Does Aetna Medicare Cover Cpap Machines

We reviewed medicare coverage for sleep studies here.

Does aetna medicare cover cpap machines. Generally you must get your health care coverage from your primary care physician pcp. Medicare medigap coverage for cpap devices. Batteries for positive airway pressure devices. If you have medicare and you re diagnosed with obstructive sleep apnea you may be eligible to receive continuous positive airway pressure cpap therapy for a three month trial period.

Aetna considers cpap or autopap medically necessary dme for members with a. In this post learn about medicare part b coverage for cpap and other pap therapy part b covers certain doctor s services out patient care medical supplies and preventative services. With medicare part b you ll pay 20 of the medicare approved amount for the cpap machine rental and supplies after reaching the medicare part b deductible. Does medicare cover cpap and other pap therapy for sleep.

Medicare may cover a 3 month trial of cpap therapy. Medicare and aetna medicare won t be responsible either. If you re enrolled in a standard aetna medicare plan hmo if you get coverage from an out of network provider your plan won t cover their charges. Upon individual review positive airway pressure devices are considered a medically necessary form of non.

Please check with your doctor before receiving new equipment to confirm it is a covered sleep apnea treatment. Medicare may cover it longer if you meet in person with your doctor and your doctor documents in your medical record that you meet certain conditions about the use of. Does aetna require compliance adherence for cpap therapy. Does medicare cover sleep apnea treatment with a cpap machine.

Aetna follows medicare dme mac rules with respect to the usual medically necessary quantity of supplies for positive airway pressure devices. Although medicare approved cpap machines are the most common treatment medicare may cover other available treatments. Medicare may cover continuous positive airway pressure cpap therapy if you ve been diagnosed with obstructive sleep apnea. In most cases medicare generally covers 80 of the allowable charges related to a sleep apnea machine.

Dc adapters for positive airway pressure devices. Aetna requires adherence and will only cover a medically necessary pap device beyond the first three months of therapy when pap use is greater than or equal to 4 hours per night on 70 of nights during a consecutive 30 day period during the first three months of therapy. Continuous positive airway pressure cpap it is expected that members receive lifestyle advice where applicable i e helping people to lose weight stop smoking and or decrease alcohol consumption.