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A CPAP machine is a piece of medical equipment used to treat Obstructive Sleep Apnea, or OSA. However, an unclean CPAP machine is unhealthy, so it must regularly be cleaned. One of the ways to do that is through purchasing and using a CPAP cleaner such as SoClean CPAP cleaner.
If you’re thinking about getting one of these cleaners you may be wondering “does Medicare cover the SoClean CPAP cleaner?” In this article, we answer that question in clear, plain English. You will also find the average costs of SoClean CPAP cleaning machines, as well as other helpful info.
The short answer is no. In most cases, Medicare will not cover the cost of SoClean CPAP cleaning machines. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your SoClean CPAP cleaning machine.
Original Medicare (Medicare Part A and Part B) does not provide coverage for the SoClean CPAP cleaning machine. That means you will have to pay 100 percent of the cost of the cleaner. CPAP cleaning machines are not considered by Original Medicare as medically necessary.
However, Original Medicare provides coverage for a CPAP machine. Coverage for a CPAP machine is provided by Medicare Part B. Medicare Part B considers CPAP machines as durable medical equipment, and they are also medically necessary to treat OSA.
Medicare Part B will provide coverage for a CPAP machine whether it is purchased or rented. Once approved by Medicare Part B, they will cover 80 percent of the costs of your CPAP machine. You will pay for the remaining 20 percent.
Just like with Original Medicare, Medicare Advantage plans (Medicare Part C) usually do not provide coverage for SoClean CPAP cleaning machines. Though it may be possible to find a plan that does (we haven’t found one though!). Medicare Advantage plans cover everything Original Medicare covers but also offer additional benefits. However, coverage and out-of-pocket costs will vary depending on the specifics of your plan.
The SoClean CPAP Cleaner and Sanitizer cost about $290. Other brands have similar prices.
Obstructive Sleep Apnea, or also known as OSA, is a medical condition wherein the patient repeatedly stops breathing while he/she is asleep. The patient’s airflow stops because his/her airway space in the throat is narrow. A common symptom of this condition is snoring.
One of the ways to treat this condition is through CPAP therapy. An alternative treatment is also available through a mandibular advancement device or also known as a mouthguard.
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.
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 doctor’s visits?