No, as of 2026, a medical assistive device (such as a CPAP machine, breast pump, or portable oxygen concentrator) does not count toward your carry-on or personal item limit on most airlines. Under the Air Carrier Access Act, these devices are considered "non-optional" medical necessities. You can bring them on board in their own dedicated carrying case in addition to your standard baggage allowance. However, there is a strict caveat: the case must contain only the medical device and its accessories. If you pack personal items like clothing or books in the same bag, the airline may legally count it as one of your allowed bags and charge you accordingly. Always check if your specific device is FAA-approved for in-flight use if you plan to operate it during the journey.