Here are some frequently asked questions including Medicare Coverage as explained by Medicare.
The following is from the Medicare website: https://www.medicare.gov/coverage/sleep-apnea-and-cpap-devices-and-accessories.html
Who is eligible for Medicare covered CPAP supplies and equipment?
People with Medicare who’ve been diagnosed with obstructive sleep apnea are eligible to get a 3-month trial of CPAP therapy. If your doctor says that the machine has helped you, Medicare may cover it longer.
Note: If you had a CPAP machine before you got Medicare, Medicare may cover rental or a replacement CPAP machine and/or CPAP accessories if you meet certain qualifications.
How often is it covered?
Medicare covers CPAP therapy equipment when medically necessary.
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount for rental of the machine and purchase of related supplies (like masks and tubing). The Part B deductible applies.
Medicare pays the supplier to rent the machine for the 13 months if you’ve been using it without interruption.
Under current Medicare rules, you own these types of equipment after renting for 13 months. When you switch to a Medicare-contract supplier instead of using a "grandfathered" supplier or other non-contract supplier, your 13-month rental period will start over, so you won't own the equipment until after the new rental period ends. This will extend your rental period and result in additional months of coinsurance. However, the amount you pay will be lower because the amount you'll pay will be based on the new payment rates under the new program.
- Once you own the equipment, you must get replacement supplies and accessories for the equipment from a contract supplier in order for Medicare to help you pay for these items. You may get repairs for the equipment you own from any Medicare-approved supplier (even a non-contract supplier), including replacement parts needed for the repair.
- If you already own your equipment, you must use a Medicare-contract supplier for your replacement supplies and accessories (like masks used with the CPAP device).
It is important to note here that Lincare CPAP Supplies is a contracted supplier with Medicare. They are contracted in all areas with the exception of the four following markets: Baton Rouge, LA; Honolulu, HI; Poughkeepsie-Newburgh-Middletown, NY and Scranton-Wilkes-Barre, PA.
CPAP Related Questions
One of our brand manufacturers, Resmed, discusses the benefits and risks of using your CPAP. You can find this plus more at www.Resmed.com
Why should I use my CPAP?
Successful CPAP users report improvements in:
- Vitality and motivation
- Job performance
- Sexual drive and performance
- Alertness while driving
- Quality of life
- Quality of sleep
A failure to use CPAP therapy may increase your risk for conditions linked to untreated Obstructive Sleep Apnea:
- Hypertension (OSA increases your risk of hypertension by up to five times)
- Congestive heart failure (CHF)
Product Related Questions
Here is some good advice regarding product care from Optigen, a division of Lincare, Inc. Visit Optigen’s website, MilitaryCPAP.com and learn more how they service the Military with CPAP supplies.
How do I clean my tubing and mask?
For home cleaning, it is recommended mix one part vinegar and three parts warm water. Allow tubing and mask parts to soak for a few minutes. Rinse clean and allow to air dry. This is a very easy and inexpensive way to clean.
How often should I replace my mask?
You should replace your mask periodically because as it becomes worn, it becomes less effective. Medicare will pay for you to replace your mask, tubing, and filters every three months. The life of a mask cushion depends on use, the oils from your skin, and cleaning. It is always a good idea to inspect your mask routinely; poor care may adversely affect the fit of the cushion and thus performance. To get the longest life from your mask, be sure to wash your face each night before putting on your mask, and wash your mask after each use. Use only original washing up liquid, nothing with perfumes, moisturizers, antibacterial agents, bleaches, etc, and always dry your mask and cushion out of direct sunlight. Poor performance is often the first clue that your cushion may need replacement. Check for small tears or pinholes, anything that might cause a leak. Cats have been known to damage cushions by playing with them and so have children, so you may want to keep your mask out of reach. Also, be sure you don't leave your mask somewhere that receives direct sunlight during the day.
What is the best way to adjust the headgear for a proper fit?
Facial muscles change when we lie down and further relax once we are asleep, so it is always best to fit the mask while you are in your sleeping position. If you sleep in a bed with no pillows, fit your mask like that. If you sleep in a recliner, fit your mask that way.
Do I have to take off the mask and headgear if I need to get up at night?
No, just disconnect the hose from the CPAP while leaving the mask on. When you return to bed, simply reconnect.