Noninvasive ventilation is the term used when you receive breathing support through a mask or interface instead of through a surgical opening in your trachea.
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With noninvasive ventilation, your mask or interface can be taken off and put on as needed. This page focuses on noninvasive ventilation with a portable ventilator.
You can use your portable ventilator in bilevel mode while sleeping. You can also use it continuously throughout the day. If you only need intermittent support during the day, you can switch to sip-and-puff mode, which allows you to take individual support breaths as needed through a straw-like mouthpiece. This same portable ventilator is also used for full-time invasive ventilation for ALS patients with tracheotomies. |
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How portable is a ventilator?
Portable ventilators have internal batteries, which means you can unplug and receive the same breathing support while moving around your home, going out, or traveling. Ventilators come with travel bags that can hook onto the back of your wheelchair. Ventilators weigh anywhere from seven to 18 pounds.
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Battery life for ventilators ranges from 6 to 8 hours, depending on which device you have. If you need more time, you can purchase additional batteries for backup. You can also connect your ventilator into the battery of your wheelchair or use an adapter to plug it into a cigarette lighter.
When should I get a ventilator?
Because most people with ALS first experience breathing difficulties when lying down, it is common to rent a bilevel machine before getting a portable ventilator. But once you also need breathing support during the day, your neurologist will prescribe a portable ventilator.
Your ALS Clinic team or neurologist will monitor your breathing every visit and let you know when you qualify for a portable ventilator.
Your ALS Clinic team or neurologist will monitor your breathing every visit and let you know when you qualify for a portable ventilator.
Vivo 45 LS Portable VentilatorWeighing just 5.3 pounds, the Vivo 45 LS by Breas is one of the smallest ventilators on the market. Its ultra-compact design maximizes mobility and independence for people living with ALS. You can use the Vivo for breathing support at night, intermittent breathing support during the day, or as a full-time life support ventilator. Learn more.
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How can I get a ventilator?
You will need to have a face-to-face meeting with your neurologist, usually during a clinic visit, to get your portable ventilator prescribed for noninvasive use. He or she will need to have pulmonary function test results and documentation that the durable medical equipment (DME) company can use to process the order through insurance. A respiratory therapist from the DME company will then deliver your ventilator and train you and your caregivers how to use it.
Note: When you receive your ventilator, you will need to return your bilevel machine if it is still considered a rental. When the ventilator is set to bilevel mode, it will perform the same function as your bilevel machine.
Note: When you receive your ventilator, you will need to return your bilevel machine if it is still considered a rental. When the ventilator is set to bilevel mode, it will perform the same function as your bilevel machine.
How much will I have to pay?Ventilators are considered long-term rentals and are covered through Medicare, Medicaid, and most private insurance plans. Most insurance companies will not question or deny an ALS patient’s need for a ventilator.
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Portable ventilators are more expensive machines than bilevels, so the monthly payment will likely be higher when you switch. Supplies such as masks, tubing, filters, and humidifiers, as well as periodic maintenance, will be included in your monthly rental fee.
Medicare will cover 80% of the cost of your monthly rental. Medicaid, supplemental plans, and secondary private insurance should pay for the remaining 20%. If you have Medicare but do not have Medicaid, a supplemental plan, or secondary private insurance, you will likely have to pay the remaining 20% out of your own pocket.
If you do not qualify for Medicare—but have Medicaid and/or private insurance—find out what your durable medical equipment (DME) benefits will cover. If you have a Medicare Advantage Plan, be sure to ask about your DME benefits.
If you are facing out-of-pocket expenses that you cannot afford, talk with your DME provider and/or local ALS organization about financial assistance options. Respiratory equipment is not generally available from loan closets, but you can always ask.
If you have questions about any of this, the social worker at your ALS clinic or someone from your local ALS organization can help guide you through the process.
Military veterans: Your coverage for equipment, including respiratory devices, is different than what is listed here. Learn more.
Medicare will cover 80% of the cost of your monthly rental. Medicaid, supplemental plans, and secondary private insurance should pay for the remaining 20%. If you have Medicare but do not have Medicaid, a supplemental plan, or secondary private insurance, you will likely have to pay the remaining 20% out of your own pocket.
If you do not qualify for Medicare—but have Medicaid and/or private insurance—find out what your durable medical equipment (DME) benefits will cover. If you have a Medicare Advantage Plan, be sure to ask about your DME benefits.
If you are facing out-of-pocket expenses that you cannot afford, talk with your DME provider and/or local ALS organization about financial assistance options. Respiratory equipment is not generally available from loan closets, but you can always ask.
If you have questions about any of this, the social worker at your ALS clinic or someone from your local ALS organization can help guide you through the process.
Military veterans: Your coverage for equipment, including respiratory devices, is different than what is listed here. Learn more.

What if I’m having trouble using my ventilator?
Some adjustments may be needed when you first start using a portable ventilator. If you are having trouble, schedule another visit with your respiratory therapist. Together, you should be able to resolve the issue. The pressure may need to be adjusted, your mask may be leaking, or you might simply need more time to get used to it. Whatever the problem, the benefits you’ll receive from your ventilator are too great to give up and stop using it.
Learn more about your respiratory options...