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$4500 for this ??
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #11
RE: $4500 for this ??
(03-15-2013 11:42 PM)Labrat0116 Wrote:  I did find it a bit odd that my Doc sent me to (1) specific company and I was not given a choice to any other. Can you say "kick-back" !! LOL!

Call your insurance company and find out if there are other durable medical equipment (DME) providers that are listed in your insurance plan. You can also ask about the cost of your machine, and then you can call other DME's on the list and ask them how much it would cost if you bought from them. Don't be surprised if you get different answers from everybody and the actual cost is different from them all.

This is the biggest problem with health care in the US: the insurance companies are running the show and have done everything they can to lobby legislators to increase their profits at our expense.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-15-2013 11:58 PM
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SuperSleeper Offline

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Posts: 9,973
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #12
RE: $4500 for this ??
Well, a $850 co-pay is still going to be a whole lot less than paying anywhere near retail price for an S9 Adapt SV.

Cheapest online price I found (for just the machine) was something like $3500, and that didn't include a climateline hose or a mask of any type, which might add $200 or more on top of that.

But keep in mind that brick-and-mortar DMEs (Durable Medical Equipment suppliers) will always have higher prices on machines than buying from an online DME. They have much higher overhead costs.

The problem is that most insurance companies won't reimburse you if you purchase a machine via on online shop. They usually have a set list of DMEs they deal with in your locale (all brick-and-mortar shops).

There is no large cost-saving alternative that I can see for you, short of shopping around to one of the local DMEs approved by your insurance company. As others have posted, that $4500 cost may or may not be the final price that insurance pays to the DME. In any case, your "out of pocket" costs of $850 or so seem small when compared to the actual cost of the machine.

That machine is not like a simple CPAP or APAP. It's an Adaptive servo-ventilation machine, which is much more complex and expensive.

Coffee

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

03-15-2013 11:59 PM
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Shastzi Offline

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Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #13
RE: $4500 for this ??
I concur with SuperSleeper, LabRat.
The Auto Servo machine is the Earthmover of APAPs.
All the rest of us, by comparision, are just using pick-up trucks.
Sounds like you are on the right path.
Best of luck with your DME, hope they can get you going soon.

"Find the resolve to get on the therapy and stay on it." : quote by me. Smile
Might want to think about getting a Medic Alert bracelet too or get yours updated if you already have one.

Cheers and Best of Luck!

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-16-2013 09:00 AM
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u2canbuild Offline

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Posts: 47
Joined: Oct 2012

Machine: ResMed Air-Curve 10 ASV
Mask Type: Nasal pillows
Mask Make & Model: Sept 1 Nasal Pillows Swift FX
Humidifier: Res-Med
CPAP Pressure: 3-8
CPAP Software: SleepyHead Other Software

Other Comments: 4 months AHI = 0.2 !! Adding 1.5 to 2 Liter O2

Sex: Male
Location: Central Massachusetts, USA

Post: #14
RE: $4500 for this ??
(03-15-2013 05:52 PM)Labrat0116 Wrote:  I would mortgage my house and spend all of the money if necessary....... to be free of Sleep Apnea.Oh-jeez

The damage my Sleep Apnea has done is huge. I most likely have had it for 25+ years.

I have had to make hours of phone calls, Many letters, ect, Seen over 9 doctors....

Not to mention, the suggestion to get a Sleep Study was not a doctor, but a friend of a distant family member.........Sad

I realize dealing with the "System" is frustrating,

Nice, but persistant calls seem to eventually work. I try to never complain, but ask "how I can facilitate the delivery" or "can I drive 200 miles to pick it up" or to a doctor " how can I help you..... help me get better...........

Sometimes I want to rant and rave to the sales people and doctors about the costs and long delivery times, lack of proper assessment............ but I bite my tongue... and go chop some firewood.

They are all people just like us who have issues, family, frustrations, and lives to live and are human .........making mistakes along the way.

When I get good service, I make it a point to comment on it, and even write a letter to their supervisor or company.Smile

Sugar gets much more done than vinegar and I have found that if I can cultivate influntial friends/people in the medical business; they can work wonders.

Clearly this is not how it "should" be and we "should" not have to work so hard to get things................ but, I look at the situation, good or bad, and try to reach my goal any effective way.

I was on a boat that sunk in the Gulf of Mexico 2 years ago, and I survived, not because of "should" or "luck" , but because I assessed the situation and took action, and the actions I took had to change direction several times .

I used to work designing medical devices; The cost to bring a product from concept to market is huge; not to mention dealing with the FDA and all of the testing and paperwork.

If a company made as many CPAPs as cars or socks, the price would be less.

Yes, the costs are excessive............ However: If companys did not make money; they would not be in business............. and we would not have a solution to our health needs...........

Sorry for the long winded essay.

Best of sucess!Cool

Eric2







Hi Folks, I've been recently diagnosed with Central/Obstructive "complex" sleep apnea. Woo! Hoo! Banana

Anyways, I haven't yet received my machine. I've been waiting on the Medical Company that the Dr. referred me to to get all the stuff authorized by my insurance. Just got verified a couple hours ago.

The Medical Equipment company gave me a quote of $4500 for the following. My out of pocket (20%) is around $850!

ResMed S9 Adapt SV and a Quattro small full face mask ??

Seriously ?? Surely this stuff can be has much less expensive!

What say you ?

TIA!

ERIC
03-16-2013 04:11 PM
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JJJ Offline

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Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

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Sex: Male
Location: USA 97217

Post: #15
RE: $4500 for this ??
(03-16-2013 04:11 PM)u2canbuild Wrote:  I used to work designing medical devices; The cost to bring a product from concept to market is huge; not to mention dealing with the FDA and all of the testing and paperwork.
If a company made as many CPAPs as cars or socks, the price would be less.
Yes, the costs are excessive. However: If companys did not make money; they would not be in business and we would not have a solution to our health needs

I do not disagree with your basic premises here. It is a free enterprise system and all the major players are publicly held companies with openly traded stock. They have no choice but to make a profit; corporation law requires that the directors do the best they can for the shareholders. But it's open competition; your competitors' prices will limit what you can charge and everyone is always striving to make a better product at lower cost.

However, I would like to point out the massive price difference between equipment sold in the U.S. and the same equipment sold in most any other country. Even Canadians pay outrageously higher prices, and they're part of the North American Free Trade Agreement. As a USan I sure don't want to mess up my good deal, but something is not right.
03-16-2013 06:33 PM
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iSnooze Offline
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Machine: Respironics PR System One C-Flex+
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Humidifier: System One Heated Humidifier
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments: also use a Comfort Gel Full Mask by Respironics

Sex: Female
Location: Indiana

Post: #16
RE: $4500 for this ??
When I was first diagnosed with sleep apnea I was also stunned at the cost of the machine and gear. I thought that it would be cheaper to buy it online and not be reimbursed than to have insure pay and I cough up the 20% out of pocket. It was actually cheaper to go with the DME and pay the 20%. I also got an excellent tutorial on how to use the machine and was able to try on many masks before settling on one. The technician who explained how to use the cpap machine didn't rush and made sure I understood everything before she let me go. I know that not all DMEs are as friendly and professional as the one I went to, but for me having the insurance pay was the right decision.
03-16-2013 06:55 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #17
RE: $4500 for this ??
(03-16-2013 06:33 PM)JJJ Wrote:  However, I would like to point out the massive price difference between equipment sold in the U.S. and the same equipment sold in most any other country. Even Canadians pay outrageously higher prices, and they're part of the North American Free Trade Agreement. As a USan I sure don't want to mess up my good deal, but something is not right.

And look at the huge difference between what equipment companies charge for the machines and what insurance companies pay them for those machines.

You know something's wrong when the buyer gets to dictate what prices they'll pay.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-16-2013 07:11 PM
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DocWils Offline

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Machine: Philips Remstar series 60
Mask Type: Nasal pillows
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Sex: Male
Location: Switzerland

Post: #18
RE: $4500 for this ??
I hear all sorts of things about why the prices differ so much between countries on all sorts of things, and of course, medical equipment is one big one. Some talk about import tariffs, others about cost of living differences, all sorts of rubbish, but the real reason is mostly "what the market will bear". So long as there are people willing to pay those prices, then the prices stay that way - the Americans are more bolshy about prices than any other country, and they expect things cheap. Even Canadians are far less aggressive that way. My real complaint is the differences between what these things really cost and what the manufacturer wants us to pay for them, or the distributor, who often sets the real price point. I know that a lot fo R&D goes into CPAP machines, for instance, but I am pretty sure that when you figure in the real cost of building one, and all the other factors, it comes out to less than the asking price. On the other hand, I know good manufacturers who we selling their goods so close to their margins that in the end they went under either because of one bad quarter in sales or because major buyers, like the US demanded still lower prices, so the devices were made and sold at a loss. My tendency is to cut them a little slack. But I really don't' know why I still have to pay 2 million for an MRI that uses the same technology form ten years ago, except it now has LCD screens - the resolution isn't better, the mag rad isn't less, so why? Same with Ultrasound machines..... thankfully scalpels and haemostats are cheap....
03-16-2013 07:58 PM
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Sleepster Offline
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Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #19
RE: $4500 for this ??
(03-16-2013 07:58 PM)wilorg Wrote:  I hear all sorts of things about why the prices differ so much between countries on all sorts of things, and of course, medical equipment is one big one. Some talk about import tariffs, others about cost of living differences, all sorts of rubbish, but the real reason is mostly "what the market will bear".

That is true in a free market. So you're right that it's mostly what the market will bear. As in, that's the case for most commodities because most are traded on the free market.

But medical equipment and services aren't an example of that. Not in the US, and likely not in other countries, either.

In the US it's the insurance companies who control prices through their vastly successful lobbying efforts. All you have to do is be a patient in the US with medical insurance and that becomes obvious. We get these so-called "explanations of benefits" where we see providers charging outrageously high prices for equipment and services and insurance companies telling them that their entitled to something far less than that. Whether those adjusted costs or those unadjusted costs are anywhere near close to what the market would bear we have no way of knowing. It's an experiment (or as they say in the medical profession, a study) that hasn't been done. And unfortunately probably never will.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-16-2013 08:14 PM
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Shastzi Offline

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Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #20
RE: $4500 for this ??
What about paying upwards of $50 for a mask cushion that is mass produced and stamped out for about 30 cents.
Isnt that just a teensy bit of gouging going on, because it is a product needed by a captive public.
The mask straps and clips are similarly stamped out of cheap crap and built to fail after a short time in order to guarantee fast replacement turnovers.

I am not averse to the making of profits, I just have issues with people helping themselves to my wallet and then telling me its ok. Smile Used car salespeople and bankers come to mind as well.

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-16-2013 08:21 PM
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