Quick Answer
Medicare Part B covers sleep studies and CPAP/BiPAP equipment for obstructive sleep apnea when medically necessary and ordered by a Medicare-enrolled provider. Coverage typically begins with a 12-week CPAP trial. After meeting the Part B deductible, Medicare pays 80% of the approved amount. A Medigap plan generally covers the remaining 20% coinsurance.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare | Covered | Part B covers sleep studies and CPAP/BiPAP when medically necessary |
| Medicare Advantage | Varies by Plan | Must cover at least Original Medicare benefits; cost-sharing and networks vary |
| Medigap | Covers Cost-Sharing | Pays Part B coinsurance (20%) for approved sleep studies and CPAP equipment |
| Medicare Part D | May Cover Related Rx | Covers related prescriptions; does not cover CPAP equipment (that is Part B DME) |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Medicare Part B covers sleep studies (polysomnography) and CPAP or BiPAP equipment as durable medical equipment (DME) when ordered by a Medicare-enrolled provider and when obstructive sleep apnea is medically necessary to treat. Coverage typically begins with a 12-week CPAP trial; continued coverage requires documentation that therapy is helping and that the device is being used consistently.
Required supplies for a CPAP machine, including masks, tubing, and filters, also receive coverage through Medicare as Part B DME. The Medicare Part B deductible ($283 in 2026) applies, after which Medicare pays 80% of the Medicare-approved amount and you pay the remaining 20% coinsurance.
If you have a Medicare Supplement (Medigap) plan, it generally covers that 20% Part B coinsurance for approved sleep studies and CPAP equipment, significantly reducing your out-of-pocket costs. The exact benefit depends on which Medigap plan you have - Plans K, L, and M handle cost-sharing differently than Plans G and N.
Medicare Advantage (Part C)
By law, all Medicare Advantage (Part C) plans must cover at least the same medically necessary sleep studies and CPAP/BiPAP equipment that Original Medicare covers. What varies between plans is the cost-sharing (copays and coinsurance), network restrictions, prior authorization requirements, and any additional supplemental benefits. Always review your plan's Evidence of Coverage or speak with a licensed agent to understand your specific costs.
Medicare Supplement (Medigap)
Medigap does not create new benefits beyond what Original Medicare covers, but it generally pays the 20% Part B coinsurance for approved sleep studies and CPAP/BiPAP equipment. This means that once Part B approves your sleep apnea treatment, a Medigap plan can effectively eliminate most of your out-of-pocket costs for those services.
The exact benefit depends on your specific Medigap plan. Most standardized plans (such as Plan G and Plan N) cover the Part B coinsurance in full. Plans K and L cover a percentage of the coinsurance rather than the full amount. Medigap policies do not have provider networks the way Medicare Advantage plans do, so you can see any Medicare-accepting provider nationwide.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed Medicare expert who has been helping beneficiaries navigate their Medicare options for over a decade.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent dedicated to helping those eligible for Medicare find the best coverage options.