It can be reimbursed, but it must be done through the hospital according to your insurance coverage. This is not a case of purchasing the device first and then submitting the receipt for reimbursement, nor is it about using the 20,000 baht limit as a discount at general stores. Insured individuals must undergo an assessment, a sleep study, meet medical criteria, and try the device as per the announcement effective from July 30, 2026.^[2]

Quick summary: What does social security pay for, and where to start?

Who is eligible to vote? Insured persons under Section 33 and Section 39 who have active eligibility and have contributed for at least 3 months within the 15 months prior to the month of receiving services, and who also meet the medical criteria.^[5,6]
Where to start: Go to the hospital under your insurance plan for a doctor to assess your condition and plan further examinations or referrals.^[2]
Sleep Test: Type 1: Monitoring by an officer throughout the inspection; reimbursement based on actual expenses, not exceeding [amount]. 7,000 baht Type 2 involves the same measurements as Type 1, but without monitoring by staff, and payment is based on actual costs, not exceeding a certain limit. 6,000 baht.^[2]
PAP machine: Payment will be made through the hospital's procedures. 20,000 baht per set Each set includes the device, mask, connecting tubing, and related accessories, ready for use.^[2]
PAP mask: Rate 4,000 baht per piece For details on the conditions for claiming replacement masks from the second time onwards, please see the section below.^[2]

Individuals insured under Section 40, who use their existing healthcare entitlements such as the National Health Security Scheme (Gold Card), should not misunderstand the PAP benefits mentioned in this article as healthcare benefits under Section 40.^[7]

Don't buy equipment in advance just because you expect to be able to claim reimbursement. The announcement designates hospitals under the insurance scheme as responsible for diagnosing and procuring equipment, or referring patients when their capabilities are exceeded.^[2]

The process for utilizing social security benefits for a PAP machine begins at the hospital designated for your insurance. If the test results and evaluation meet the criteria, a trial PAP treatment will be conducted for the period confirmed by the hospital. Once the criteria are met, the hospital will procure or coordinate the transfer. — Start with the hospital that accepts your insurance, and don't buy the device in advance just because you expect it to be reimbursed.

Criteria for receiving PAP/CPAP machines and masks.

The word PAP The new regulations cover single-level, two-level, or automatic positive pressure air (CPAP) machines, subject to specified specifications. CPAP is a commonly used term. All applications meeting the criteria below must be submitted through a hospital under your insurance coverage; purchasing the machine or mask first and then claiming reimbursement is not permitted.^[2]

Criteria for receiving your first PAP/CPAP machine.

Receiving your first PAP/CPAP machine isn't just about the AHI value; all of the following conditions must be met.^[2]

The physician has assessed that non-surgical treatment (referred to as "conservative methods" in the publication) is ineffective, or cannot be corrected with uncomplicated surgery, or surgery was performed but was ineffective.
There are sleep study results and a report available.
It meets one of the following categories of severity.
- AHI ≥30 times per hour or
- AHI 15–29 times per hour And have at least one of the following conditions: stroke, myocardial infarction, heart failure, or resistant hypertension (blood pressure of 140/90 mmHg or higher while using at least three classes of antihypertensive medications).
Try using PAP at least. 1 or 2 weeks Based on the timeframe confirmed by the hospital prior to the start of the trial, and with reported average usage of at least... 4 hours per night, calculated cumulatively for all nights during the trial period.

The announcement does not specify whether a one-week or two-week trial period is required for certain cases, so it is advisable to clarify the duration and reporting format with the hospital before beginning the trial.^[2]

AHI (Acute Health Intake) is the average number of breathing pauses or shallow breathing events per hour, obtained from a sleep study. This figure must be interpreted by a physician in conjunction with other sleep study results and overall health; it should not be used to diagnose any illness or make self-informed decisions regarding health insurance coverage.^[2]

Criteria for receiving the next PAP/CPAP machine (from the second time onwards).

According to the new regulations of 2026, applications for subsequent PAP/CPAP machines must be submitted through the hospital covered by your insurance. The current criteria are as follows:.^[2]

There is evidence that the original machine was faulty.^[2]
Try out the new device for at least 4 weeks.^[2]
The new machine was reported to be used for an average of at least 4 hours per night, calculated over all nights during the trial period.^[2]

A new regulation in 2026 does not specify a 5-year waiting period for the next PAP/CPAP machine.^[2]

The original announcement from 2024 stipulated that for a second or subsequent request for a replacement device, the original device must be damaged and irreparable, as confirmed by the supplier. Replacement is possible every 5 years, and evidence of average daily use of the device (at least 4 hours per day, with a total daily usage of at least 701 TP3T) over a period of at least 3 months is required. Those who previously received benefits under the original announcement should have their status checked by the hospital on a case-by-case basis.^[2,3]

Criteria for receiving replacement PAP masks from the second time onwards.

For replacement PAP masks from the second time onwards, please contact your designated hospital first. The current criteria are as follows:.^[2]

The mask is damaged or unusable.^[2]
You can claim a maximum of 1 item per year.^[2]
There is evidence of average use of the machine for at least 4 hours per day, with no less than 70% of total daily use, over a period of at least 3 months.^[2]

These three conditions have been in place since the announcement in 2024; they are not new conditions for 2026.^[2,3]

How to claim social security benefits for PAP/CPAP machines.

Check your insured status and the hospital you are entitled to. Check if your status is still active and which hospitals are covered by your insurance. If you are unsure, contact the Social Security hotline at 1506.^[5,6]
See a doctor at the hospital under your insurance coverage. Describe any symptoms you are experiencing, such as snoring, sleep apnea observed by loved ones, or unusual daytime sleepiness.
Receive a pre-evaluation before submission for testing. The physician will take a medical history, perform a physical examination, and use the STOP-Bang assessment tool. This assessment evaluates the risk of obstructive sleep apnea, with a minimum score of 4 points required. In cases falling outside the established criteria, a sleep medicine specialist will determine the necessity of a sleep study.^[2]
Sleep study The hospital will consider whether to test for type 1 or type 2 and may refer the patient to another medical facility if it exceeds their capacity.^[2]
Have a doctor assess whether you meet the medical criteria for receiving PAP. Based on AHI test results, comorbidities, past treatments, and the suitability of the device.^[2]
Try it out and save the report. According to the timeframe confirmed by the hospital before the trial began.^[2]
Please wait for the hospital to inform you on how to receive the device. If a hospital under your insurance coverage is unable to provide the necessary equipment due to exceeding its capacity, it will refer you to a more capable or qualified medical facility as per the announcement. This does not mean that insured individuals should purchase the equipment from stores themselves. Regarding the timeframe, the announcement stipulates that hospitals have one month to procure the equipment and masks, but it does not specify the start date. Therefore, it is advisable to clarify this with your hospital.^[2]

What information should I prepare to take to the hospital?

The following list is for preparation purposes only and is not a list of required documents that must be used by all hospitals.

Please provide your national ID card and the name of the hospital you are entitled to. If you are unsure which hospital to choose, please contact the Social Security hotline at 1506.
Sleep test results or original medical certificate, if available.
List of pre-existing medical conditions and medications currently being used.
Report on the use of the existing device and details of any problems with the device or mask for those who are already using it.
Questions regarding machine type, excess costs, warranty, and post-delivery responsibilities.

What brand of CPAP machine can I get, and can I choose the machine myself?

The announcement does not specify any brand and does not guarantee that insured individuals can choose any model they wish, but it does define the relevant features and responsibilities as follows:.^[2]

Hospitals must provide equipment with at least a warranty on the device itself. 5 years And if the equipment breaks down, the hospital is responsible for repairing or replacing it.^[2]
The machine must pass quality certification from... Food and Drug Administration (FDA).^[2]
It is a positive pressure (PAP) machine. 1 level, 2 levels, or automatic..^[2]
The machine must have a system to calculate the average percentage of days the machine was used. 4 hours a day And this usage data can be recorded continuously for at least... 1 year This is a mandatory feature for the device, not an additional eligibility criterion for patients.^[2]
The distributing company must have a system for monitoring results and educating users.PAP Education).^[2]

Although the announcement mentions excess costs if patients voluntarily request it, it does not make it a general right to purchase the device from any store and then claim or deduct it as a discount later.^[2]

How have the criteria for 2026 changed from the previous ones?

Compare the criteria for 2024 and 2026.

Comparing the criteria for accepting PAP/CPAP machines and masks in 2024 and 2026.
case	Original criteria in 2024.	New criteria for 2026.
The first PAP/CPAP machine	AHI >15 or AHI 5–15 combined with cardiovascular disease, hypertension, or stroke.^[3]	AHI ≥30 or AHI 15–29 combined with stroke, myocardial infarction, heart failure, or treatment-resistant hypertension, and a trial period of at least 1 or 2 weeks as confirmed by the hospital, with a reported average usage of at least 4 hours per night, calculated over all nights during the trial period.^[2]
The next PAP/CPAP machine	The original machine is damaged and irreparable, as confirmed by the supplier. Replacement is possible every 5 years, and evidence of average daily use of at least 4 hours, totaling at least 701 TP3T per day, over a period of at least 3 months, is required.^[3]	There is evidence that the original device was faulty. A trial period of at least 4 weeks is required, with an average usage of at least 4 hours per night, calculated over all nights during the trial period. A 5-year waiting period is not specified.^[2]
Replacement PAP masks are available from the second use onwards.	A reimbursement rate of 4,000 baht is provided for damaged or unusable equipment, limited to one item per year. Proof of average daily use of the device (at least 4 hours per day) and a total of at least 701 TP3T usage over a period of at least 3 months is required.^[3]	The rate is 4,000 baht. The item must be damaged or unusable. A maximum of one item can be reimbursed per year. Proof of average daily use of the device is required, with at least 4 hours of use per day and a total of at least 701 TP3T (Total Daily Volume) used over a period of at least 3 months. These three conditions have been in place since the 2024 announcement and are not new requirements for 2026.^[2,3]

Things you should ask the hospital before receiving the device or paying for it.

The first device needs to be tested for 1 or 2 weeks, and what format should the usage reports be in?
Does the hospital provide it itself or refer it to somewhere else? And from what date does the "within 1 month" period begin?
What types, brands, and models of PAP machines are available on the procurement list, and which models are suitable for the doctor's prescription?
If additional features are required, what will the extra cost be, and to which agency should the payment be made?
Who is responsible for training on how to use the machine, follow-up, warranty, repairs, replacement, and loaner units while your machine is being repaired?

FAQ

If I only snore, can I claim for a CPAP machine?

It's still inconclusive. Snoring is a valid reason to see a doctor, but receiving a sleep study requires passing a sleep study, adhering to severity criteria, previous treatments, trial PAP trials, and hospital procedures.^[2]

Is a sleep test reimbursable through social security?

Yes, if the doctor and hospital under the insurance scheme deem it necessary. Social security sets the cost for Type 1 testing at a maximum of 7,000 baht and Type 2 testing at a maximum of 6,000 baht. The eligibility for testing is separate from the conditions for receiving a PAP machine.^[2]

Does Article 39 grant the right to do so?

Yes, if your Section 39 insured status is still active and you have contributed for at least 3 months within the 15 months prior to the month of receiving services, then proceed at your designated hospital for a doctor's assessment, sleep study, and to determine if you meet the criteria for receiving a PAP machine according to the announcement.^[2,5,6]

Can I buy the equipment myself first and then claim 20,000 baht?

You should not purchase it yourself beforehand because the announcement does not approve purchasing the equipment yourself and then claiming reimbursement, or using the 20,000 baht allowance as a general discount. The hospital must confirm the procurement method, equipment model, and payment method first.^[2]

Can I change my mask every year?

This is not an automatic annual entitlement. From the second time onwards, mask claims must be for damaged or unusable masks. A maximum of one mask can be claimed per year, and proof of PAP usage according to the criteria is required.^[2]

summarize

CPAP/PAP machines are covered by social security for eligible individuals. Here's what you should do: Check your insurance status and the hospital you are entitled to. See a doctor and undergo a sleep study. If you meet the criteria, try a PAP trial for the period confirmed by the hospital. Then wait for the hospital to inform you of the method for receiving the device before paying or choosing a device..^[2,5,6]

This article contains general information from official announcements and cannot replace a specific diagnosis or advice from a physician. Required documents, referral procedures, waiting times for devices, and device models may vary from hospital to hospital.