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Does Insurance Cover CPAP Machines?
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Key Takeaways
- Medical insurance, Medicare, and Medicaid usually cover most of the cost of CPAP machines and accessories for qualifying policy-holders.
- To qualify for insurance coverage for CPAP equipment, policy-holders must receive a medical diagnosis for obstructive sleep apnea (OSA) or another medical condition CPAP is used to treat.
- Those who want to pay for their CPAP equipment with insurance coverage also need a doctor’s prescription specifying that, without CPAP therapy, they’ll likely need surgery.
- Out-of-pocket costs for CPAP machines vary by the device’s type, size, and brand, but typically start at $700.
Frequently Asked Questions
How much is a CPAP machine without insurance?
The cost of a CPAP machine depends on a number of factors, including quality, type, price, and size. Standard fixed CPAP machines typically cost $700 to $1,000 without insurance. More advanced devices such as BiPAP and APAP machines can cost significantly more.
In addition to the CPAP machine, you’ll also need to purchase a CPAP mask because this component is sold separately. Other equipment such as the connective tubing, humidifier, and air filter are included with your CPAP machine purchase.
How much does a CPAP machine cost with insurance?
Private insurance, Medicare, and Medicaid will usually cover a percentage of the cost of a CPAP machine as long as it's deemed medically necessary. How much the insurance provider pays depends on your particular plan.
Does insurance cover APAP or BiPAP machines?
APAP and BIPAP machines are alternative devices to CPAPs. An APAP’s main purpose is regulating airflow breath-by-breath. A BIPAP is designed to keep the airflow regulated as you breathe in and as you breathe out through two separate pressure settings, one for inhaling and one for exhaling.
Like CPAP machines, most insurance policies will help offset some of the cost of BiPAP and APAP machines. Since BiPAP and APAP devices tend to cost more than fixed CPAP machines, you may need to pay more out of pocket even if your insurance plan covers the same percentage of the cost.
References
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