Original Medicare (Parts A & B): Continuous Positive Airway Pressure (CPAP) Devices, Accessories, and Therapy
Once diagnosed with obstructive sleep apnea (OSA), your loved one can trial and rent-to-own a CPAP device and accessories.
How To Receive
Details on how to apply
Must have a diagnosis of obstructive sleep apnea (OSA).
Obtain a provider order for continuous positive airway pressure (CPAP).
Locate a CPAP supplier that accepts Medicare.
Your loved one's provider may be able to make a referral.
Arrange for CPAP demonstration and order the device and supplies.
Receive the device and supplies and commence using it during sleep hours.
For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.
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Obstructive sleep apnea (OSA)
Obstructive sleep apnea (OSA) is intermittent airflow blockage during sleep and is the most common sleep-related breathing disorder. It is seen in all age groups, but the frequency increases with age and obesity.
Continuous positive airway pressure (CPAP)
Continuous positive airway pressure (CPAP) is a mechanical means of continuously introducing a set pressure of airflow into the airways throughout the respiratory cycle, both during inspiration (inhalation) and expiration (exhalation), resulting in improved oxygenation.
Your loved one is fitted for a CPAP machine, including mask size and hose length, that they will wear during sleep hours.
Coverage
Medicare may cover a 3-month trial of CPAP therapy (including devices and accessories) if your loved one has been diagnosed with OSA. After the trial period, Medicare may continue to cover CPAP if your loved one meets with their provider in person and the provider documents in the medical record that they meet certain conditions and the therapy is helping them.
Medicare pays the supplier to rent the machine for 13 months with uninterrupted use. After your loved one has rented the machine for 13 months, they own it.
Medicare may also cover a rental or a replacement CPAP machine and/or accessories if your loved one had a CPAP machine before they got Medicare and meets certain requirements.
