Medicare may cover a 3-month trial of CPAP therapy (including devices and accessories) if you’ve been diagnosed with obstructive sleep apnea. After the trial period, Medicare may continue to cover CPAP therapy, devices and accessories if you meet with your doctor in person, and your doctor documents in your medical record that you meet certain conditions and the therapy is helping you.
Your costs in Original Medicare
After you meet the Part B deductible , you pay 20% of the Medicare-Approved Amount for the machine rental and purchase of related supplies (like masks and tubing). Medicare pays the supplier to rent a CPAP machine for 13 months if you’ve been using it without interruption. After Medicare makes rental payments for 13 continuous months, you’ll own the machine.
Medicare will only cover your durable medical equipment (DME) if your doctors and suppliers are enrolled in Medicare. If a DME supplier doesn't accept assignment , there’s no limit on the amount they can charge you. You may also have to pay the entire bill (your share and Medicare's share) at the time you get the DME.
What it is
CPAP therapy is an in-home treatment for people with sleep apnea.
Things to know
If you had a CPAP machine before you got Medicare and you meet certain requirements, Medicare may cover a rental or replacement CPAP machine and/or CPAP accessories.