CPAP Resupply Schedule: What Insurance Usually Covers

The short answer

Most insurance plans, including Medicare, allow CPAP supplies to be replaced on a published schedule — cushions monthly, tubing quarterly, headgear twice a year, and a new mask frame every three months. You typically do not need a new prescription each time, but you may need to show that you are using the machine.

Typical replacement intervals

Item	Common allowance
Mask cushion or nasal pillows	2 per month (pillows) / 1 per month (cushion)
Full mask with headgear	Every 3 months
Headgear	Every 6 months
Tubing	Every 3 months
Disposable filter	2 per month
Reusable filter	Every 6 months
Humidifier water chamber	Every 6 months

Your plan may be more or less generous. Commercial plans often mirror the Medicare schedule; some are more flexible.

What plans ask for

Three things come up repeatedly:

• A current order from your prescriber for PAP supplies. This does not usually need to be reissued every shipment, but it does expire.
• Proof of use. Many plans want to see that you are using the device — commonly a minimum number of hours on a majority of nights during a review period. Your machine reports this automatically over cellular or Wi-Fi.
• Confirmation that you actually need the supplies. Plans generally require that you request the shipment rather than receiving it automatically, which is why we contact you before each order.

Why supplies stop shipping

When a resupply order stalls, it is nearly always one of these:

• The prescribing order on file has expired and needs renewal.
• Usage data has not transmitted — often because the machine was unplugged, moved out of cellular range, or is in airplane mode.
• The deductible reset in January and the patient share changed.
• Insurance changed and the new plan needs fresh documentation.

None of these are dead ends. Most are resolved with a phone call and a records request to your sleep clinic.

What it costs

Supplies are typically billed like other durable medical equipment: your plan pays its share after your deductible, and you owe coinsurance or a copay. If cost is the barrier, ask us — financial hardship assistance is available, and we will tell you the expected patient responsibility before we ship anything.

Keeping it simple

You do not need to track a spreadsheet. We monitor your eligibility dates, confirm your coverage, and reach out when items come due so you can say yes or skip that cycle. If something feels off — supplies arriving too often, or not often enough — tell us and we will adjust the cadence.

Your next step today

Check the date on your current cushion. If you cannot remember when you replaced it, it is probably time. Contact us and we will look up exactly what you are eligible for right now.