RE: Anyone gone rogue? (No insurance)
Try a Mirage Activa mask. It is a nasal mask but has a very good seal that is very forgiving on leaks. It is larger than most modern nasal masks but if it works for you.
Using the system prior to sleep is a method of helping your body get used to it. After all we were not born with an alien stuck to our face. ;-)
RE: Anyone gone rogue? (No insurance)
I guess I went rogue years ago. I don't remember the last time I got the insurance company to pay for a CPAP or supplies. Its been a lot simpler to pay for everything out of pocket and then take the expense off on my taxes! Howwever, I may have to revert to the insurance when my itemizations no longer surpass the standard deductions.
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.
03-12-2021, 03:44 PM
(This post was last modified: 03-12-2021, 03:47 PM by Canuck 2.)
RE: Anyone gone rogue? (No insurance)
I went on my own "pay as you need Cpap Supplies" about 5 1/2 years ago when I retired from my job. My wife was telling me you can buy products on line in Canada and found out you need a prescription from my doctor which was not a problem after explaining my situation.
For me to buy from my prescribed previous supplier from Canada with out insurance for a Airsense 10 autoset was just over $2100 with the heated hose & no mask. Online was just under 1/2 of that amount which gave myself the funds to supply my filters and mask straps and distilled water for the next 5 years. I just replaced my 5 yr old Resmed Airsense 10 autoset and it was less cost than 5.5 years ago from my same online supplier(sale).
I liked it when the company's insurance picked up the tab, but being controlled by the insurance company is not a very nice thing and they no doubt had folks who could not adapt to the machines and would not use these expensive devices so they made up their own rules how to control this issue.
I had no problem adapting to the machine and when you get the right mask and the wife is use to seeing me dawning it was not a problem for insurance rules.
For just buying a regular Cpap machine and with the insurance deductible's in the US and Canada it makes more sense to buy your own device more than likely until you get into the high end Resmed ASV machine and Bipap machines it would be nice to have insurance then.
You can also buy from Supplier #2 used products also.
So going rouge for the last 5-6 years is not a big deal IMO.
RE: Anyone gone rogue? (No insurance)
If the DME was doing their job, they would find a mask that works for you.
To their credit, my DME did find a mask that worked for me, a F&P Bravida. It was covered by insurance, except I had not met my deductible. So I paid $300 when I could have bought one from Supplier #1 for $89. It also took 6 weeks to get it. That was the last time I dealt with them. I buy my supplies for a fraction of the DME costs and I don't need their ridiculous schedule.
RE: Anyone gone rogue? (No insurance)
Is it true that after 13 months you re done no more renting cost monthly for a machine paid by Advantage plan?
I was charged $8.55 monthly for Resmed Airsense 10. I bought another brand new machine for back up but waiting for the 13th coming - because of this required insurance.
RE: Anyone gone rogue? (No insurance)
I'm fortunate to have insurance that pays for everything with no deductible or copay thanks to California Public Employees Retirement. Even so, since I'm over 65 Medicare is mandatory, and all the rules that go with it. As my Vauto is now over 5-years old and 17,200 hours, I called may supplier about a replacement. They warned that my machine must first fail, and my last sleep test was in 2008 so I may have to demonstrate the need for the bilevel machine I have been prescribed and using the last six years or so. So even though I have great insurance, I am also subject to government bureaucracy and supplier indifference and have to prepare for battle. I have located a used Resmed Aircurve 10 Vauto with 3206 hours that will cost $150 plus about $25 shipping and insurance. Having the backup will allow me to survive a breakdown of my old machine and provide leverage in acquiring a replacement. I figure that's a decent deal.
RE: Anyone gone rogue? (No insurance)
I live in Canada, maybe the general rules are different. I abandoned APAP for about 7 years, self funding some pretty pricey OA appliances. Over that period I helped a few others find affordable CPAP solutions because of no insurance. Looking back at my purchase history, every insurance paid CPAP was priced @ 2,000.00CAD$. Over a 5 year machine replacement cycle, 400.00CAD$/year or 1.10CAD$/day.
I have recently returned to CPAP therapy. I have some form of coverage, but have to go through the hoops to get approved. To expedite replacing my RemStar M from 2009, I went online and picked up a new AirSense 10 Auto, delivered for 800.00CAD$. Over a 5 year machine replacement cycle, 160.00CAD$/year or 0.44CAD$/day.
I pay around 8.00CAD$/day for combined electricity and natural gas.
Either way, CPAP is a very inexpensive treatment. Now replacing accessories according to the manufactures schedule is obscene unless really required. If you look after your equipment properly, hoses and mask are pretty tough components. I can see the head strap losing its elasticity before a complete mask needs replacement. The silicone parts that touch your skin might need replacing based on your personal skin condition, but for me they use to last for several years with regular careful washing. Not boiling them or using aggressive cleaners. Dial Antibacterial soap or Dawn. If it doesn't hurt birds caught in oils slicks, it won't hurt us.
With the improvements in auto technology, you only really need a therapist for your first setup. Pay close attention to what they do, and sever the cord.
Don
RE: Anyone gone rogue? (No insurance)
I dunno but just being on Apnea Board probably makes you a rogue already. Messing with pressure dials and all that dangerous blowing up lungs kinda stuff.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Anyone gone rogue? (No insurance)
I just started, but I started as rogue. My insurance deductible is high enough that I decided to just pursue the sleep study and treatment on my own and not have to hassle with their rules. I am pretty sure that I still saved money by shopping around vs. using an "in network" provider and paying those rates prior to the deductible kicking in.
RE: Anyone gone rogue? (No insurance)
(03-11-2021, 01:47 PM)Crimson Nape Wrote: 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.
I agree completely with the above answer. When first diagnosed over 10 years ago, I tried going through insurance. They wanted me to use some crappy subsistence level machine without all the nice features - and my co-pay was huge. I said FI and just bought my own machine(s) and never looked back. My Rx is on file with the provider I use for masks and replacement machines, so I just direct order them at a good price. This way I can get what i want, when I want it.
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