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Anyone gone rogue? (No insurance)
#1
Anyone gone rogue? (No insurance)
I'm really bothered by the demands of the insurance company. If I don't log four hours a day on CPAP, they won't pay for it. I also don't like the idea of my medical data being transmitted to anyone. I'm thinking about returning the equipment, and simply buying my own stuff. Then, if I don't feel like using it, no one will know or care. Right now, every time I try a new mask, I have to take a day or two off to catch up on my sleep. I certainly am not able to meet the minimum threshold of 4 hours a day. So far, my insurance is paying, but at a 'price'. Thoughts?
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#2
RE: Anyone gone rogue? (No insurance)
To help get use to Cpap take it to your living room and hook it up watching tv or reading a book. You only have to log in 4 hours a day. The Cpap does not know if you are asleep or watching tv. It is very easy to get 4 hrs.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Anyone gone rogue? (No insurance)
Some questions about the CPAP "calling home."  I know the real purpose is to generate the compliance report for insurance / Medicare. I really don't mind that, I pay for a Medicare Advantage Plan (Kaiser), and I would really rather pay 20% rather than 100%, not just for  the machine but all the on-going costs for supplies that need periodic replacement. BUT who is on the other end of the call when the CPAP calls home?  Only Apria (my supplier), or others as well? If so, who?  And couldn't I just email the OSCAR compliance report to Kaiser  instead? If not, why not?
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#4
RE: Anyone gone rogue? (No insurance)
On compliance, If you are not using your CPAP it is not helping you.

Usin your CPAP while doing something that you enjoy doe help you to get used to it.

We do our best work when we see the OSCAR nightly charts, with them we can often see what is happening and why it is happening. Often it is a few simple changes to settings that make things better.

Also, Be specific about your issues. I see complaints about mask usage, but no hints about what problems you are having. And specifically why are't you able to use your CPAP for more than 4 hrs per night?

On going Rogue, There are many here that, to some extent or another, have gone "Rogue". It is often cheaper than your insurance.
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#5
RE: Anyone gone rogue? (No insurance)
I've ultimately gone rouge.   I was on private insurance when I started therapy.  About 4-months in, I switched to a Medicare Advantage plan.  This caused problems because my doctor had acted as my DME.  This is a big "no-no" with Medicare.    After getting this straightened out, I soon realized that I could directly purchase supplies cheaper than what my co-pay was.  That was in 2014, and I've never looked back.  

A side note:  Supplies last a considerably longer than what is on the replacement schedule.   I am still using most of my original supplies.  The last item, that I can remember purchasing, was a F30 mask sometime last year.
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#6
RE: Anyone gone rogue? (No insurance)
Wow, that is eye-opening. Direct purchase for less than the co-pay? I also thought that supplies must last a lot longer than the replacement schedule. I think if I replaced everything on Resmed's recommended schedule I would soon have a drawer full of perfectly serviceable masks, hoses, and water tubs!
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#7
RE: Anyone gone rogue? (No insurance)
My problem with masks is that they all leak- a lot. Too much to get any useful data or therapy. Only if I clamp them down painfully tight do they seal acceptably. I tried a nasal pillow, and while I think it seals pretty well, I think my mouth opens when I'm asleep, even with a chin strap. Someone suggested tape; um, no, I'm not going to tape my mouth shut.

Everyone keeps telling me about the benefits of the therapy, but you have to bear in mind that I don't have any symptoms of OSA. I sleep well, don't snore, wake refreshed, and have energy all day long.
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#8
RE: Anyone gone rogue? (No insurance)
(03-11-2021, 05:46 PM)SCgargoyle Wrote: My problem with masks is that they all leak- a lot. Too much to get any useful data or therapy. Only if I clamp them down painfully tight do they seal acceptably. I tried a nasal pillow, and while I think it seals pretty well, I think my mouth opens when I'm asleep, even with a chin strap. Someone suggested tape; um, no, I'm not going to tape my mouth shut.

Everyone keeps telling me about the benefits of the therapy, but you have to bear in mind that I don't have any symptoms of OSA. I sleep well, don't snore, wake refreshed, and have energy all day long.

Leakage is one of the things recorded by the Airsense 10 and reported by OSCAR.  I would have to disagree that they all leak "too much."  How much is "too much"? That is a subjective statement. Leakage is graphed by OSCAR. You can see when it occurred, how much, and and perhaps correlate to something else that you can fix to reduce leakage. You use OSCAR, what is it showing you?
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#9
RE: Anyone gone rogue? (No insurance)
I don't have a choice about going rogue. To get insurance for my OSA I'd have to have the top level cover - not worth it. Canny buying from suppliers like #2 has been a godsend.
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#10
RE: Anyone gone rogue? (No insurance)
(03-11-2021, 01:00 PM)staceyburke Wrote: To help get use to Cpap take it to your living room and hook it up watching tv or reading a book. You only have to log in 4 hours a day. The Cpap does not know if you are asleep or watching tv. It is very easy to get 4 hrs.

I've had several people recommend using the machine 4 hours a day while watching TV or reading. What's the point in doing that? That's like continuing a medicine prescription, but flushing them down the toilet. If it's not working for you, why not just return the equipment? I can't imagine trying to read with air blasting out of the leaky mask.

Last night was typical. I spent about 3 hours screwing around with the mask. I started very loose. I put a very small amount of tension on it, and it sealed- for a couple breaths. No matter how tight or loose, it won't seal for more than maybe a minute or two. I can't get to sleep because of the noise of the rushing air, and feeling it blow all over my face. No matter how good the seal seems, the slightest movement of my face results in leakage. After the machine ramps up to full pressure, it just gets that much harder to obtain and keep a good seal. Around midnight, I gave up and turned it off. I woke at 4 AM like usual, and feel fine.

Right now, I feel pressured to 'perform' due to insurance requirements. I also don't like sharing my medical data. If I go rogue, I can use it when I feel like it, or not. Right now, I screw around with it every other night so I can catch up on my sleep.
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