10 CPAP Supplies You May Still Need But Medicare Won't Cover

Here is the short answer: Medicare does cover CPAP therapy, but only the medically necessary parts. It rents you the machine and pays toward replacement masks, cushions, tubing, and filters. What it does not cover are the comfort, cleaning, and power accessories that make therapy easier to stick with. Those come out of your pocket. Below is what Medicare covers, and 10 CPAP supplies you will likely pay for yourself.

Does Medicare cover CPAP supplies?

Yes, in part. If you have been diagnosed with obstructive sleep apnea (OSA) through a sleep study (in a lab or with an approved home test), Medicare covers your CPAP machine as durable medical equipment (DME). Medicare "pays the supplier to rent a CPAP machine for 13 months, as long as you're using it continuously" (Medicare.gov). After those 13 months of continuous use, you own the machine.

Here is what that means for your wallet:

• You pay the Part B deductible, then 20% of the Medicare-approved amount for the rental and for covered supplies.
• Medicare also covers replacement masks, cushions, tubing, headgear, and filters on a set schedule. Per the CMS coverage policy, "accessories are separately reimbursable at the time of initial issue and when replaced" (CMS). Check Medicare.gov for the current replacement frequency, since it can change.
• A Medigap plan may cover your coinsurance. A Medicare Advantage (Part C) plan has at least the same benefits, but check the plan for details.
• Your doctor and supplier both have to be enrolled in Medicare for the equipment to be covered.

New to therapy? Start with what CPAP therapy is. Now, the supplies Medicare leaves off the list.

10 CPAP supplies Medicare won't cover

These are not covered because Medicare treats them as comfort, convenience, or cleaning items rather than medically necessary equipment. They are still worth having, and they are often what keeps people on therapy.

1. A CPAP cleaning machine

Keeping your mask, tubing, and chamber clean matters, but Medicare does not cover automatic CPAP cleaning machines. Worth knowing: the FDA has not cleared or approved any automatic cleaner (see below), so soap and water is the recommended method. A cleaning machine is a convenience you buy yourself.

2. Mask liners

A mask liner sits between your skin and the cushion, cutting leaks, red marks, and irritation, and absorbing facial oils that shorten cushion life. See our picks for the best CPAP mask liners.

3. A CPAP battery

A CPAP battery keeps therapy running during travel, flights, and power outages. Medicare covers the machine, but not a backup power source.

4. Mask wipes

Daily mask wipes are the fast, no-water way to keep your mask clean between deeper washes. Handy to keep on the nightstand, and not covered.

5. Headgear comfort pads

Strap covers and headgear comfort pads ease the red marks and pressure that make the first weeks of therapy hard. Small item, real difference in comfort.

6. A CPAP pillow

A contour CPAP pillow is cut to make room for your mask and hose, so you can sleep on your side without breaking the seal. More on options in our best pillows for CPAP users guide.

7. A CPAP hose holder

A hose holder suspends your tubing above the bed so it does not tug on your mask or tangle while you move. A simple fix for a common annoyance.

8. Tubing wraps

A fabric wrap over your tubing reduces rainout (condensation) inside a standard hose and softens drag and noise as it slides across your bedding.

9. Nasal pads

Nasal pads add a hypoallergenic barrier over the bridge of your nose to prevent soreness and leaks. Options like the RemZzzs nasal liner and Snugz nasal mask liner are washable and reusable.

10. DC power cords

A DC power cord runs your machine from a vehicle outlet, which is ideal for road trips and camping. Like batteries, it is a power accessory you buy yourself.

Why doesn't Medicare cover these supplies?

Medicare covers what is medically necessary to deliver therapy: the machine, mask, cushions, tubing, and filters. Comfort and convenience items (pillows, liners, comfort pads, hose holders, batteries, power cords) do not meet that bar, so they are on you.

Cleaning machines are a special case. The FDA states that "there are currently no FDA cleared or approved devices for cleaning, disinfecting, or sanitizing CPAP machines" (FDA), which is part of why Medicare does not reimburse them. And distilled water for your humidifier, which ResMed recommends for standard water tubs (ResMed), is a small but ongoing cost Medicare will not cover either.

The bottom line: know what your plan covers, keep your supplier enrolled in Medicare, and budget for the comfort extras, because staying comfortable is what keeps you on therapy.

Frequently Asked Questions

Does Medicare cover CPAP supplies?

Yes, in part. Medicare covers the CPAP machine as durable medical equipment (a 13-month rental, then you own it) plus replacement masks, cushions, tubing, and filters, after you meet the Part B deductible and pay 20% coinsurance. It does not cover comfort or cleaning accessories.

How often can you get CPAP supplies on Medicare?

Medicare covers replacement supplies on a set schedule, with items like cushions and filters replaced more often than masks and tubing. Check Medicare.gov or your enrolled supplier for the current frequency, since it can change.

Does Medicare cover a CPAP cleaner like SoClean?

No. Medicare does not cover automatic CPAP cleaning machines, and the FDA has not cleared or approved any device for cleaning CPAP equipment. Washing with mild soap and water is the recommended method.

Do I have to keep buying distilled water for my CPAP?

If your humidifier uses a standard water tub, yes. Manufacturers like ResMed recommend distilled water for those tubs, and it is a small ongoing cost that Medicare does not cover.

What CPAP costs does Medicare cover?

After the Part B deductible, Medicare pays 80% of the approved amount and you pay 20% for the machine rental and covered supplies, as long as you keep using the machine and your supplier is enrolled in Medicare.

Are comfort accessories like CPAP pillows and mask liners covered?

No. Medicare treats CPAP pillows, mask liners, comfort pads, hose holders, batteries, and power cords as comfort or convenience items rather than medically necessary equipment, so you pay for them yourself.

References

• Medicare.gov. "Continuous Positive Airway Pressure (CPAP) devices." medicare.gov
• CMS Medicare Coverage Database. "Positive Airway Pressure (PAP) Devices, Policy Article A52467." cms.gov
• U.S. Food & Drug Administration. "Do You Need a Device with Claims to Clean Your CPAP Machine?" fda.gov
• ResMed. "Frequently Asked Questions" (distilled water for humidifier tubs). resmed.com