Does Medicare Cover a CPAP Machine? Your Complete Guide

Struggling to Sleep? You’re Not Alone

If you’ve been diagnosed with sleep apnea — or suspect you might have it — you’re probably wondering: does Medicare cover a CPAP machine? It’s one of the most common questions we hear from readers over 60, and for good reason.

Sleep apnea affects an estimated 39 million adults in the United States, according to the National Council on Aging. Among older adults, the numbers are even more striking — studies suggest that over 50% of people aged 65 and older have some form of obstructive sleep apnea. Left untreated, it can increase the risk of heart disease, stroke, high blood pressure, and even cognitive decline.

A CPAP (Continuous Positive Airway Pressure) machine is the gold-standard treatment for sleep apnea, but these devices can cost anywhere from $500 to $3,000 or more. That’s a significant expense on a fixed income. The good news? Medicare does cover CPAP machines — but there are specific rules, timelines, and requirements you need to know about before you get one.

Let’s walk through everything step by step so you can breathe easier — literally and financially.

How Medicare Covers CPAP Machines: The Basics

Medicare classifies a CPAP machine as durable medical equipment (DME), which falls under Medicare Part B. This means that if you have Original Medicare (Parts A and B), your CPAP machine coverage comes through Part B — the same part that covers doctor visits, outpatient care, and preventive services.

Here’s what Medicare Part B typically covers for sleep apnea treatment:

• The CPAP machine itself (as a rental — more on this below)
• The mask and tubing
• Replacement supplies like filters, cushions, and headgear on a set schedule
• A sleep study to diagnose sleep apnea (either in a sleep lab or sometimes a home sleep test)

Under Part B, Medicare pays 80% of the approved amount after you meet your annual Part B deductible (which is $240 in 2024). You’re responsible for the remaining 20% coinsurance. If you have a Medigap (Medicare Supplement) plan, it may cover some or all of that 20%.

For a deeper look at what Part B covers beyond CPAP machines, visit our Medicare Benefits Hub for a full breakdown.

The Rental Rule: Why Medicare Doesn’t “Buy” Your CPAP Right Away

Here’s something that surprises many people: Medicare doesn’t purchase your CPAP machine outright. Instead, it rents the machine for you over a 13-month rental period.

During those 13 months, you’ll pay your 20% coinsurance on each monthly rental payment, and Medicare covers the other 80%. After the 13-month rental period ends, you own the CPAP machine — it’s yours to keep.

But there’s an important catch you need to be aware of:

1. Initial 3-month trial period: Medicare requires a compliance check during the first 90 days. Your doctor must document that the CPAP is working and that you’re actually using it.
2. Usage requirements: You must use your CPAP machine for at least 4 hours per night, for at least 70% of nights over a 30-day period. Your machine tracks this data automatically.
3. Doctor follow-up: Between days 31 and 91, you need a face-to-face visit with your prescribing doctor who must confirm the therapy is beneficial and that you want to continue.

If you don’t meet these compliance requirements, Medicare can stop paying for the rental — and you may have to return the machine. This is one of the most important rules to understand, and it trips up more people than you’d think.

What About Medicare Advantage Plans?

If you’re enrolled in a Medicare Advantage plan (Part C) instead of Original Medicare, your CPAP coverage may work a little differently — but the core benefit must be at least as good as Original Medicare’s.

Medicare Advantage plans are required by law to cover everything that Original Medicare covers, including DME like CPAP machines. However, there are some key differences:

• Your out-of-pocket costs may vary. Some Advantage plans have lower copays for DME, while others may charge more.
• Network restrictions apply. You may need to rent your CPAP from an in-network DME supplier, or you could face higher costs or denied claims.
• Prior authorization may be required. Many Advantage plans require pre-approval before they’ll cover a CPAP machine.

Always call your plan directly or check your Evidence of Coverage document to confirm the specifics. And if you’re comparing plans, our Medicare blog has plenty of guides to help you understand the differences.

Getting Your CPAP Covered: A Step-by-Step Process

Now that you know what Medicare covers, here’s your practical roadmap to getting a CPAP machine with Medicare’s help:

1. Talk to your doctor about your symptoms. Common signs of sleep apnea include loud snoring, gasping during sleep, excessive daytime sleepiness, morning headaches, and difficulty concentrating. Don’t dismiss these as “just getting older.”
2. Get a qualifying sleep study. Medicare requires a sleep test to diagnose sleep apnea. This can be done in a sleep lab (polysomnography) or with a home sleep test approved by your doctor. Your Apnea-Hypopnea Index (AHI) must be at least 5 events per hour for Medicare to consider coverage.
3. Get a prescription from your treating doctor. Your doctor must write a detailed order for the CPAP machine, specifying the diagnosis and the equipment needed.
4. Choose a Medicare-approved DME supplier. This is critical. If you rent from a supplier that isn’t enrolled in Medicare, you could be stuck paying the entire bill yourself. You can search for approved suppliers at Medicare.gov.
5. Meet the 90-day compliance requirements. Use your machine consistently, and don’t skip that follow-up appointment with your doctor.
6. Continue renting for 13 months. After that, the machine is yours. Medicare will also continue to cover replacement supplies on a schedule.

Pro tip: Set a reminder on your phone or calendar for your follow-up appointment between days 31 and 91. Missing this window is one of the most common reasons people lose their CPAP coverage.

Replacement Supplies: What Medicare Covers and When

Once you have your CPAP machine, you’ll need to replace certain parts regularly for hygiene and effectiveness. Medicare covers replacement supplies on a specific schedule:

• CPAP mask cushions/pillows: Every 1–2 months (depending on type)
• Full CPAP mask: Every 3 months
• CPAP tubing: Every 3 months
• Disposable filters: Every 2 weeks (2 per month)
• Non-disposable filters: Every 6 months
• Headgear and chin straps: Every 6 months
• Humidifier water chamber: Every 6 months

Keep in mind that your DME supplier should help you stay on track with replacements. Many suppliers offer automatic resupply programs. Just make sure they’re billing Medicare correctly and not sending you supplies you don’t need — unfortunately, some less scrupulous companies have been known to do this.

After five years of owning your CPAP machine, Medicare may cover a replacement machine if your doctor documents that it’s medically necessary and the old machine is no longer functioning properly.

Tips to Save Money on Your CPAP With Medicare

Even with Medicare coverage, costs can add up. Here are some practical ways to keep your out-of-pocket expenses manageable:

• Consider a Medigap plan. If you have Original Medicare, a Medicare Supplement plan can cover your 20% coinsurance, potentially eliminating your share of CPAP costs entirely.
• Compare DME suppliers. Prices can vary between suppliers, even for the same equipment. Get quotes from at least two or three Medicare-approved suppliers.
• Ask about financial assistance programs. Some manufacturers and nonprofit organizations offer assistance for people who struggle with out-of-pocket costs.
• Stay compliant. The single most important money-saving tip is to use your CPAP as directed. If Medicare stops covering your rental because you didn’t meet usage requirements, you’ll owe the full cost yourself.
• Review your Medicare plan annually. During Open Enrollment each fall, compare your current plan’s DME coverage with other options. You may find a plan with better coverage or lower costs.

Don’t Let Sleep Apnea Go Untreated

If there’s one thing we want you to take away from this article, it’s this: sleep apnea is a serious health condition, and you deserve treatment. The risks of untreated sleep apnea — including heart attack, stroke, Type 2 diabetes, and depression — are too significant to ignore, especially as we age.

Medicare was designed to help you access the care you need, and CPAP therapy is one of those covered benefits. Yes, there are rules and requirements to navigate, but once you understand the process, it’s very manageable.

If you’re feeling overwhelmed by Medicare’s rules around CPAP coverage — or any other benefit — you’re not alone. We’ve created resources specifically to help you make sense of it all.