Medicare Part B covers CPAP machines, but only after a sleep study shows you have obstructive sleep apnea

Yes, Medicare Part B will pay for a CPAP machine and related supplies if you meet specific requirements. The machine itself is covered at 80 percent of the approved amount after you pay your Part B deductible. You pay the remaining 20 percent. However, Medicare does not pay for the machine until you have had a sleep study (called a polysomnography) that documents obstructive sleep apnea, and a doctor has written an order for the device.

The coverage includes the CPAP machine, mask, tubing, and filters — but Medicare treats these as separate items with separate payment rules. A mask might be covered under one payment category while the machine itself falls under another. This matters because it affects how much you pay and how often you can get replacements.

Key Takeaways

  • Medicare Part B covers CPAP machines at 80 percent after your deductible, but only with a doctor's order based on a completed sleep study.
  • You must use a Medicare-approved supplier to purchase or rent the machine; buying from a non-approved seller means Medicare will not pay.
  • Medicare covers replacement masks, tubing, and filters on a schedule — typically one mask per month and filters every three months — but only if you continue using the machine.
  • You can rent a CPAP machine for up to 13 months, after which Medicare switches to a purchase model where you own the device.
  • If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower, depending on your specific plan.

What the sleep study requirement means

Before Medicare will cover a CPAP machine, your doctor must order a sleep study. This study measures how many times per hour your breathing stops or becomes shallow during sleep. Medicare requires that the study show at least 15 events per hour (called the apnea-hypopnea index, or AHI) for coverage. If your AHI is between 5 and 14, Medicare may still cover the machine, but only if you also have symptoms like daytime sleepiness, witnessed breathing stops, or high blood pressure.

The sleep study can happen in a lab (where you sleep overnight with sensors attached) or at home using a portable device. Your doctor decides which type is appropriate for you. Once the study is complete and shows obstructive sleep apnea, your doctor writes an order for the CPAP machine. Without this order, Medicare will not pay, even if you buy the machine yourself.

How to use a Medicare-approved supplier

You cannot buy a CPAP machine from any seller and expect Medicare to pay. You must work with a Medicare-approved durable medical equipment (DME) supplier. These are companies that Medicare has vetted and enrolled in the program. Your doctor's office can usually tell you which suppliers are approved in your area, or you can search the Medicare website's supplier directory.

When you contact an approved supplier, bring your doctor's order and your Medicare card. The supplier will handle the paperwork with Medicare and bill them directly. You will pay your 20 percent coinsurance at the time of purchase or rental, plus any amount above Medicare's approved price if the supplier charges more. Some suppliers charge the same as Medicare's approved amount; others charge more, which means you pay the difference out of pocket.

If you use a non-approved supplier, Medicare will not reimburse you at all, and you will pay the full cost yourself. This is why confirming approval before you buy is important.

Renting versus buying: Medicare's 13-month rule

Medicare allows you to rent a CPAP machine for up to 13 months. During this time, you pay 20 percent of the rental cost each month (after your deductible). After 13 months of rental payments, Medicare switches the arrangement: you own the machine outright, and the supplier transfers ownership to you. You do not make any additional payment for this transfer.

If you stop using the machine before 13 months are up, you can return it to the supplier. If you have paid for several months of rental, you do not get that money back — rental payments are not refundable. Some people choose to buy a machine outright instead of renting, but Medicare will not pay more for a purchase than it would for 13 months of rental, so buying upfront usually costs you more out of pocket.

Masks, tubing, filters, and replacement supplies

Medicare covers replacement masks, tubing, and filters as separate items. The coverage rules vary by item type. You can typically get one replacement mask per month, replacement tubing as needed (usually every few months), and replacement filters every three months. However, Medicare will only pay for these supplies if you are actively using your CPAP machine — the supplier may ask for proof that you are using it, such as data downloaded from the machine itself.

Different mask styles (nasal, full-face, nasal pillows) are all covered, but Medicare pays a set amount for each type. If you want a more expensive mask, you pay the difference. Replacement supplies are also billed at 20 percent coinsurance after your deductible, just like the machine itself.

If you own your machine (after the 13-month rental period), you can continue to get replacement supplies covered under the same rules. The supplier will continue to bill Medicare for masks and filters as long as you are using the device.

What happens if you have a Medigap or Medicare Advantage plan

If you have a Medigap policy, it may cover some or all of your 20 percent coinsurance for the CPAP machine and supplies. The exact coverage depends on which Medigap plan you have. Plans C, D, G, and M cover the Part B coinsurance, which means you would pay only your deductible and nothing else. Plans F and G also cover the deductible itself. Contact your Medigap insurer to confirm what they cover before you buy.

If you have a Medicare Advantage plan, your coverage for CPAP machines works differently. Medicare Advantage plans must cover CPAP machines at least as well as Original Medicare does, but they may have different rules — for example, they might require you to use a specific supplier or get prior approval from the plan before the sleep study. Contact your Medicare Advantage plan before you schedule a sleep study to understand their specific requirements.

What Medicare does not cover

Medicare does not cover a CPAP machine if you do not have a documented sleep study showing obstructive sleep apnea. It also does not cover machines for other types of sleep apnea (such as central sleep apnea) unless specific conditions are met — ask your doctor whether your type of apnea qualifies. Medicare does not cover travel CPAP machines, which are smaller and more portable but more expensive. It does not cover humidifiers that attach to the machine, though some suppliers sell them separately.

If you want features beyond what Medicare covers — such as a machine with a heated humidifier built in, or a mask with extra padding — you pay the full cost of the upgrade yourself. The supplier can tell you what the upgrade costs and what Medicare will cover separately.

Frequently Asked Questions

Do I need a new sleep study if I already have one from my doctor?

No. If your doctor has a sleep study on file that shows obstructive sleep apnea and was done within the past year, Medicare will accept it. You do not need a second study. If your study is older than a year or was done for a different reason, your doctor may order a new one, but this is a medical decision between you and your doctor, not a Medicare requirement.

Can I buy a CPAP machine online and have Medicare pay for it?

Only if the online seller is a Medicare-approved DME supplier. Many online retailers are not approved by Medicare. If you buy from a non-approved seller, Medicare will not pay anything, even if the seller claims to be Medicare-approved. Always check the Medicare supplier directory or call Medicare at 1-800-MEDICARE before you buy online.

What if my CPAP machine breaks during the rental period?

Contact your supplier when ready. If the machine is defective, the supplier should replace it at no cost to you. You do not pay a replacement fee or start the rental period over. If you damaged the machine through misuse, the supplier may charge you a repair or replacement fee, but this varies by supplier. Check your rental agreement for details.

Can I get a different mask if the first one does not fit?

Yes. Medicare covers one mask per month, so if the first mask does not fit or work for you, you can get a different style or size. Tell your supplier which mask is not working, and they can order a different one. You still pay 20 percent coinsurance for the replacement, but there is no penalty for trying different styles to find what works.

What happens to my CPAP coverage if I switch from Original Medicare to Medicare Advantage?

Your coverage continues, but the rules may change. Medicare Advantage plans must cover CPAP machines, but they may require prior approval, use different suppliers, or have different coinsurance amounts. Contact your new plan before you make the switch to understand how they handle CPAP coverage and whether your current supplier is in their network.