Medicare covers CPAP machines and most supplies through Part B, but you'll pay a share of the cost and the equipment must come from a Medicare-approved supplier.

If you have been diagnosed with obstructive sleep apnea and your doctor prescribes a CPAP (continuous positive airway pressure) machine, Medicare Part B will help pay for it. You do not pay the full price upfront. Instead, Medicare pays a set amount, and you pay your share — usually 20 percent of that approved amount after you meet your Part B deductible for the year.

The catch is that your CPAP machine and supplies must come from a Medicare-approved durable medical equipment (DME) supplier. If you buy from a non-approved supplier or order online from a retailer that is not enrolled with Medicare, Medicare will not pay anything toward it, and you will owe the full cost yourself.

Key Takeaways

  • Medicare Part B covers CPAP machines, masks, tubing, and filters when prescribed by your doctor and obtained from a Medicare-approved DME supplier.
  • You pay 20 percent of the Medicare-approved amount for the machine after meeting your Part B deductible; supplies are covered under the same 20 percent coinsurance.
  • The supplier handles billing to Medicare directly, so you should not pay the full retail price at the time of purchase.
  • Medicare covers replacement supplies (masks, tubing, filters) on a schedule — typically one mask per month and filters as needed — not all at once.
  • You can find Medicare-approved DME suppliers by searching the Medicare Supplier Directory or calling 1-800-MEDICARE.

What CPAP Equipment and Supplies Medicare Covers

Medicare Part B covers the CPAP machine itself, along with the mask, tubing, filters, and humidifier chamber that come with it or are needed for ongoing use. The machine is considered durable medical equipment, which means it is expected to last and be used repeatedly.

Replacement supplies are also covered, but on a schedule set by Medicare. You can typically receive one mask per month and filters as often as medically necessary — usually every few months, depending on the type. If your mask breaks or wears out faster than the standard schedule, your supplier can request an exception from Medicare, but you will need your doctor to document the medical reason.

Humidifier water chambers and tubing are covered as replacement items as well. The exact coverage depends on the specific equipment code Medicare assigns to your machine, so ask your supplier to confirm what is included in your plan before you start using the equipment.

How to Find a Medicare-Approved CPAP Supplier

Not every medical supply store or online retailer is enrolled as a Medicare supplier. To make sure you use an approved one, search the Medicare Supplier Directory at dmepos.cms.gov. Enter your ZIP code and select "CPAP" or "respiratory equipment" as the equipment type. The directory will show you suppliers in your area that Medicare recognizes.

You can also call 1-800-MEDICARE (1-800-633-4227) and ask for a list of approved suppliers near you. The representative can tell you which ones are currently accepting new patients and may have information about their hours and whether they offer home delivery.

Once you have chosen a supplier, bring your prescription from your sleep specialist or primary care doctor to their office or arrange for them to contact your doctor directly. The supplier will handle the paperwork with Medicare and bill them on your behalf. You should receive an Advance Beneficiary Notice (ABN) before any service or equipment is provided — this document tells you what Medicare will and will not pay for, so you know your cost responsibility upfront.

What You Pay Out of Pocket

Your out-of-pocket cost depends on whether you have met your Part B deductible for the year. For 2024, the Part B deductible is $240 (this amount changes yearly). Once you meet that deductible, you pay 20 percent of the Medicare-approved amount for the CPAP machine and all supplies.

The Medicare-approved amount is not the same as the retail price. For example, a CPAP machine might have a retail price of $1,000, but Medicare's approved amount might be $600. You would pay 20 percent of $600 ($120) after your deductible, not 20 percent of $1,000. This is why using an approved supplier matters — they accept Medicare's approved amount as payment in full and do not bill you for the difference.

If you have a Medigap or Medicare Advantage plan, your coinsurance may be lower or covered entirely. Check your plan documents or call your plan's customer service to find out what your CPAP coverage looks like under your specific plan.

The Rental-to-Purchase Option

Medicare allows you to rent a CPAP machine for up to 13 months. During the rental period, you pay 20 percent coinsurance on the monthly rental fee. After 13 months of rental payments, the machine becomes yours — you own it outright and do not pay anything more for the equipment itself.

Some suppliers offer a purchase option instead, where you pay for the machine upfront (your 20 percent share) and own it when ready. Compare both options with your supplier. The rental-to-purchase route can be easier on your budget if you are not sure the machine will work well for you, since you can return it during the rental period if needed. However, if you know you will use it long-term, purchasing outright may cost less overall.

Replacement Machines and When Medicare Covers a New One

Medicare will cover a replacement CPAP machine if your current one breaks down and cannot be repaired, or if your medical condition changes and you need a different type of machine (for example, switching from a standard CPAP to a BiPAP). Your doctor must document the medical reason for the replacement.

Medicare does not cover a new machine straightforward because you want an upgrade or because technology has improved. You typically must have used your current machine for at least five years before Medicare will cover a replacement, unless there is a documented medical reason to change sooner.

If your machine is still under warranty and breaks, contact the supplier first — they may repair or replace it at no cost to you. If it is out of warranty and cannot be fixed, your supplier can work with Medicare to request coverage for a replacement.

If You Have Medicare Advantage Instead of Original Medicare

Medicare Advantage plans (Part C) must cover CPAP equipment and supplies at least as well as Original Medicare does, but they may have different rules. Some plans require you to use specific suppliers, may have different copays or coinsurance amounts, or may require prior authorization from the plan before you order equipment.

Contact your Medicare Advantage plan before you see your doctor about a CPAP prescription. Ask whether you need prior authorization, which suppliers are in-network, and what your out-of-pocket cost will be. This step can save you from ordering equipment and then finding out Medicare Advantage will not cover it the way you expected.

Frequently Asked Questions

Can I order a CPAP online from a big retailer and have Medicare pay for it?

Only if that retailer is enrolled as a Medicare-approved DME supplier. Most large online retailers are not. Check the Medicare Supplier Directory before ordering. If you order from a non-approved source, Medicare will not pay anything, and you will owe the full cost.

What if my doctor prescribes a CPAP but I do not have a sleep study showing I have sleep apnea?

Medicare requires a sleep study (either in-lab or home-based) documented in your medical record before it will cover a CPAP machine. Your doctor must have the study results and a diagnosis of obstructive sleep apnea on file. If you do not have a study yet, ask your doctor to order one before the CPAP prescription.

Do I have to use the mask that comes with the machine, or can I buy a different one?

You can use a different mask if your doctor or supplier recommends it for medical reasons — for example, if the standard mask causes skin irritation or does not fit your face shape. The replacement mask must still come from a Medicare-approved supplier and be billed to Medicare. You pay your 20 percent coinsurance on the approved amount.

What happens if I lose or damage my CPAP mask before the replacement schedule allows a new one?

Contact your supplier and explain what happened. They can request an exception from Medicare if the damage was accidental or the mask is defective. You may need to provide proof (like a damaged mask) or a note from your doctor. If Medicare approves the exception, you pay your normal coinsurance. If not, you may have to pay out of pocket for an early replacement.

Will Medicare cover a CPAP if I have not been diagnosed by a sleep specialist?

Yes — your primary care doctor can diagnose sleep apnea and prescribe a CPAP. However, Medicare still requires a sleep study (documented diagnosis) in your medical record. The study does not have to be ordered by a sleep specialist, but the diagnosis must be there before Medicare will cover the equipment.