How Long Medicare Covers Your CPAP Machine and Supplies

Medicare covers CPAP equipment for 36 months, then stops paying for the machine itself

Medicare Part B pays for a CPAP machine and supplies if your doctor prescribes it for sleep apnea. The coverage works in two phases: for the first 36 months, Medicare covers the machine, mask, tubing, and filters. After 36 months, Medicare stops covering the machine but continues to cover replacement supplies — masks, tubing, and filters — for as long as you have the prescription and meet the program's requirements.

The 36-month clock starts the month your doctor writes the prescription, not the month you receive the equipment. If you get your CPAP in March, the 36 months runs through February three years later. After that date, you own the machine outright and Medicare will not pay to replace it, but you can keep using it as long as it works.

Key Takeaways

Medicare Part B covers your CPAP machine, mask, tubing, and filters for the first 36 months after your doctor prescribes it.
After 36 months, Medicare stops paying for a replacement machine but continues to cover replacement supplies like masks and tubing indefinitely.
Your doctor must write a new prescription every 12 months, or Medicare will stop covering supplies even during the first 36 months.
You pay 20 percent of the approved amount for the machine and supplies during the first 36 months, after you meet your Part B deductible.
Medicare requires you to rent the machine for the first 13 months; after that, the rental payments count toward ownership and you own it outright by month 36.

How the 36-month rental-to-ownership timeline works

Medicare does not sell you a CPAP machine outright. Instead, you rent it through a durable medical equipment (DME) supplier that Medicare has approved. For the first 13 months, you pay a monthly rental fee. Starting in month 14, those same monthly payments count toward the purchase price. By month 36, you have paid enough in rental fees that you own the machine.

This means you do not have a choice to buy the machine outright in month one — Medicare's rules require the rental period. However, once you reach month 36 and own the machine, you can keep it and use it for life if it still works. You do not have to return it or trade it in.

If your machine breaks during the 36-month period, the DME supplier must replace it at no cost to you. After you own it (month 37 and beyond), repairs and replacement are your responsibility, though you can purchase a warranty or replacement plan from a private company if you choose.

What supplies Medicare covers and what you pay

During the first 36 months, Medicare covers the CPAP machine itself, the mask (including headgear), tubing, filters, and a humidifier if your doctor prescribes one. You pay 20 percent of the Medicare-approved amount for all of these items, after you have met your Part B deductible for the year. The approved amount varies by supplier and region, but Medicare sets a maximum it will pay.

After 36 months, Medicare continues to cover replacement masks, tubing, and filters — but not a replacement machine. You can order new supplies as often as your prescription allows. Most prescriptions permit one mask per month, one set of tubing per month, and filters based on how often you need to replace them. You still pay 20 percent of the approved amount for these supplies.

If you have a Medigap or Medicare Advantage plan, your supplemental coverage may pay some or all of your 20 percent cost-share. Check your plan documents or call your plan to find out what CPAP supplies are covered.

Your doctor's prescription must be renewed every 12 months

Medicare requires your doctor to write a new prescription for your CPAP every 12 months. If your prescription expires and your doctor does not renew it, Medicare will stop covering your supplies when ready — even if you are still within the first 36 months of coverage.

To keep your coverage active, contact your doctor's office 30 days before your prescription expires and ask them to send a renewal to your DME supplier. Many suppliers will contact your doctor automatically, but you should not rely on this. If your doctor's office says they need to see you in person before renewing, schedule that appointment before your prescription runs out.

If your prescription lapses and you need to restart coverage, you will have to go through the approval process again, which can take one to two weeks. During that time, Medicare will not cover your supplies.

What happens after 36 months: owning your machine and buying supplies

Once you reach month 37, you own your CPAP machine and Medicare will not pay to replace it. If it breaks, you can choose to repair it yourself, buy a new one out of pocket, or check whether a private insurance plan or a manufacturer's warranty covers replacement.

Your replacement supplies — masks, tubing, and filters — remain covered by Medicare as long as your prescription is active and you renew it every 12 months. You continue to pay 20 percent of the approved amount. Many people find that buying supplies through their Medicare-approved DME supplier is less expensive than buying them retail, even with the 20 percent cost-share, because Medicare's approved amounts are often lower than retail prices.

If you switch to a different CPAP machine brand or model after month 36, Medicare will not cover the new machine, but it will cover compatible supplies like masks and tubing if they fit your new machine and your prescription is still active.

How to choose a Medicare-approved DME supplier

You cannot order CPAP supplies directly from Medicare. You must work with a DME supplier that has a contract with Medicare. Your doctor can recommend a supplier, or you can search for one using Medicare's Supplier Directory at dmepos.cms.gov. Enter your ZIP code and search for "CPAP" or "respiratory equipment" to see which suppliers serve your area.

When you contact a supplier, ask whether they accept Medicare assignment. This means they agree to accept Medicare's approved amount as payment in full and will bill you only for your 20 percent cost-share. Suppliers that do not accept assignment can bill you for the difference between their charge and Medicare's approved amount, which can cost you significantly more.

You can change suppliers at any time, even during the first 36 months. If you are unhappy with your current supplier's service or pricing, ask your doctor to send your prescription to a different Medicare-approved supplier. The new supplier will take over your account and continue the same 36-month timeline — the clock does not restart.

What to do if Medicare denies your CPAP coverage

Medicare may deny coverage if your doctor's prescription does not meet Medicare's requirements. Medicare requires that your doctor document that you have obstructive sleep apnea based on a sleep study, and that the CPAP prescription includes the specific pressure settings your machine should use. If your prescription is missing these details, ask your doctor to update it and resubmit it to your DME supplier.

If Medicare denies your claim, your DME supplier will send you a notice explaining the reason. You have the right to request a review of that decision. The notice will explain how to file an appeal and the important date for doing so — usually 120 days from the date of the denial. You can appeal on your own or ask your doctor or supplier to help you.

If you believe the denial is incorrect, contact your doctor's office first to confirm that your prescription meets Medicare's requirements. Then contact your DME supplier and ask them to resubmit the claim with any additional documentation your doctor can provide.

Frequently Asked Questions

Can I get a new CPAP machine after 36 months if mine stops working?

No. After 36 months, Medicare will not pay for a replacement machine. You would need to purchase one out of pocket, check whether a private insurance plan covers it, or see if the manufacturer offers a warranty. However, Medicare will continue to cover replacement supplies like masks and tubing for your existing machine.

What if I stop using my CPAP before 36 months — does Medicare stop paying?

Medicare does not require you to use your CPAP to keep coverage active. However, your doctor's prescription must remain active and be renewed every 12 months. If you decide to restart using your CPAP later, you can order supplies again as long as your prescription has not expired.

Do I have to use the DME supplier my doctor recommends?

No. You can choose any Medicare-approved DME supplier. Ask your doctor to send your prescription to the supplier of your choice. Make sure the supplier accepts Medicare assignment so you pay only your 20 percent cost-share and not any additional charges.

If I have Medicare Advantage, does the 36-month timeline still explore?

Yes. All Medicare plans, including Medicare Advantage, follow the same 36-month coverage timeline for CPAP machines. However, your cost-share and which suppliers are in-network may differ. Check your plan documents or call your plan to understand your specific coverage and costs.

What if I move to a different state — can I keep the same DME supplier?

Some suppliers serve multiple states, but many do not. If your current supplier does not serve your new state, you will need to switch to a Medicare-approved supplier in your new location. Ask your doctor to send your prescription to a new supplier, and the 36-month timeline continues from where it left off.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.