Durable medical equipment (DME) is an item your provider prescribes for use at home, such as a CPAP machine, glucose monitor, wheelchair, oxygen equipment, hospital bed, or crutches. This equipment needs a prescription. Your provider decides whether it is appropriate for you.
This article explains how to ask for a prescription, where we can send it, when to contact the support team, and what to do if something doesn't go to plan.
Looking for something else?
Specialist referrals, imaging, and lab orders follow different processes (see the end of this article).
How long does an equipment prescription take?
Each request is different and has a different timeframe based on the equipment supplier. Use these as a guide, not a guarantee.
Your provider places the prescription: during your appointment, or after they review a request you sent in chat.
We send it: after the prescription is ready, to the pharmacy or supplier you asked for. For a CPAP, that is usually Nationwide Medical or Lincare, unless you ask for a different company. See CPAP machines below.
You get an update: in your chat messages from the support team.
A prior authorization, if your plan requires one: some decisions come back right away and others take longer. Your insurance decides this, not Circle Medical. See Equipment billing and costs below.
Step 1: Your provider decides a prescription is appropriate
Equipment can only be prescribed for a need you discussed with your provider. If this is a new need, or your last visit was more than 6 months ago, book an appointment first.
If you were seen in the last 6 months and this equipment was discussed, start a chat and tell us what you need. Your provider reviews every request and may still ask to see you first.
A CPAP has an extra requirement. Your provider can prescribe one only after a diagnostic sleep study shows sleep apnea. The details are under CPAP machines below.
Step 2: Tell us where to send it
For most equipment, you tell us where the prescription should go. We can also help you find a location or supplier.
A pharmacy, when the item is stocked there. Provide the pharmacy name and location.
An equipment supplier, when a pharmacy cannot fill it. Start a chat with the supplier name and, if you have it, their fax number and address.
If you are not sure which supplier is in-network, call your insurance before you ask us to send the prescription. The pharmacy or company bills your plan, not Circle Medical. See Equipment billing and costs below.
A CPAP is the exception. You do not have to name a company first. We can send a CPAP prescription to Nationwide Medical or Lincare. If you want a different company, or neither of those is in-network for your plan, use the same step as other equipment and tell us the company name. The full list is under CPAP machines below.
Step 3: We send the prescription
Once your provider has written the prescription, it is sent to the pharmacy or supplier you provided. You'll get an update in your chat once we've sent the order.
For a CPAP, we send the prescription together with the sleep study report and the other records the company needs. The company then contacts you about the device, supplies, and setup.
Equipment suppliers will contact you to arrange pickup or delivery. If you're picking up from a pharmacy, contact them directly before arrival to make sure it's ready.
Ask them to confirm they are in-network for your specific plan before you accept the equipment. See Equipment billing and costs below for what you may owe.
Common types of equipment
Your provider decides what they can prescribe. These are examples of equipment patients ask about, and how each one usually works.
Glucose monitors and continuous glucose monitors (CGMs), such as FreeStyle Libre or Dexcom. These are often sent to a pharmacy. Your plan may require a prior authorization before the pharmacy can fill them. See Equipment billing and costs below.
Blood pressure cuffs. Many cuffs are sold without a prescription. If your plan will only cover one with a prescription, your provider can write one for a pharmacy.
Wheelchairs, oxygen equipment, hospital beds, and crutches. Tell us the supplier you want, including a fax number if you have it. Your provider writes the prescription if they agree it is medically necessary, and we send it there.
CPAP machines
A CPAP (continuous positive airway pressure) machine, or a similar device such as an APAP, uses air pressure to help you breathe steadily while you sleep.
A CPAP requires a prescription. You can't order one on your own. Your provider writes the prescription after reviewing a diagnostic sleep study that shows sleep apnea. The equipment company needs that study report. A visit note that mentions sleep apnea is not enough. If we don't have the report, we can't send the order, and your provider may ask you to complete a diagnostic study first during a Sleep appointment.
Circle Medical can send a CPAP prescription to these equipment companies:
Nationwide Medical. Nationwide does not serve patients in Tennessee or Maine.
Lincare.
We send the prescription and the records the company needs. The company then contacts you about the device, supplies, and setup. Many insurance plans cover CPAP devices. The company bills your plan. See Equipment billing and costs below.
If you want a different company. If Nationwide and Lincare are not in-network for your plan, or you already have an equipment company, start a chat with the company name and, if you have it, their fax number. Your provider can write a prescription we send there.
If you already use a CPAP. Questions about supplies, settings, or a compliance report can start in chat. Tell us which company supplied the device. For a problem with the machine itself, or a return, contact that company directly. Replacement supplies, a settings change, or a compliance report may need your provider, and they may ask you to book another appointment.
If a CPAP is not the right fit. Your provider may recommend an oral appliance for sleep apnea instead. That is a different order from a CPAP prescription.
When to contact the support team
Most prescriptions move once your provider has written them. Use these checkpoints:
Your provider discussed an equipment order, and you have not heard back after 4 business days since your appointment: start a chat so we can check whether your provider has reviewed the request.
The pharmacy or supplier says they never received the prescription: start a chat with their name and what they told you. This includes Nationwide Medical, Lincare, or another CPAP company.
You need it sent somewhere else and it has not been filled yet: start a chat with the new pharmacy or supplier name. For a CPAP, say so before the order is sent, and tell us if Nationwide or Lincare already has it.
You have an issue with your equipment: get in touch with the equipment supplier directly.
The pharmacy or supplier says your prescription has expired: book an appointment to discuss a new one. See How long an equipment prescription lasts below.
Your insurance denied a prior authorization: see What to do if a prior authorization is denied.
What to do if something goes wrong
I haven't received my prescription
Your provider may still be reviewing the request, or the prescription may still be on its way to the pharmacy or supplier. If it has been more than 4 business days since your appointment or you reached out, start a chat and we'll check the status.
The pharmacy or supplier says they don't have my prescription
Start a chat with the pharmacy or supplier name, the location, and what they told you. We'll check that it was sent to the right place and resend it if needed. If a CPAP company needs a different form, tell us that too.
I want it sent somewhere else
Start a chat before the equipment is provided, and name the pharmacy or supplier you want. Include a fax number if the new place is an equipment supplier. If it has already been dispensed, the original supplier has to help with a return or transfer.
I have an equipment issue
If you have an issue with your equipment, or need to return the equipment, contact your supplier directly. Replacement supplies, or a problem your supplier cannot fix, may need your provider. They may ask you to book another appointment.
My prescription expired
Some medical equipment prescriptions expire after 12 months. If yours has expired, or the pharmacy or supplier will not accept it, book an appointment so your provider can discuss a new prescription. An expired prescription can't be renewed in chat.
My insurance denied the equipment
If the denial is for a prior authorization, see What to do if a prior authorization is denied. If the pharmacy or supplier says your plan does not cover the item, ask them for the self-pay price, and start a chat if you want your provider to discuss an alternative.
Equipment billing and costs
The pharmacy or equipment company bills your insurance directly. An equipment bill is not a Circle Medical bill, and the copay for your Circle Medical appointment does not include the equipment.
Circle Medical does not set the price and cannot tell you what you will owe.
Before you accept the equipment, ask the pharmacy or company for an estimate. Ask for both numbers:
What you would owe with your insurance, after any deductible or coinsurance
The self-pay price, if you pay them directly and do not use insurance
In some cases the self-pay price is lower than using insurance. The pharmacy or company is the only place that can compare those prices for your equipment and your plan.
If they send you a balance after you receive the equipment, contact them. Contact your plan if the question is about coverage, a deductible, or a denial. Circle Medical cannot resubmit their claim.
Some plans limit which supplier you can use. Call your plan and ask which pharmacies or companies are in-network before we send the prescription.
Prior authorization
Some equipment needs approval from your insurance before they will cover it. Continuous glucose monitors often do. A CPAP sometimes does. Your plan decides whether one is required and how long it takes. Some decisions come back right away. Others take longer.
Learn more in What is a prior authorization?
If the pharmacy or company says Circle Medical has to submit the authorization, start a chat. Include their name and what they asked for. Who submits it depends on the equipment. We often submit it for a glucose monitor, and the equipment company may submit it for a CPAP.
If the authorization is denied, see My insurance denied the equipment above.
How long an equipment prescription lasts
How long is my prescription valid? Some medical equipment prescriptions expire. They are typically valid for 12 months from the date your provider writes them. A pharmacy or supplier may set its own shorter limit, so if you have not filled the prescription yet, confirm with them that it is still current.
My prescription expired, or the pharmacy or supplier wants a newer one. Book an appointment to discuss a new prescription with your provider. We can't send a new equipment prescription from an expired one, and it can't be renewed in chat.
Not medical equipment? Other types of orders
Specialist referrals (dermatology, cardiology, physical therapy, and others): see How specialist referrals work at Circle Medical.
Imaging (X-ray, CT, MRI, ultrasound, mammogram): see How imaging orders work at Circle Medical.
Lab orders: see How lab orders and testing work.
Medication refills: see Requesting medication refills.
Still have a question about medical equipment? Start a chat in the app or web portal. Please include the item you need and the pharmacy or supplier name so we can help faster.