself and keeps the airways open throughout the night. The design of the mask is contingent on whether the user will need a mask that filters air through the nose or mouth, but ultimately the decision will come down to the personal preference of the wearer.

How to choose a CPAP mask and headgear

Individuals who are looking to begin nightly use of a CPAP machine will have many options to choose from when picking a CPAP mask and headgear, but they should look for the following features via American Sleep Apnea Association:

  • Proper Seal: In order to receive the correct amount of pressurized air each night, CPAP users should ensure that their masks form a tight seal around the nose/mouth to make therapy easier.
  • Versatile Headgear Straps: Adjustable headgear straps that can be altered to suit one's comfort level are vital for ensuring the mask is working properly. Additionally, look for a product with quick release tabs - these can hold the straps in place in their optimal setting and provides a fast method to remove the mask if needed.
  • Mask Materials: The overall setup of the mask is vital in choosing the right one for a patient's needs. For instance, if the wearer breathes from his/her mouth, a mask that covers the entire face is usually necessary. Once the correct mask design is chosen, the optimal cushion types (gel silicone, foam, cloth, etc.) should be tested with each mask to find the right fit and comfort level to suit the wearer.
  • Accessory Compatibility: When a CPAP user finds the correct mask to suit his/her needs, it's also important to check the mask's compatibility with common CPAP accessories like pillow and hose holders. Testing out these components together will ensure that CPAP mask wearers can enjoy a restful sleep without having to adjust their equipment during the night.

Under IRC 213(d)(1), "medical care includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body." This includes medical equipment, supplies and devices.