Medicare & CPAP: What's Covered in 2026

If you're starting CPAP therapy or renewing equipment in 2026, here's exactly what Medicare covers, what you'll pay out of pocket, and how Florida DME suppliers like AHCEQUIP handle the process.

Medicare's CPAP Coverage Rules

Medicare Part B covers CPAP therapy for patients diagnosed with obstructive sleep apnea through a qualifying sleep study. Coverage starts with a 3-month trial period, during which Medicare requires documented compliance (typically using the device at least 4 hours per night, 70% of nights) before continuing coverage long-term.

What's Covered

• CPAP or BiPAP machine (often covered through a rent-to-own structure over 13 months)
• Mask and headgear
• Tubing
• Filters
• Humidifier and water chamber

See our full CPAP resupply schedule for how often each item is eligible for replacement.

What You'll Pay

After meeting the annual Part B deductible, Medicare pays 80% of the approved amount, leaving you responsible for the remaining 20% unless you have supplemental insurance (Medigap) or are also enrolled in Medicaid. AHCEQUIP accepts Medicare assignment, which caps what you can be charged.

The 13-Month Rental Period

Medicare typically covers CPAP machines through a rental arrangement: Medicare pays a monthly rental fee for up to 13 months, after which you own the equipment outright, provided you've met compliance requirements throughout.

Compliance Requirements

During the initial 90-day trial, your machine tracks usage data that's reported to your physician and, if requested, Medicare. Falling short of compliance (4+ hours nightly, 70% of nights) can result in Medicare discontinuing coverage, so consistent use matters from day one.

Florida Medicaid as Secondary Coverage

If you're dual-eligible for Medicare and Florida Medicaid, Medicaid may cover your remaining 20% coinsurance, reducing your out-of-pocket cost to $0 in many cases.

Frequently Asked Questions

Does Medicare cover a new CPAP machine if mine is old?

Generally, Medicare covers a replacement after the reasonable useful lifetime of equipment (typically 5 years) or if the original equipment is lost, stolen, or irreparably damaged, with updated documentation.

What happens if I don't meet the compliance requirement?

Medicare may stop covering the rental and require a new sleep study and trial period before resuming coverage.

Does Medicare cover travel CPAP machines?

Medicare typically covers one CPAP device for primary use; a separate travel unit is usually not separately covered unless medically justified.

Is BiPAP covered the same way as CPAP?

BiPAP coverage follows similar rules but may require documentation that CPAP alone was insufficient, depending on the diagnosis.

For the full official policy, see Medicare.gov's DME coverage page. Starting CPAP therapy or due for a resupply? Contact AHCEQUIP and we'll verify your coverage.