MEDICARE COVERAGE FOR CPAP MASKS
Once you’ve met your deductible and requirements, Medicare coverage includes 80 percent of the cost of CPAP services and accessories. For accessories, this includes face masks, filters, and tubes, among other things.
To maintain and keep your CPAP accessories up-to-date, you may need to replace them from time to time. According to the Department of Health and Human Services (HHS), certain supplies for CPAP and other accessories are replaced on “the basis of medical necessity.” This can vary widely by state and whether your provider can provide a Medicare-approved amount of coverage for CPAP accessories.
As an example, CPAP tubing with a heating element can be replaced every three months, compared to a nondisposable filter, which needs to be replaced every six months. According to HHS, Medicare will cover the following CPAP accessories:
- CPAP tubing with heating element: one per three months
- CPAP mask: one per three months
- Replacement oral cushions: two per month
- Replacement nasal pillows: two per month
- Headgear: one per six months
- Chinstrap: one per six months
- Tubing: one per three months
- Disposable filter: two per one month
- Nondisposable filter: one per six months
What's The Difference Between Traditional Medicare Coverage & Medicare Advantage?
Since the 1990s, Medicare recipients have been able to choose private health plans as an alternative to original Medicare. These health plans, once called Medicare Part C, are now known as Medicare Advantage.
The Basics: If you have original Medicare, the government directly pays for your Medicare benefits. In contrast, with Medicare Advantage plans, you receive your benefits from private medical insurance companies that Medicare has approved.
We Bill Traditional Medicare Only!
We do not work with private insurance / Medicare Advantage plans currently.