BiPAP advice please?

[Fats Drywaller]

I am going for the AirCurve 10 VAuto.

It's relatively expensive and you wouldn't want to buy it yourself if you can get it via insurance, unless you're rich and you can afford to pay to minimize hassles & delays. The high cost could be why the DME is giving you a runaround. The plain old APAP machine in the Resmed line is around $900, but the Aircurve 10 VAuto bilevel is around $1700. If your insurance is current and your prescription specifies a bilevel machine, then you're entitled to it and you should push for it. There's also the possibility of finding a different DME (in-network, as recommended by your insurance provider) that's not such a PITA.

[Fats Drywaller]

I then called Blue Cross and they again confirmed I am eligible for a machine with a current script and to call CareCentrix (the overseer?). I called CareCentrix and they switched my DMEs from Lincare to Aprea.

Aha, there you go. I posted my previous reply before reading yours.

So I will wait and see what Aprea does. How do people who aren’t well equipped to advocate for themselves able to navigate the systems?

I've wondered that myself.

[GrimeyGal]

I have great insurance, have already met my annual deductible, and am not concerned with paying the difference or paying up front and waiting for reimbursement. 

More importantly, I had not even told them what a machine I want yet!

[Fats Drywaller]

I have great insurance, have already met my annual deductible, and am not concerned with paying the difference or paying up front and waiting for reimbursement. 

More importantly, I had not even told them what a machine I want yet!

If Apria doesn't do it for whatever reason (and I assume that Apria customers/victims here can give you more information about that in addition to the existing discussions going way back), one possibility would be to take a look at Supplier #30 after having your BCBS custservdroid confirm that it's OK to use an out-of-network DME, which is what #30 is. Supplier #2 is also a DME but according to its web site it doesn't have a new A10 VAuto in stock at the moment, only used ones. Supplier #15 says on its site that it is not a DME but it can connect you with one and it provides a form to fill out to get started.

[Sleeprider]

If anyone wants to verify the function of your old machine, you might just want to offer to bring it to them. It's something of a doorstop anyway. I think DMEs often make up problems that don't exist. They have to submit any new machine request to your insurer for coverage. If you have documentation of your coverage, that should satisfy the requirement. You might even want to check with Supplier #30 and see if they will help you navigate the insurance issues. They are one of the few online suppliers (located in California) that offers to do insurance reimbursements.

[ardenum]

I've got a question to US people. When I check any of the US shops, it says prescription required, does that mean you can't buy it without a prescription? I'm confused, how would you buy a machine if you wanted to just pay for it?

[Sleeprider]

There are many ways to buy the machines used and new; with and without a prescription. DMEs will not sell them since they are audited for prescription records to support their sales, but surprisingly, distributors are not, and often run a thriving back-door business.

[Crimson Nape]

CPAP machines and complete masks require a prescription in the U.S.. Just about any medical professional that can write prescriptions,except a Dentist, can write the script.  An easy thing to do is ask your PCP for the script.

[GrimeyGal]

Ummmm.... I repeat... I have a NEW SCRIPT.

[Crimson Nape]

GrimeyGal, I was replying to crowtor's post above.  

I've got a question to US people. When I check any of the US shops, it says prescription required, does that mean you can't buy it without a prescription? I'm confused, how would you buy a machine if you wanted to just pay for it?