A Continuous Positive Airway Pressure (CPAP) machine is also known as a respiratory assist device. A CPAP machine is durable medical equipment. This is a limited benefit.
TRICARE may cover CPAP machines for:
- Obstructive sleep apnea syndrome
- Respiratory insufficiency
Portable CPAP Machines
TRICARE may cover a portable CPAP machine. You must be an active duty service member. You must have a referral. The referral must note:
- Your diagnosis of obstructive sleep apnea
- You travel on official business at least three days per month, or you're being deployed
- You aren't retiring or separatingSeparating from the military means that you leave the service before you retire. from the military within the year
Also, the device must have humidification and battery capability.
If you have a standard CPAP machine, you can get a portable machine as long as you meet the above conditions. TRICARE won't authorize a standard CPAP machine if you already have a portable machine.
TRICARE covers batteries for active duty service members for standard and portable CPAP machines. You must submit a request to your regional contractor. The request must note:
- You're deployed
- You aren't retiring or separating from the military within the year
You'll get a new battery if your current battery:
- Doesn't work after normal use
- Gets damaged during your deployment
TRICARE doesn't cover:
- Variable Positive Airway Pressure (VPAP) machines
- Adaptive Servo-Ventilation (ASV) machines
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 3/20/2022