Insurance & Costs
What Will I Pay for CPAP or CGM Supplies?
The honest answer: it depends on your plan. What we can promise is that you will know your estimated cost before anything ships — we verify your benefits first and never ship on guesswork.
Quick Answer
Your cost depends on your plan type, whether you have met your deductible, and whether you have secondary coverage. With original Medicare, Part B typically pays 80% of the approved amount for durable medical equipment after the deductible and you pay 20%. Medicare Advantage, Medicaid, and commercial plans each set their own amounts. Specialty Medical Equipment verifies your specific benefits and confirms your estimated cost with you before any supplies ship.
The four things that decide your cost
Your plan type
Medicare, Medicare Advantage, Medicaid, and commercial plans each cover CPAP and CGM supplies differently. In-network status with your specific plan matters most.
Your deductible
If you have not met your plan’s annual deductible, you may pay more early in the year. Once it is met, coinsurance usually applies instead.
Coinsurance and secondary coverage
Many plans pay a percentage and leave you the rest. A secondary or supplemental plan may cover part or all of your share.
Documentation
Plans pay only when the prescription and medical records meet their rules. Missing paperwork is the most common reason a claim is denied — we check this before shipping.
A general Medicare example
With original Medicare Part B, durable medical equipment like CPAP machines and CGMs generally works like this: after you meet your annual Part B deductible, Medicare typically pays 80% of the Medicare-approved amount and you pay the remaining 20%. CPAP machines are usually rented for 13 continuous months, after which you own the machine.
If you have a Medigap supplement or secondary insurance, it may cover some or all of your 20%. Medicare Advantage, Medicaid, and commercial plans each follow their own fee schedules and rules.
This is a general description of Medicare policy, not a quote. Your actual cost depends on your specific plan and is confirmed with you before anything ships.
Find out your actual cost
Send us a few details and we will verify your benefits with your insurance plan, then tell you your estimated out-of-pocket cost. No commitment, no charge for the check.
Prefer to talk? Call 1-877-622-3023
Insurance cost questions
Coverage and costs depend on your insurance plan, your diagnosis, and your prescription, and must be verified before any supplies ship. Nothing on this page guarantees coverage or a specific price.