Does Medicare Cover CPAP Devices and Therapy?

 

Discover when Medicare covers CPAP therapy, including devices and accessories.

David Minaya
May 17, 2024

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A good night’s sleep can keep seniors more alert during the day and prevent falls. In the US, 40% -74% of seniors experience fatigue symptoms , which may result from a lack of sleep .

Fatigue can also be a sign of medical problems. For example, older adults are much more likely  to have obstructive sleep apnea than younger people. Fortunately, Medicare can cover CPAP devices and therapy.

Let’s look at quality sleeping tips for seniors.

CPAP Medicare Coverage

Medicare Part B may cover CPAP machines and accessories (like masks and tubing) after you meet the Part B deductible. Then, you pay 20% of the Medicare-Approved Amount for the machine rental and purchase of accessories. If you use the CPAP machine without interruption, Medicare pays the CPAP supplier to rent the machine for 13 months .

How to Qualify for CPAP Therapy with Medicare

To qualify for Medicare-covered CPAP therapy, take the following steps:

  1.   Schedule an appointment with your doctor to discuss your sleep apnea concerns, which may include loud snoring and breath-holding.
  2.   Complete a sleep test to determine if you experience sleep apnea episodes. Based on the results, your doctor may prescribe CPAP therapy.
  3.   If you comply with the 90-day trial period, Medicare may cover CPAP therapy.
  4.   Within three months of starting CPAP therapy, attend a follow-up doctor visit.

Most insurance providers require you to sleep with your CPAP equipment for at least 21 nights per month  for a minimum of four hours per night.

Does Medicare Cover Sleep Studies?

Medicare Part B only covers Type I sleep tests if administered in a sleep lab facility. Furthermore, your doctor must order the test. You pay 20% of the Medicare-approved amount after you meet the Part B deductible.

Call Senior Healthcare Direct at 1-833-463-3262 and speak with a licensed agent about Medicare coverage.

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