Home oxygen, CPAP and ventilation equipment in Spain

Key rules

• Prescription: Only a public-system specialist can start the process for free equipment, after diagnostic tests.
• Cost: Therapy prescribed in the public system is free to you.
• Provider: Your region chooses the contracted company, so you cannot pick your own.
• Private patients: Private patients are not covered by the public contracts.

The short version

In the public system, a specialist prescribes your home breathing therapy, your region's health service authorises it, and a private company under contract to that region delivers and services the equipment. If the therapy is prescribed in the public system, you do not pay for it. The details change from region to region.

Who prescribes it

You need a specialist from the public health service. This is usually a pulmonologist (neumólogo). It can also be a sleep unit doctor or, for children, a paediatrician.

The specialist first runs tests, such as blood gases or a sleep study. Then they prescribe the therapy that fits: oxygen, CPAP or home ventilation. Nebulisers and similar therapies are covered in the same way.

Who authorises it

Your regional health service authorises the prescription under its own protocol for terapias respiratorias domiciliarias. It then sends the order to the contracted company. Forms and steps differ by region, so ask your hospital unit what happens in yours.

Who delivers and services the equipment

Each region hires private companies by tender to install, deliver, maintain and monitor the equipment at your home. That covers oxygen concentrators, liquid oxygen, CPAP machines and ventilators. Which company serves you depends on your region, and contracts are renewed every few years.

Contact that company for supplies, repairs and technical follow-up. The specialist still reviews whether the therapy is working.

What it costs

Nothing, if the therapy is prescribed in the public system. Private patients are not covered by these contracts, so a privately prescribed machine is arranged and paid for outside this route.

How regions differ

Spain's 17 autonomous regions each run their own health service. Expect differences in:

• who may prescribe, often a hospital pneumology or sleep unit
• how often your use of the equipment is checked, which matters especially for CPAP
• which supplies are provided, such as masks, humidifiers or portable concentrators
• waiting times

If you move region, ask the new hospital unit how it handles your therapy. Do not assume the same company, supplies or check-up schedule will carry over.

Where to find your region's rules

Search your regional health service's website for terapias respiratorias domiciliarias. The tender documents also describe what the contractor must provide. The checklist and questions below cover the steps and common doubts.

Checklist

• Ask a public-system specialist, usually a pulmonologist or sleep unit doctor, to assess you with the needed tests, such as blood gases or a sleep study.

• Ask the specialist to prescribe the therapy you need, such as oxygen, CPAP or home ventilation.

• Check that your regional health service has authorised the order and sent it to the contracted company.

• Find your region's rules on its health service website under terapias respiratorias domiciliarias.

• Ask your hospital unit how often your use of the equipment is checked and which supplies, such as masks or humidifiers, are provided.

Frequently asked questions

Who can prescribe CPAP or home oxygen in the public system?

A specialist of the public health service prescribes it, usually a pulmonologist (neumólogo) in a hospital pneumology or sleep unit. A paediatrician or another specialist can also prescribe it. Prescribing rules differ by region, so ask your hospital unit.

Do I pay for home respiratory equipment prescribed in the public system?

No, the service is free to you when the public system prescribes it. The contracted company installs, repairs and services the equipment, and the specialist reviews your therapy.

Does a private patient get the same contracted service?

No, these public contracts do not cover private patients. If you are treated privately, ask your private provider how equipment and servicing are arranged.

Where do I find the rules for my region?

Look on your regional health service's website under terapias respiratorias domiciliarias. You can also ask your hospital pneumology unit, which knows the current contractor, follow-up intervals and supplies such as masks and humidifiers.