Does Medicare Cover CPAP Cleaning Machines?
- CPAP cleaning machines make it easier to keep CPAP devices in working order. Explore Medicare's coverage rules for CPAP cleaning and sanitizing machines.
Although Medicare may cover CPAP devices for seniors who’ve been diagnosed with obstructive sleep apnea, the program doesn’t cover cleaning machines.
If you’re using a continuous positive airway pressure (CPAP) machine to treat obstructive sleep apnea, regular cleaning is required to keep the equipment functioning properly and safely. Although you can typically clean these devices by hand, CPAP cleaning machines may make the job easier and clean the equipment more thoroughly.
Keep reading to learn more about sleep apnea, CPAP therapy and why Medicare doesn’t cover cleaning equipment.
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What Is Sleep Apnea?
Sleep apnea is a common sleep disorder that may cause an individual to stop breathing repeatedly while sleeping. Common symptoms include:
- Insomnia
- Irritability
- Loud snoring
- Daytime fatigue
- Morning headaches
- Dry mouth upon waking
An individual’s chance of developing sleep apnea may increase if they have risk factors such as smoking, obesity or a family history of the condition.
How Do You Treat Sleep Apnea?
Mild cases of sleep apnea are often managed through simple lifestyle changes such as quitting smoking, losing weight or treating nasal allergies.
For individuals who have a moderate or severe case of sleep apnea, treatment may be more complex, and can include supplemental oxygen, oral appliances or airway-pressure devices, including CPAP machines. Treatment for sleep apnea may also involve therapies for related medical conditions such as neuromuscular disorders.
How Do CPAP Machines Work?
CPAP machines, which sit beside a user’s bed, generate positive air pressure to minimize airway obstruction during sleep. This pressurized air is delivered through tubes to a mask, which the user wears over their nose, or nose and mouth.
The machine's pressurized airflow keeps the user's throat from collapsing. It also prevents the tongue, uvula and soft palate from shifting and potentially blocking the airway. Additionally, CPAP therapy may relieve nasal swelling, clear out mucus and eliminate snoring.
With use of the device, breathing typically normalizes, improving sleep quality and helping to maintain normal oxygen levels. Some automatic CPAP machines can also detect an airway collapse and adjust the pressure as necessary to resolve episodes of sleep apnea.
How Much Do Positive Airway Pressure Machines Cost?
The cost of a positive airway pressure machine depends on the unit's quality and features, and prices for standard CPAP machines typically range between $250 and $1,000.
Bilevel positive airway pressure (BPAP) machines, which provide distinct pressure levels for inhalation and exhalation, are more expensive and can cost as much as $6,000 for advanced models.
Automatic CPAP machines (APAP), which can adjust the airflow pressure if it detects an airway collapse, typically range in cost from $450 to $1,800.
Does Medicare Cover CPAP Machines?
Medicare Part B covers CPAP machines for beneficiaries who’ve been diagnosed with obstructive sleep apnea, as long as the equipment is procured through a Medicare-approved supplier.
Coverage includes machine rental and the purchase of masks, tubing and other related supplies. Typically, once you’ve rented a CPAP machine for 13 uninterrupted months, you own it.
Original Medicare enrollees are responsible for 20% of the Medicare-approved amount of the rental and any related supplies. Coverage may be higher through certain Medicare Advantage plans.
How Do CPAP Cleaning Machines Work?
Most CPAP machines require daily cleaning, and cleaning machines can streamline the routine so users are more likely to comply with prescribed therapies. CPAP cleaning machines typically use one of two primary cleaning methods:
- Activated oxygen: Activated oxygen CPAP cleaning machines create oxidants, which eradicate germs and bacteria.
- Ultraviolet light: UV cleaners use specific wavelengths of ultraviolet light to break down microorganisms and sanitize equipment.
Neither method uses chemicals.
Does Medicare Cover CPAP Cleaning Machines?
No, CPAP cleaners and sanitizers aren’t considered medically necessary, so Medicare doesn’t reimburse for this equipment.
How Can You Reduce the Cost of a CPAP Cleaning Machine?
Fortunately, there are ways to make the purchase of a CPAP cleaning machine more affordable:
- Health Savings Accounts/Flexible Spending Accounts: HSAs and FSAs let account holders set aside money for expenses related to medical care without paying taxes on it. Because HSAs and FSAs both list CPAP cleaning machines as durable medical equipment, you may use these earmarked funds to pay for a device.
- Health Reimbursement Accounts: Some jobs include employer-funded HRAs to help workers pay for medical expenses. Depending on the rules of your HRA, which are set by your company, you may be able to use these funds to pay for CPAP cleaners and sanitizers.
- Financing: If you can’t afford the cost of a CPAP cleaning machine, some companies offer financing plans, which let you pay for the equipment through low monthly payments.
Does Medicare Cover Purchase of CPAP Machines?
You'll be responsible for a 20 percent coinsurance, calculated based on the Medicare-approved amount for the CPAP machine. Medicare Part B takes care of the remaining 80 percent of the cost, but keep in mind that the Part B deductible will apply.
If you have been diagnosed with obstructive sleep apnea, Medicare might offer coverage for a three-month trial of CPAP therapy, which includes devices and accessories.
Can a CPAP Machine Be Cleaned Manually?
Without regular, thorough cleaning, a CPAP machine can create health hazards for the user. If you can’t afford a CPAP cleaning machine, most standard devices may be cleaned manually by following several simple steps:
- Unplug your device.
- Disconnect the air tubing, mask and humidifier tub from the machine.
- Separate the mask into its components: the frame, cushion and headgear.
- Submerge the tubing, mask cushion and headgear in a tub of warm, drinking-quality water.
- Use a mild soap to gently clean each part of the mask and tubing. Tubing should be flushed with soap and water inside and out.
- Soak the humidifier tub for 15 minutes in a mixture made of equal parts white vinegar and water.
- Rinse each component thoroughly.
- Place the components on a clean, flat towel, out of direct sunlight, to air dry.
The mask should be cleaned daily to minimize the growth of microbes and mold, and the other components should be maintained at least once a week.
You should never use household cleaners, antibacterial soap, detergents or other harsh chemicals to clean your device, and equipment should be dried thoroughly before use to reduce the risk of mold and mildew.
Always consult your CPAP machine’s user's instructions prior to cleaning and adhere to the specific manufacturer's guidelines.
Is a CPAP Cleaning Machine Worth the Money?
Although it's possible to clean your CPAP equipment by hand, it can be nearly impossible to remove all the dirt and debris from your device manually. If your unit isn't 100% clean, it can cause a buildup of mold and microbes, which can be damaging to your health.
CPAP cleaning machines may prevent additional medical problems caused by unwanted mold and microbes, making them a sound investment for anyone using a CPAP machine.
