Getting a CPAP machine is vital for treating sleep apnea and achieving a better night’s sleep. Whether you are looking to your first machine or a travel-sized CPAP machine, you’ll likely want to have your insurance company pay for most or all of the cost. This begs the question: does insurance cover the cost of CPAP machines?

The Long and Short Answers

The short answer is yes, most insurance providers will reimburse you for the cost of your CPAP machine. The long answer is maybe, as it really depends on your insurance carrier.

Most insurance providers cover at least a part of the cost, and the amount that you can be reimbursed depends on your medical insurance provider and the plan you have with them. Some providers and plans will cover the full cost of the machine while others will only pay out a portion of it. It’s also possible (however rare) that your insurance provider will not reimburse you for any of the amount paid.

It’s highly recommended that you contact your insurance provider right after you have received a prescription from your primary care physician for a CPAP machine (you cannot purchase one without the prescription).

Does Medicaid and Medicare Cover the Cost of a CPAP Machine?

If you are on Medicaid, you still can qualify for a CPAP machine, but you will need to obtain authorization, and the process and amount covered will vary by state. It’s best to contact your state benefits provider for clarification on what they cover and to obtain authorization.

Medicare recipients also qualify for Continuous Positive Airway Pressure (CPAP) therapy if they have been diagnosed with obstructive sleep apnea. Medicare usually covers a 3-month trial of CPAP therapy and may provide longer coverage if your doctor provides information stating that you met certain conditions.

This information may change as new laws are put in place, check with medicare.org for the most recent coverage for CPAP machines.

Can I Pay Using an HSA or FSA?

Yes, you can pay for a CPAP machine using funds contained within your HSA or FSA accounts. For more information, read our post about it here.

Get the Treatment You Need

Even if your insurance provider does not cover the cost for a CPAP machine, it’s still worth it to purchase one and begin getting the treatment you need. CPAP machines are relatively affordable medical devices, and there are ways to obtain one without paying 100% up front. In the end, the benefits of having CPAP therapy wherever, whenever, far outweigh the total cost of the machine.

Need assistance financing your CPAP machine? Contact Us today to ask about how you can pay for your MyTranscend purchase!