Sleep Apnea: What Medicare Covers

Snoring may be a sign of obstructive sleep apnea.

Photo By WavebreakMediaMicro

Obstructive sleep apnea is experienced by many people and may influence a variety of health concerns as time goes on. The good news is that if someone has been diagnosed with this condition, Medicare Part B may be able to help them offset the expense of CPAP therapy. Receiving treatment is important as it will reduce health risks and improve overall health.

What to Look For

There are several prominent symptoms to watch for that may raise the alarm for obstructive sleep apnea. Becoming excessively sleepy during the day as well as loud snoring that disturbs the sleep of others are two things to watch for. Other signs include waking up suddenly, gasping for air, or experiencing pauses in breathing throughout the night. The risks associated with obstructive sleep apnea are quite serious. Leaving it untreated increases the risks for heart disease, diabetes, cognitive decline, as well as many other concerns. Talking to a doctor to evaluate symptoms and determine the severity, is really essential.

Getting Treated

After reviewing symptoms, the doctor will likely find it necessary to refer the patient to a sleep center for further testing and evaluation. The sleep center will require an overnight stay for testing to take place. During the stay, monitoring of movements, heart activity, breathing, and oxygen levels will take place. The information gathered will be used to determine if sleep apnea is occurring and what the possible causes may be. Sleep apnea has several different types, based on the cause, however, obstructive sleep apnea is the most common diagnosis. When cases are determined to be moderate to severe, a CPAP machine usually the treatment of choice. The therapy involves applying consistent pressure to the airways in order to prevent the airways from closing during sleep. The air pressure is delivered via a face mask that is worn while sleeping.


The costs required for CPAP therapy may be covered by a Medicare Plan B insurance plan. Upon diagnosis of obstructive sleep apnea, Medicare may authorize a three-month trial period for renting CPAP equipment. Additional coverage may be obtained if a doctor can confirm that the therapy is providing relief for the patient. The extended coverage will allow for an additional ten months, after which the patient will own the CPAP machine. Medicare will cover 80% of the Medicare-approved costs and the patient will be responsible for the remaining 20 %  plus any applicable Part B deductibles.



We hope that this information on Medicare’s coverage for obstructive sleep apnea is useful to you.

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