Does Medicare cover CPAP machines?

What does Medicare cover for CPAP therapy?

Medicare Part B covers CPAP therapy, an in-home treatment for people with sleep apnea, as durable medical equipment (DME). Medicare may cover a 12-week trial of CPAP therapy, including the device and accessories, if you've been diagnosed with obstructive sleep apnea, and Part B also pays its share for related supplies like masks and tubing.

If you had a CPAP machine before you got Medicare and you meet certain requirements, Medicare may cover a rental or replacement CPAP machine, CPAP accessories, or both.

Who qualifies for Medicare CPAP coverage?

Medicare covers CPAP for adults with obstructive sleep apnea when the therapy is medically necessary and your provider prescribes it for use in your home. Under CMS's national coverage policy for CPAP, the diagnosis must include a clinical evaluation and a positive sleep test that your treating doctor ordered. The sleep test can be one of these:

• An attended sleep study (polysomnography) in a sleep laboratory
• An unattended home sleep test with a Type II or Type III home sleep monitoring device
• An unattended home sleep test with a Type IV device that measures at least 3 channels

What sleep test results does Medicare require for the CPAP trial?

CMS's coverage policy covers the first 12 weeks of CPAP when your sleep test meets either of these measures, counted as the average number of breathing events (apneas and hypopneas, or respiratory disturbances) per hour:

• 15 or more events per hour, or
• 5 to 14 events per hour, with documented excessive daytime sleepiness, impaired thinking, mood disorders or insomnia, or with documented high blood pressure, ischemic heart disease or a history of stroke

What happens after the 12-week CPAP trial?

Medicare may continue to cover CPAP therapy after the trial period if you meet with your doctor or other health care provider in person, and they document in your medical record that you meet certain conditions and the therapy is helping you. CMS's coverage policy says CPAP is covered after the trial only for people who benefit from it during the 12 weeks.

Before you start, the CPAP supplier must teach you how to use the device properly. A caregiver, like a family member, can fill that role if they're consistently available in your home and willing and able to operate the device safely.

What do I pay for a CPAP machine with Medicare?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for the machine rental and related supplies, like masks and tubing, if your supplier accepts assignment. Medicare pays the supplier to rent the CPAP machine for 13 months as long as you use it continuously, and after 13 continuous months of rental payments you own the machine.

Ask whether a supplier participates in Medicare or accepts assignment before you get the machine. A participating supplier must accept assignment and can charge you only the coinsurance and the Part B deductible. A supplier that doesn't accept assignment may charge you more, and for rented equipment, if the supplier won't accept assignment for all rental months, you may have to pay the full cost upfront and wait for Medicare to pay you its share after your claims are processed.

Does Medicare Advantage or Medigap change CPAP coverage?

Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, but costs vary by plan, you may need to use suppliers in the plan's network, and you may need the plan's approval (prior authorization) first. A Medigap (Medicare Supplement Insurance) policy helps pay your share of Original Medicare costs, like the 20% coinsurance; what it pays depends on the policy you buy. See how Medicare Advantage differs from Original Medicare.