CPAP and Medicare

I have been using a CPAP machine since 2005. I purchased my last machine out of pocket. I have Medicare and Medicare supplemental plan F Insurance that Im told will cover the cost of a new machine and supplies. "ANY TIPS" for working with my General Practitioner toward this process? Medicare tells me the doctor will have the forms?

If you have just joined Medicare, they may require a sleep study. Otherwise all you need is a prescription from the doctor ordering a CPAP/BIPAP and listing the recommended settings.

If your last sleep study was done by a Medicare-approved clinic, it is usually accepted.
Contact Medicare directly, and ask them if your data is up to date.
Since your Medicare part B and supplement plan F will cover all the expenses,
if they do need another sleep study--you would only be out the time.

Thanks. I will start the process with doctor and medicare.

I transitioned last year to Medicare. The sleep Dr said a sleep study was required and scheduled it. The DME provider said it wasn't, that all they needed was the original sleep study (which they had) and a note from the Dr saying I was using CPAP and still needed it. That worked. No new sleep study. FYI, once given the new machine, Medicare requires proof the new one is being used and a note from the Dr saying you're using it based on the downloaded data.

CPAP2017 wrote: ↑

Thu Mar 03, 2022 2:59 pm

I transitioned last year to Medicare. The sleep Dr said a sleep study was required and scheduled it. The DME provider said it wasn't, that all they needed was the original sleep study (which they had) and a note from the Dr saying I was using CPAP and still needed it. That worked. No new sleep study. FYI, once given the new machine, Medicare requires proof the new one is being used and a note from the Dr saying you're using it based on the downloaded data.

My experience was the same 1) sleep study done and Cpap treatment initiated prior to Medicare coverage. Years later, now on Medicare, new sleep study was not needed to obtain new machine. 2) what was required was a new script from doctor and his determination of medical necessity. During the Medicare rental period (13 months) he or the DME had to verify that I was using it per medicare's requirements.(Actually this seems to be paperwork that the DME has to maintain - but they don't send anything to Medicare unless Medicare is investigating).

Only thing required of Dr is prescription (or equipment order) and a statement of Medical Neccesity (which is a form), otherwise the DME should handle and maintain all the required information.
Easy-peasy