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Snoring may not seem like a big deal to many. But little do they know; snoring may be a symptom of obstructive sleep apnea or OSA.
One way to treat OSA is through CPAP (Continuous Positive Airway Pressure) therapy. Of course, CPAP machines and their supplies are not cheap. So a common question many people have is, “Does Medicare cover CPAP supplies?” In this article, we answer the question in clear, plain English. You will also find the average costs of CPAP supplies, as well as other helpful info.
Does Medicare Cover CPAP Supplies?
The short answer is yes; Medicare will cover the cost of CPAP supplies. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your CPAP supplies. Below we look at what these are so you know what to expect.
CPAP machines, along with necessary supplies, is considered Durable Medical Equipment (DME). Medicare Part B covers DME, but only under certain conditions.
Medicare will only cover CPAP and its supplies if it is medically necessary and prescribed by your doctor, who has to be Medicare-approved. For it to be medically necessary, you have to be diagnosed with conditions like obstructive sleep apnea.
The company you get your CPAP supplies from also has to be enrolled in Medicare to get your costs covered. If the company does not accept Medicare assignment, Medicare will not limit the amount that he/she may charge you.
Medicare Advantage plans (Medicare Part C) may also cover CPAP machines and their supplies. They are obliged to cover anything Original Medicare covers plus some additional benefits.
If you’re not happy with the coverage of your current Medicare Advantage plan, you can always shop around for a plan that better meets your needs.
How Much Do CPAP Supplies Cost?
Each piece of CPAP equipment has its own costs. CPAP masks cost between $35 to $150. CPAP humidifiers cost from around $150 to $200. Hoses and tubing for CPAP machines typically cost between $10 and $40. Other additional supplies like filters may cost from $10 to $40.
What Is A CPAP Machine?
A CPAP machine is medical equipment that many people use to treat OSA. The machine uses air pressure to keep the person’s airway open as they sleep.
The air pressure that the machine blows can be adjusted to the patient’s needs. The patient’s ideal air pressure is determined during a sleep study. Sleep studies are usually performed before you start CPAP therapy.
CPAP Machines Equipment
CPAP machines feature many different types of equipment. This includes masks, humidifiers, hoses, tubes, and filters. Masks are important because one that fits you well will make CPAP therapy more comfortable and effective.
You also may need supplies to help keep your CPAP equipment clean. CPAP cleaners, unfortunately, are not covered under Medicare.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover lift chair rental?