CPAP Refills

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.
  • If your insurance has changed since the last time you received supplies, please contact Jayhawk Patient Supply by emailing This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it. or calling 785-235-9700.
  • 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.

Personal Information


Order Preferences

If your shipping address is different than the address you entered above, please add it here.


CPAP Resupply schedule only

Please select the supplies you wish to order below.

Use the chart to determine resupply intervals [click to enlarge the chart].* 

If you have questions, please call 785.235.9700 or email Paige at This email address is being protected from spambots. You need JavaScript enabled to view it..

*NOTE: intervals may vary by insurance coverage.

 
 
 
 











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