Jayhawk Pharmacy is now offering online reordering of CPAP and BIPAP supplies and equipment.
Customers with Medicare coverage:
- Medicare determines the frequency that you can receive certain items. Check with your Medicare provider for allowed time periods.
Customers with commercial insurance plans:
- Commercial insurance typically will cover these items every 3 or 6 months. Your Jayhawk Pharmacy and Patient Supply patient care 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 be aware that you will be responsible for any co-payment or deductible amount that your insurance requires. If your insurance requires a pre-authorization or if you need a new prescription, we will request it and then your order will be processed.
Please allow 24 hours to process your order, or 2 days if order is placed on Saturday.
This form is for refills only. New CPAP supply orders must be presented at Jayhawk Patient Supply. Thank you!
CPAP Refill Order Form
Please fill out and submit the order form below to refill your CPAP / BIPAP supplies and equipment.