03-16-2018, 01:52 PM
BiPap taken away/Medicare rules
Hi All,
I was wondering if anyone else has had this problem. Sorry this is long.
I have been on BiPap for 8 years. It has definitely helped me sleep, and definitely has helped me during the day as to how I feel. I had my original sleep study in January 2010, had sats in the 70's, had apnea and hypopnea, and the diagnosis was made. I have mostly central apnea, some obstructive due to my weight and a short neck.
I had another study done in December 2015, which didn't go well. I never really fell asleep, they did not have the proper mask for me, after telling me I did not need to bring anything. They used a very small, tight, ill fitting mask; I am use to the Liberty Mirage mask/hybrid. I complained to my pulmonary doctor. He just said it showed I still had apnea.
I went on Medicare in October 2016. I went to my pulmonary doc for the 'Medicare' visit that month. He supposedly filled out all the paperwork. Apria apparently never sent paper work to Medicare for my BiPap machine, the monthly 'rental', during this whole time period. Apria kept calling me about the bill. I had made many calls back to Apria during this time period, and never once did they tell me anything about 'Medicare guidelines'. They kept telling me the doctor needed to send this paperwork or that paperwork. They put me in the middle, they made no calls to the doctor's office until the end of this mess. I now have a $1200 bill that has been sent to a collection agency.
I saw my pulmonary doc in February and again told him about the mess. He said let's get another sleep study. First he did a home sleep study, which showed I had 5 or less episodes of apnea/hypopnea per hour. He then ordered a lab sleep study. I had some trouble getting to sleep. The next thing I know, the tech is waking me up at 4:30am, telling me I had only 1 episode of apnea, and several episodes of hypopnea per hour. He said my sat never fell below 88. He said I didn't have enough episodes to go into the second part of the test, to test me on bipap.
So when I visited my pulmonary doc after the testing. He said the study in Dec. 2015 showed no apnea and that's what he had sent to Apria. He said the current study showed I had few episodes. He says I don't need to be on bipap!! It didn't matter that my app on my phone, linked to my machine, said I had nights with varying episodes of apnea and hypopnea. Sometimes I'd have 1-2 episodes per hour, sometimes 8-9! It didn't matter that my husband notes at night, that when I sleep without the Bipap (like when I had the respiratory flu in January), I still have loud snoring, gasping and irregular breathing. It didn't matter that the bipap helps me get a better night sleep and I wake up alert and rested. NO...I don't qualify under Medicare guidelines for Bipap anymore!!
So now I am without a Bipap machine! I do not know what I can even do about it! Has anyone else had this problem, and how did you handle it?
Tired, groggy, foggy, headachy, angry....
RM
I was wondering if anyone else has had this problem. Sorry this is long.
I have been on BiPap for 8 years. It has definitely helped me sleep, and definitely has helped me during the day as to how I feel. I had my original sleep study in January 2010, had sats in the 70's, had apnea and hypopnea, and the diagnosis was made. I have mostly central apnea, some obstructive due to my weight and a short neck.
I had another study done in December 2015, which didn't go well. I never really fell asleep, they did not have the proper mask for me, after telling me I did not need to bring anything. They used a very small, tight, ill fitting mask; I am use to the Liberty Mirage mask/hybrid. I complained to my pulmonary doctor. He just said it showed I still had apnea.
I went on Medicare in October 2016. I went to my pulmonary doc for the 'Medicare' visit that month. He supposedly filled out all the paperwork. Apria apparently never sent paper work to Medicare for my BiPap machine, the monthly 'rental', during this whole time period. Apria kept calling me about the bill. I had made many calls back to Apria during this time period, and never once did they tell me anything about 'Medicare guidelines'. They kept telling me the doctor needed to send this paperwork or that paperwork. They put me in the middle, they made no calls to the doctor's office until the end of this mess. I now have a $1200 bill that has been sent to a collection agency.
I saw my pulmonary doc in February and again told him about the mess. He said let's get another sleep study. First he did a home sleep study, which showed I had 5 or less episodes of apnea/hypopnea per hour. He then ordered a lab sleep study. I had some trouble getting to sleep. The next thing I know, the tech is waking me up at 4:30am, telling me I had only 1 episode of apnea, and several episodes of hypopnea per hour. He said my sat never fell below 88. He said I didn't have enough episodes to go into the second part of the test, to test me on bipap.
So when I visited my pulmonary doc after the testing. He said the study in Dec. 2015 showed no apnea and that's what he had sent to Apria. He said the current study showed I had few episodes. He says I don't need to be on bipap!! It didn't matter that my app on my phone, linked to my machine, said I had nights with varying episodes of apnea and hypopnea. Sometimes I'd have 1-2 episodes per hour, sometimes 8-9! It didn't matter that my husband notes at night, that when I sleep without the Bipap (like when I had the respiratory flu in January), I still have loud snoring, gasping and irregular breathing. It didn't matter that the bipap helps me get a better night sleep and I wake up alert and rested. NO...I don't qualify under Medicare guidelines for Bipap anymore!!
So now I am without a Bipap machine! I do not know what I can even do about it! Has anyone else had this problem, and how did you handle it?
Tired, groggy, foggy, headachy, angry....
RM
opinion is that it wouldn't have had the best outcome should you have 
