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Medicare Insurance
Q. Do Medicare Advantage Plans cover CPAP Machines?
A. Continuous Positive Airway Pressure (CPAP) machines are medical devices that delivers a constant flow of air into the airway while an individual sleeps. The CPAP helps to reduce apnea (cessation of breathing) or hypopnea (reduced oxygen intake) events, which in turn can reduce more serious health conditions like heart attack and stroke.
Like many other medical devices, CPAP’s will generally be covered by a Medicare Advantage plan. Your provider will submit a request for prior approval to your Plan for review. Once approved, a CPAP machine and the needed supplies will most often be processed under the Durable Medical Equipment (DME) provision on your plan. This will generally
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require your cost share of twenty percent (rather than a flat copay). This 20% will be applied toward your maximum out-ofpocket.
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