Does Medicare Cover My Sleep Apnea Equipment and CPAP Machine?
This article was updated on: 10/20/2018
Sleep apnea might be your diagnosis if you momentarily stop breathing while you sleep — sometimes many times per night, according to the U.S. Food and Drug Administration.
If you have Medicare and you’re diagnosed with obstructive sleep apnea, you may be eligible to receive Continuous Positive Airway Pressure (CPAP) therapy for a three-month trial period. With Medicare Part B, you’ll pay 20% of the Medicare-approved amount for the CPAP machine rental and supplies, after reaching the Medicare Part B deductible. You must get the CPAP equipment from a Medicare-assigned supplier for Medicare to cover it. If your health-care provider decides that the sleep apnea therapy is helping, you may continue to be covered under Medicare for a longer period.
To avoid possible extra costs, you might want to make sure your CPAP machine is medically necessary according to your Medicare-assigned doctor.
If you already owned a CPAP machine before getting Medicare, some costs related to it may be covered by Medicare if you meet specific qualifications. Keep in mind that people who live in certain parts of the U.S. may be affected by the Medicare Competitive Bidding Program, which requires beneficiaries with Original Medicare to get durable medical equipment, such as the CPAP machine, from Medicare contracted suppliers in order to be covered by the Medicare program. You can visit Medicare.gov to learn more and to find out if you live in an area affected by the program.
Medicare Part B and sleep apnea treatment
As mentioned, with Medicare Part B, you will be responsible for paying 20% of the Medicare-approved amount to rent a CPAP device and necessary parts or accessories, and the Part B deductible applies. Medicare pays the supplier to rent the CPAP machine for up to 13 months, and after that, the CPAP machine is considered yours.
Medicare Supplement coverage for Medicare Part B’s out-of-pocket costs
Medigap (Medicare Supplement) plans, offered by private insurance companies, can help you pay your out-of-pocket costs for services covered under Original Medicare.
If you think you need more coverage for your sleep apnea, we’d like to help. You can schedule an appointment by clicking the link below, or let me email you some personalized info to review. Or you can check out possible plans for yourself by clicking the Find Plans button on this page.
This website and its contents are for informational purposes only. Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.