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Advise please - navigating US health system for a sleep study
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OpalRose Offline

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Posts: 3,167
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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #11
RE: Advise please - navigating US health system for a sleep study
The problem here in the US is that health insurance coverage varies from state to state, and who your coverage is with. Although most insurance try to follow Medicare guidelines even if not on Medicare. When I hear that some insurances don't cover Sleep tests, that confuses me.

I believe that when you have a deductable (whether high or not), that must be met before they kick in any payments.

Your son really needs to do his homework and find out exactly what his coverage is, and if he discovers that he will have to pay most out of pocket, then the cheapest way would be an overnight home study. Then start checking online for a reasonably price APAP. (Not a Cpap).

He can see a regular GP or dentist, but sometimes they are not that keen on writing a script for anything Cpap related. My dentist stated he didn't know much about Cpap and was not comfortable with writing a script, and my GP said much the same.
I had to see a sleep specialist. Sad

Anyway, as I said, you son needs to check first on his coverage.
Good luck in helping your son maneuver the Heath Care system.

OpalRose
05-22-2016 10:49 AM
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Posts: 3,331
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #12
RE: Advise please - navigating US health system for a sleep study
Keeping it simple: At the top of this page is a link to the Supplier List. Supplier #30 may be a good fit for your needs. For $299 U.S. they will provide a home sleep study and physician review. This results in a legal prescription for machine, mask etc. That is about 1/10th the cost of a clinic sleep study, not to mention the cost of doctors appointments. You can choose to use that prescription to buy from any supplier. If there is insurance applicability, Supplier 30 will bill, and I'm sure they can make any costs apply to the HSA. Unless you are into a lot of trial and error, this is about as straight-forward as it gets for highly discounted health services and equipment, whether insurance applies or not.

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05-22-2016 12:21 PM
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Carbon Offline

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Posts: 53
Joined: Feb 2016

Machine: Resmed Airsense 10
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed
CPAP Pressure: 10-13
CPAP Software: SleepyHead

Other Comments: EPR 3cm, Autoramp from 8cm

Sex: Male
Location: Australia

Post: #13
RE: Advise please - navigating US health system for a sleep study
Thanks for all the great input! I'll run all this past him and see how we go. Sleeprider, the straight forward approach sure appeals!
05-23-2016 03:14 AM
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ED OF SO CAL Offline

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Posts: 3
Joined: Dec 2015

Machine: ResMed AirSense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: Mirage FX Nasal Mask
Humidifier: built into unit
CPAP Pressure: unsure - Autoset
CPAP Software: Other Software

Other Comments:

Sex: Male
Location:

Post: #14
RE: Advise please - navigating US health system for a sleep study
I live in Southern California. I contacted an uncle who used to be a Baja California "DIPUTADO" - Senator/Congressman in Mexico. He referred me to a highly reputable "CARDIO PNEUMOLOGIST" in Mexicali Mexico and he conducted a sleep study on me. The Study ($250.00 USD), the Dr's Visit with prescription ($50.00 USD) and the followup visit with a one hour English letter to the F.A.A. for my Pilot's Medical ($50.00 U.S.D.) was the entire Medical expense. Note that I already have a Mexican Cardiologist for High B.P. and he had already conducted the bloodwork ($120.00 USD) & 3 visits at $50.00 USD each, (during the three visits the Doctor personally did a full body ultrasound & ekg on me)... that was all of the Medical expense involved. The Equipment was around $1,250.00 cash payable to an internet supplier in the USA with a prescription... Which included a Resmed Autoset 10 with climateline heated hose & an FX Mirage Nose mask, spare filters etc.

The F.A.A. was happy... & although I did not think that I had a problem.... I learned that I did have a real problem which is being treated ... and I feel better.

I have a supposedly "good healthcare plan that is Obamacare compliant" but the delays... the idiotic paperwork... the stupid referrals and the wasted time etc., caused me to blow off the American Health Insurance and get the job done direct with qualified medical professionals and pay cash.

I used a dental appliance available in a regular drug store for about $15.00 USD to train myself to sleep with a closed mouth.... I have previously always been a mouth breather at night.... I think because I have a mild nasal obstruction.... The Resmed gear fixed that problem.

Oh yes... I also eliminated the RAMP Time.... I felt like I was asphyxiating with the Ramp feature activated.

In about four weeks, I pretty much got it well in hand.... I have now been on the CPAP for about 8 months.... no problems except when my cat took to punching holes in my hose and I had to replace it. GRRRRRR...

Oh Well.... That kitty no longer sleeps in the same room that I sleep.

It took a positive attitude ...

By the way, I also SCUBA..... Not a problem for me .....

My 2 cents. (Maybe 50 Cents? ? ) ;-)
07-15-2016 02:34 AM
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OpalRose Offline

Monitors

Posts: 3,167
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #15
RE: Advise please - navigating US health system for a sleep study
Welcome to Apnea board ED!
It sounds like you took control of your situation. Now you may want to consider downloading the free SleepyHead software so that you can monitor your progress. We can help with any questions you have.
http://sleepyhead.jedimark.net/

OpalRose
07-15-2016 05:46 AM
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Posts: 3,331
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #16
RE: Advise please - navigating US health system for a sleep study
ED, I'm glad you found a solution. Trips to Mexico are not convenient nor economical for most of us, and as long as you're willing to forego insurance reimbursement, economical alternatives are available to everyone. For example, Supplier #30 on our supplier list http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List offers a sleep study and prescription program for $299, which is a bit less than you paid. Lots of problems with the medical system, but that discussion ventures into the political realm that is kind of off-limits here.

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07-15-2016 08:48 AM
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ED OF SO CAL Offline

New Members

Posts: 3
Joined: Dec 2015

Machine: ResMed AirSense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: Mirage FX Nasal Mask
Humidifier: built into unit
CPAP Pressure: unsure - Autoset
CPAP Software: Other Software

Other Comments:

Sex: Male
Location:

Post: #17
RE: Advise please - navigating US health system for a sleep study
Sorry that I mentioned the "WHYs" because I just wanted to share. It was not the focus of my sharing. I just wanted to put out my story and why it was that I did not just go through the "regular process". I guess I am lucky that I could do it and I just wanted to put that idea out so that others who might want to get their problem solved faster could also act "outside of the box"... The whole process for me took about three weeks. It took that long because I work and had to come and go into Mexico....

Thank you for providing this forum...

I have downloaded the software that lets me print out the reports and look at all of the "Issues" that I have as recorded by my RESMED machine.

This is a great site.

Thank you for keeping it online with the opportunity to share experiences, advice and software.

A rather "recent" airtube head.....

Ed.
07-21-2016 11:49 PM
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