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Does insurance cover my CPAP machine?

Filed in
  • Sleep apnea
  • CPAP

By Corinne Lederhouse  |  May 08, 2019
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If you have obstructive sleep apnea, you may be wondering if your health care insurance will cover the cost of a CPAP machine. The short answer is – probably.

Most private health insurance policies cover positive airway pressure (PAP) equipment, like CPAP machines and masks. The level of coverage and the rules for coverage depend on your specific insurance policy.

Medicare typically covers a three-month trial for PAP therapy. If you use the treatment consistently, then you will qualify to keep using the machine.

Your insurance provider might make you buy or rent your PAP machine. If you have a high-deductible insurance plan and will be paying a lot right away for your machine, you might choose to pay it yourself without using your insurance. This is the “self-pay” option, which could be cheaper.

Most durable medical equipment (DME) providers and online stores have lower prices for cash purchases compared to those bought through insurers. If you choose to do self-pay, you don’t have to follow adherence regulations from your insurer.


CPAP “adherence” – also called “compliance” – refers to how often you use your machine. Your adherence data is transmitted by your CPAP machine to the DME company or office where you got your device. This data is shared with your health insurance provider.

The insurer will monitor your adherence data. If you don’t use CPAP regularly, the insurer may stop paying for the CPAP machine. The insurer also may require that you return it and buy your own CPAP machine.

The Centers for Medicare and Medicaid Services (CMS) has specific adherence rules during the first three months of usage. CMS requires you to use your machine for at least 4 hours per night on 70 percent of nights during a consecutive 30-day period. This means that in a 30-day period, you must have used your machine for at least 4 hours on at least 21 days. Many private insurers also follow these CMS rules. You should check directly with your insurer to confirm its specific adherence requirements.

Talk to your medical provider if you’re having trouble with your CPAP machine. Notify your provider if you feel like the treatment is not helping you. Contact an AASM-accredited sleep center if you need more help. It’s important to ensure that your treatment is effective.

For more information, download the fact sheet, “Positive Airway Pressure and Your Insurance: What You Should Know,” which is available on the website of the American Alliance for Healthy Sleep.



  1. 1 Dan 03 Aug
    Beware - CIGNA covers the cost of a sleep study but does NOT cover a CPAP or the supplies. They consider it to be an "experimental or unproven" treatment.
  2. 2 Thomas Beck 04 Jun
    I have been prescribed a CPAP machine I guess three years ago. Whatever I choose to purchase new equipment I have to go to my local hospital in which my insurance is registered. I'd like to find some CPAP provider whereas I can go through the mail instead of having to go to the hospital each and every time. Your help in this matter would be greatly appreciated.
  3. 3 Thomas Wilson 03 Apr
    There is strap to hold it and tube will connect it to the CPAP machine from the front part of the mask.
  4. 4 gpks00 21 Nov
    Has anyone had insurance cover a TRAVEL Cpap? Which ins do you have? What circumstances did your Dr give them for the need of a mini? Ect. Any help would be appreciated.
  5. 5 Kathy 18 Nov
    Reply to Shannon:  go see your provider for a new order.  I the progress notes from that visit, make sure they address why you need a new machine.  If your doctor doesn't have your sleep study, you may need another one.  All of this gets sent to your DME company and they get the authorization from your insurance company.
  6. 6 Shannon R Goodman 03 Nov
    Need a new machine what do I do. I have bcbc nc
  7. 7 keith 09 Jul
    Is the recalibration covered by Medicare?  In-home testing? I have been using one since 2015 and just deiscovered I need to have a titration done.  Preferably at home.