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Does Medicare Pay for CPAP Machines and Supplies?

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Medicare pays most prices of CPAP, a typical remedy for folks with obstructive sleep apnea, or OSA. To get protection, you’ll want a doctor to prescribe a CPAP machine based mostly on exams — together with a sleep examine — displaying that you’ve OSA.

OSA, which afflicts 25 million adults in the US, is a critical situation that, along with disturbing your sleep, will increase the chance of heart problems, diabetes and melancholy. A CPAP machine supplies steady constructive airway stress through a masks to maintain your higher airway clear for simpler respiration, higher sleep and improved total well being.

What’s required to get protection for CPAP

Medicare Half B covers CPAP remedy in two phases. There’s a three-month trial interval prescribed by your physician to find out if CPAP works for you. If the trial is profitable, there’s a rental interval of as much as 13 months, after which you personal the machine. To acquire protection, you should hire the machine from a Medicare-approved provider of sturdy medical tools.

However even earlier than you start the trial, you should have a sleep check to find out that you just meet the medical standards for obstructive sleep apnea. The excellent news is that if house sleep check tools is out there via a neighborhood doctor’s workplace or sleep clinic, you needn’t spend the night time in a sleep lab.

CPAP remedy comes with persevering with bills

CPAP remedy requires periodic buy of alternative provides, together with masks, filters, headgear, the water reservoir within the humidifier and the tubing that connects the CPAP machine along with your face masks. Medicare covers these provides on various schedules; a reliable provider will make it easier to optimize the timing of those purchases.

What you pay for CPAP

As a result of CPAP is roofed as sturdy medical tools, the Medicare Half B deductible applies; it’s $203 in 2021. Then you definitely pay 20% of the Medicare-approved quantity for the CPAP machine rental and ongoing provide purchases.

Make certain that each your physician and your CPAP provider are enrolled in Medicare; if not, your provider would possibly cost you extra.

Medicare Benefit could present better protection for CPAP. Contact your native Medicare Benefit suppliers to search out out what the financial savings could be.

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