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MedicareDoes Medicare Cover CPAP Machines? 5 Things We Found Out

Does Medicare Cover CPAP Machines? 5 Things We Found Out

Yes, Medicare Part B covers CPAP machines and related supplies when you have been diagnosed with obstructive sleep apnea. Medicare classifies CPAP machines as durable medical equipment (DME), and you pay 20% of the Medicare-approved amount after your Part B deductible.

Requirements for Medicare to Cover Your CPAP

  • You must have a written order from a Medicare-enrolled doctor
  • A sleep study must document your diagnosis of obstructive sleep apnea
  • The supplier must be a Medicare-enrolled DME supplier
  • You must demonstrate that the CPAP therapy is helping — Medicare requires a follow-up visit within 90 days of starting CPAP therapy

The 3-Month Trial Period

Medicare initially rents the CPAP machine for a 3-month trial. If your doctor documents that CPAP therapy is helping you, Medicare continues to rent the equipment. After 13 months of continuous rental, Medicare ownership transfers to you.

What Supplies Medicare Covers

  • CPAP machine (rented, then owned after 13 months)
  • Replacement masks — typically every 3 months
  • Tubing — typically every 3 months
  • Filters — typically every month (disposable) or every 6 months (reusable)
  • Humidifier chamber — typically every 6 months
  • Chinstrap (if medically necessary)

BiPAP and Other Sleep Therapy Devices

Medicare also covers BiPAP machines and APAP (auto-adjusting) devices under the same DME rules. The clinical requirements are similar — documented sleep apnea, physician order, Medicare-enrolled supplier.

How to Ensure Coverage

  • Use only Medicare-enrolled DME suppliers (you can search at Medicare.gov)
  • Get a new prescription and updated sleep study if your equipment is more than 5 years old
  • Keep records of your usage — Medicare may request data downloads from your CPAP to confirm ongoing use

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