Wondering “Does Medicare provide coverage to the CPAP machine?” Let’s find it out!
Medicare gives coverage to the CPAP machine. The main function of the CPAP machine is to treat patients with sleep apnea. The treatment takes place under durable medical equipment benefits. Furthermore, To qualify for CPAP coverage by Medicare following requirements are a must.
You will need to take a complete sleep test at a laboratory or home with a proper testing kit.
To get the coverage of a CPAP machine, you must show the diagnostics with sleep apnea, which will be concluded based on sleep test results.
It would be best to carry a prescription written by your doctor to be eligible for this coverage.
Medicare gives coverage to the CPAP machine for the first three months. The reason behind this is that CPAP treatment sometimes does not help the patient. Your doctor will check you after three months and observe if this machine is helping you. Medicare can extend this therapy for the long-term if the doctors experience the patient’s right and notable results.
What Will Be the Cost of a CPAP Machine Along With Medicare?
The payment you will make for the CPAP machine will be 20 percent coinsurance based as approved by Medicare amount. Medicare Part B will cover the rest of the 80 percent payment. The deductibles of Part B will apply.
Medicare will assist the patients in the payments for a CPAP machine’s rental for 13 months only if they continue to use it without interruption. After 13 months, that CPAP machine will be under your possession.
If you have opted Medical supplement plan, also known as Medigap, then the CPAP machine’s rental expenses will be covered by Medicare. Moreover, if you associate yourself with the Medicare advantage plan or Part C, you will have to verify in the details what is the cost of the CPAP machine in your plan. Medicare part C or Medicare Advantage plan must provide the same services as Part B, but both plans have their terms and services according to their pricing.
Does Medicare Provide Coverage to the CPAP Machine?
The Medicare Part B’s medical durable equipment benefit and CPAP machines give coverage to the CPAP supplies, including face masks, filter, and tubing. You will have to pay 20 percent of Medicare’s coinsurance payment; the rest of Medicare will cover 80 percent as stated in the Medicare-approved amount. The coinsurance payment you will pay will move forward through the Medicare supplement plan. However, if you have a Medicare Advantage plan, your payment cost will be different.
Since the supplies get dirty after frequent usage and you will dispose of them. So, Medicare regularly supplies the CPAP essentials from time to time. The replacement will depend upon the type of instrument. Specifically, you will need to refer to your doctor about the replacement of the supplies. You can discuss this with your doctor about the replacement of the supplies from time to time.
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