Key takeaways

  • Medicare Part B will cover part of the cost of a CPAP machine if you’ve received an obstructive sleep apnea diagnosis.
  • To qualify for coverage, you must receive an obstructive sleep apnea diagnosis from your doctor, which typically requires a sleep study, after which Medicare will cover a 3-month trial of a CPAP machine.
  • If both your doctor and the supplier participate in Medicare, it covers 80% of the cost of CPAP equipment after you’ve met your deductible of $257 in 2025, including the CPAP machine rental, masks, tubing, and other accessories.

Original Medicare (Part A and Part B) offers coverage for continuous positive airway pressure (CPAP) machines. Part B is the section that pays for durable medical equipment, such as CPAP machines.

To have your CPAP machine covered, you need to make sure that your healthcare professional and device supplier participate in the Medicare program. You can search for local Medicare-approved healthcare professionals and suppliers.

To qualify for Medicare coverage of a CPAP machine, your doctor has to make an obstructive sleep apnea (OSA) diagnosis. This often requires a sleep study. Part B covers the cost of sleep studies as well.

If you’ve recently received an OSA diagnosis, Medicare will cover a 3-month trial of a CPAP machine.

If your doctor documents that CPAP therapy is helping your condition and writes an order for continued therapy, Medicare will keep covering your CPAP machine.

You need to be sure that you’re up to date in paying your Part B premiums and have met your annual deductible. In 2024, the monthly premium for most people is $174.70, and the annual deductible is $240.

Once you’ve met this one-time deductible for the year, you’re responsible for 20% of the Medicare-approved amount for covered equipment.

If your doctor orders CPAP therapy for you, Medicare will cover 80% of the cost of the following equipment after you’ve met your deductible:

  • CPAP machine rental for a 3-month trial if you’ve newly received a diagnosis
  • CPAP rental for 13 months if you’ve been using it consistently (after 13 months, you’ll own the CPAP machine)
  • masks or nose pieces you wear when using the machine
  • tubing to connect the mask or nose piece to the machine

This Medicare coverage applies only if your doctor and supplier participate in the Medicare program.

You may be asked to pay the entire cost up front and then be reimbursed by Medicare.

If the amount of your equipment is more than what Medicare allows or your supplier doesn’t participate in Medicare, you could have to pay more than 20% of the cost — even the entire amount.

Medicare Advantage (Part C) may offer additional coverage for medical equipment and services that fall under Part B coverage. The amount you’ll pay for these devices will depend on the plan you choose.

It’s important to note that some Part C plans place additional restrictions and conditions on the suppliers and healthcare professionals you can choose based on their network.

Medicare has certain rules when it comes to equipment replacement for CPAP machines.

If you’re new to Medicare and already have a CPAP machine, you’ll be covered for the cost of equipment that works with it.

After 13 months, your CPAP machine is paid for, and you’ll own it. It should last several years, but you may have it replaced with your medical benefit after this period.

Other supplies are less sustainable and need more frequent replacement. Below is a list of how many times per year Medicare will pay for a portion of certain CPAP supplies, according to the Department of Health and Human Services:

  • humidifier water chamber: 2 times per year
  • non-disposable filters: 2 times per year
  • chinstrap: 2 times per year
  • headgear: 2 times per year
  • CPAP tubing with heating element: 4 times per year
  • combination oral and nasal CPAP mask: 4 times per year
  • full face mask: 4 times per year
  • nasal interface: 4 times per year
  • tubing: 4 times per year
  • full face mask interface: 12 times per year
  • cushion for nasal mask interface: 24 times per year
  • nasal pillows: 24 times per year
  • disposable filter: 24 times per year
  • replacement oral cushion for oral and nasal mask: 24 times per year
  • replacement nasal pillows for oral and nasal mask, 1 pair: 24 times per year

How do you know which CPAP machine is right for you?

A CPAP machine isn’t something you buy at a local retail store. Your doctor or a respiratory therapist will usually recommend a specific device. They may even point you to a supplier.

Some considerations when selecting a CPAP machine include:

  • your individual preferences about a nose piece versus a full face mask
  • your living situation and sleep habits
  • your individual medical needs
  • any specific features you may need, like compact size for travel, low motor noise, or a built-in humidifier to prevent a dry mouth and nose

Your doctor will write an order for your CPAP machine with specific goals and settings in mind. Your selection should fit those needs, and your supplier should have a copy of your doctor’s order to make sure you receive the correct fit and device.

If a CPAP machine is the right solution for you, you’ll probably need to undergo a sleep study. Both your sleep study and CPAP machine will be covered by Part B, as long as your healthcare professional and supplier participate in Medicare.

Expect to pay a share of the costs under your Part B or Part C plan.