Does Medicare Cover CPAP Machines?

Medicare typically pays 80% of approved costs for CPAP machines and BiPAP machines. Certain supplies, such as tubing and masks, are also partially covered. You may need to undergo a doctor-supervised sleep study to qualify for a CPAP machine covered by Medicare.

Rachel Christian, writer and researcher for RetireGuide
  • Written by
    Rachel Christian

    Rachel Christian

    Financial Writer and Certified Educator in Personal Finance

    Rachel Christian is a writer and researcher for RetireGuide. She covers annuities, Medicare, life insurance and other important retirement topics. Rachel is a member of the Association for Financial Counseling & Planning Education.

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    Matt Mauney
    Matt Mauney, Senior Editor for RetireGuide

    Matt Mauney

    Financial Editor

    Matt Mauney is an award-winning journalist, editor, writer and content strategist with more than 15 years of professional experience working for nationally recognized newspapers and digital brands. He has contributed content for ChicagoTribune.com, LATimes.com, The Hill and the American Cancer Society, and he was part of the Orlando Sentinel digital staff that was named a Pulitzer Prize finalist in 2017.

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  • Reviewed By
    Aflak Chowdhury
    Aflak Chowdhury

    Aflak Chowdhury

    Medicare Expert

    Aflak Chowdhury is a Medicare expert and independent insurance broker specializing in group health insurance. He has worked for major providers including Humana and Principal Financial Group and today works mainly in the small group market.

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  • Published: February 22, 2021
  • Updated: October 20, 2023
  • 7 min read time
  • This page features 11 Cited Research Articles
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APA Christian, R. (2023, October 20). Does Medicare Cover CPAP Machines? RetireGuide.com. Retrieved October 7, 2024, from https://www.retireguide.com/medicare/services/durable-medical-equipment/cpap-machines/

MLA Christian, Rachel. "Does Medicare Cover CPAP Machines?" RetireGuide.com, 20 Oct 2023, https://www.retireguide.com/medicare/services/durable-medical-equipment/cpap-machines/.

Chicago Christian, Rachel. "Does Medicare Cover CPAP Machines?" RetireGuide.com. Last modified October 20, 2023. https://www.retireguide.com/medicare/services/durable-medical-equipment/cpap-machines/.

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CPAP Machine Coverage at a Glance
Medicare PlanCPAP Machine Coverage
Part A (Inpatient)N/A
Part B (Outpatient)Covers 80% of CPAP machine costs once you meet your Part B deductible. Accessories are partially covered.
Part C (Medicare Advantage)Coverage mirrors Part B. Select plans may offer additional benefits.
Part D (Prescription Drugs)N/A
Supplemental InsuranceCan help cover equipment costs not covered by Medicare. Coverage varies by plan.

What Is Sleep Apnea and How Is It Treated?

Sleep apnea is a potentially serious disorder in which your breathing repeatedly stops and starts during sleep. Apnea occurs when your airflow stops for at least 10 seconds.

According to the Mayo Clinic, if you snore loudly and feel tired the next day even after a full night’s sleep, you may have sleep apnea.

Most Common Types of Sleep Apnea
Obstructive Sleep Apnea (OSA)
Occurs when the airway at the back of your throat becomes physically blocked. This obstruction causes you to temporary stop breathing.
Central Sleep Apnea (CSA)
Occurs when there is a problem with how your brain controls muscles involved in respiration, which leads to slower and shallower breathing.

Research has found OSA to be much more common than CSA. When people use the generic term “sleep apnea,” they’re usually referring to OSA.

Common Signs and Symptoms of Sleep Apnea
  • Loud snoring
  • Gasping for air during sleep
  • Waking up with a dry mouth
  • Headaches in the morning
  • Insomnia
  • Excessive daytime sleepiness

Sleep apnea is most common in people who are overweight, use alcohol or sedatives, smoke or suffer from certain medical conditions such as congestive heart failure.

The condition is also more common in men than women.

The most common treatment for moderate to severe sleep apnea is a breathing device, such as a Continuous Positive Airway Pressure, or CPAP, machine.

CPAP therapy delivers a flow of pressurized air from a machine through a mask that fits over your mouth or nose. This helps keep your airway open and breathe more easily while you sleep.

CPAP machines also include tubing that connects the machine to the face mask. It may also have a humidifier attachment.

A bilevel positive airway pressure, or BiPAP, machine is another device used to treat sleep apnea. It’s like a CPAP machine but provides more air pressure when you inhale and less pressure when you exhale.

How Much Does a CPAP Machine Cost with Medicare?

Generally, Medicare covers 80% of costs related to sleep apnea machines. The Part B deductible applies.

You may pay less or owe nothing if you have Medicaid as your secondary payer.

Medicare Advantage plans also generally cover CPAP machines and therapy because these plans must offer at least the same coverage as Original Medicare.

Many Medicare Advantage plans require doctors to submit a prior authorization request before the insurer will pay for a sleep study or CPAP machine.

Because CPAP treatment doesn’t work for everyone, Medicare initially covers the machine for a three-month trial period after you are diagnosed with sleep apnea.

Medicare may extend coverage if your doctor determines that the therapy is helping your condition.

After this three-month trial, you will owe 20% of the Medicare-approved cost to rent the machine as durable medical equipment.

The equipment supplier will provide you with instructions on how to use the CPAP machine.

Medicare pays its share to the supplier to rent the machine for 13 months. After that, you own the machine outright.

You must rent your device from a supplier enrolled in Medicare, and the doctor who orders your sleep apnea machine must also accept Medicare.

Medicare will usually cover the cost of a new CPAP machine every five years.

If you had a machine before enrolling in Medicare, Medicare may cover some of the costs for a replacement CPAP machine rental and accessories if you meet certain requirements.

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Medicare Coverage of CPAP Supplies and Sleep Studies

In addition to CPAP machines, Medicare Part B covers other treatments and supplies related to sleep apnea.

Medicare may also cover:
  • Certain sleep studies
  • Other sleep apnea machines, such as a BPAP machine
  • Oral appliance therapy with sleep apnea devices
  • Supplies, such as tubing, masks and filters

Your doctor will need to run tests and order a sleep study to formally diagnose you with sleep apnea.

Your doctor may either order an at-home sleep apnea test or require you to undergo a formal lab sleep study at an overnight clinic.

Medicare generally pays 80% of the approved cost for sleep studies, and the Part B deductible applies.

Medicare will also cover 80% of the cost of replacement CPAP supplies on a regular schedule.

That’s because CPAP supplies can get dirty or worn out over time. For example, the face mask material tends to absorb oil from your skin and may become stiff.

Medicare CPAP Machine Supply Replacement Schedule
  • Full Face Mask: One every three months
  • Full Face Cushion: One per month
  • Nasal Cushions: Two per month
  • Headgear: One every six months
  • Chinstrap: One every six months
  • Tubing: One every three months
  • Disposable Filters: Two per month
  • Non-Disposable Filters: One every six months
  • Heated Humidifier: One every five years

Original Medicare typically doesn’t pay for items or services that exceed this replacement schedule.

If you have a Medicare Advantage plan, check with your insurance company to see how often they will pay for replacement supplies.

Does Medicare Cover CPAP Cleaners Like SoClean?

Manufacturers, suppliers and sleep physicians all recommend that patients regularly clean their CPAP machines and supplies.

However, there are certain CPAP supplies Medicare won’t cover.

Medicare typically doesn’t pay for cleaning supplies, power solutions or certain comfort accessories.

Other CPAP supplies Medicare doesn’t cover include:
  • Mask wipes
  • Mask liners
  • Headgear comfort pads
  • Tube covers and wraps
  • Hose holders

These items may be expensive without insurance. The SoClean device, for example, can average around $400.

Philips CPAP Machine Recall

In June 2021, millions of CPAP and BiPAP machines were recalled by Philips Respironics due to the degrading of sound abatement foam inside the machines, which can break down and lead to serious health issues like inflammation in the respiratory system, cancer and other dangerous effects.

The recall was classified by the U.S. Food and Drug Administration (FDA) as a Class I recall due to the toxic effects from the machines as capable of causing severe injury or death.

According to Philips, these products are not affected by the recall:
  • Trilogy Evo
  • Trilogy Evo OBM
  • Trilogy EV300
  • Trilogy 202
  • A-Series Pro and EFL
  • Respironics M-Series REMStar CPAPs, Auto CPAPs, BiPAPs
  • DreamStation 2 Auto CPAP Advanced and DreamStation 2 Auto CPAP
  • Omnilab and OmniLab Advanced Titration devices
  • V60 Ventilator
  • V60 Plus Ventilator
  • V680 Ventilator
  • REMStar SE and Sleep Easy CPAPs​
  • Dorma 100, Dorma 200 CPAPs (not marketed in US)​
  • All oxygen concentrators, respiratory drug delivery products and airway clearance products.

People using a Philips CPAP can check their medical device recall notification page or call 877-907-7508.

FAQs About CPAP Machines & Coverage Under Medicare

Does Medicare require a prescription for CPAP supplies?
A doctor is required to run tests and order a sleep study to formally diagnose sleep apnea before Medicare will cover a CPAP machine or supplies.
How often can you get a CPAP machine with Medicare?
Typically, Medicare will cover a portion of the costs of a new CPAP machine once every five years. Medicare will cover 80% of the cost and you are responsible for the other 20% after you have paid your Medicare Part B deductible for the year — $240 in 2024.
What are Medicare's guidelines for CPAP coverage?
Medicare may cover the cost of devices and supplies for a three-month CPAP therapy trial if you are formally diagnosed with sleep apnea. Medicare may continue covering durable medical equipment and supplies after the trial if you meet in person with your doctor, who must document that you meet certain requirements and are being helped through CPAP therapy.
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Last Modified: October 20, 2023

11 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2023, October 12). 2024 Medicare Parts A & B Premiums and Deductibles. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2024-medicare-parts-b-premiums-and-deductibles
  2. National Heart, Lung, and Blood Institute. (2022, March 24). What Is Sleep Apnea? Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea
  3. Centers for Medicare & Medicaid Services. (2020, December 17). CPAP For Obstructive Sleep Apnea. Retrieved from https://www.cms.gov/Medicare/Coverage/Coverage-with-Evidence-Development/CPAP
  4. Mayo Clinic. (2020, July 28). Sleep apnea. Retrieved from https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
  5. Mayo Clinic. (2019, May 21). How CPAP controls sleep apnea. Retrieved from https://www.mayoclinic.org/diseases-conditions/sleep-apnea/multimedia/cpap/vid-20084718
  6. U.S. Department of Health and Human Services. (2013, June). Replacement Schedule for Medicare Continuous Positive Airway Pressure Supplies. Retrieved from https://oig.hhs.gov/oei/reports/oei-07-12-00250.pdf
  7. Centers for Medicare & Medicaid Services. (n.d.). National Coverage Determination (NCD) for Continuous Positive Airway Pressure (CPAP) Therapy For Obstructive Sleep Apnea (OSA) (240.4). Retrieved from https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=226&ver=3
  8. Medicare.gov. (n.d.). Continuous Positive Airway Pressure devices, accessories, & therapy. Retrieved from https://www.medicare.gov/coverage/continuous-positive-airway-pressure-devices
  9. Medicare.gov. (n.d.). Sleep studies. Retrieved from https://www.medicare.gov/coverage/sleep-studies
  10. Philips. (n.d.). Medical Device Recall Notification. Retrieved from https://www.usa.philips.com/healthcare/e/sleep/communications/src-update
  11. U.S. Food and Drug Administration. (2021, July 29). Certain Philips Respironics Ventilators, BiPAP, and CPAP Machines Recalled Due to Potential Health Risks: FDA Safety Communication. Retrieved from https://www.fda.gov/medical-devices/safety-communications/certain-philips-respironics-ventilators-bipap-and-cpap-machines-recalled-due-potential-health-risks