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Buying a machine without Rx?
#1
Does anyone know where you can buy a machine without a doctor's Rx? I doubt that is even possible but this morning I had my appointment to pick up my new machine with my pressure setting, mask, etc and at the end of the appointment they asked me to sign a "Rental Agreement" which stated that I rent the machine for 3 months after which I could purchase the machine. My insurance will cover it 100% IF I adhere to strict guidelines of using it for at least 4 hours a night for 90 nights in a row. No exceptions, no second chances, not even allowed to miss 1 night or 1 hour. That's a tall order to fill. I won't lose anything except the machine. No copays, no deductible. If I can buy a machine on my own, I can avoid all this. Oh and the way they know if you are using the machine every night gets even better: There is a radio transmitter on it that sends info back to Carecentrics who then notifies my insurance company whether I am using it! Unbelievable. Like being spied on. Thanks for any info and sorry for rambling!
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#2
I bought both of my machines on Craigslist. Risky, but I did not need to provide my prescription. Also you need to learn how to DIY since it won't be set to your pressure.
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#3
You may also want to consider using an online supplier. See the link to the suppliers list at the top of the page. The online suppliers provide transparent pricing as a straight purchase without a contract or rental agreement. They are set up to contact your doctor to obtain your prescription. You can contact your insurance company to see if they will reimburse an online purchase--but the online suppliers do not provide insurance billing, so expect it to be out of network. Be aware that Medicare does not reimburse online purchases.
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#4
You can take your chances on Craigslist and hope you get a machine that actually works.

However, the 4hrs a night thing is not that hard to accomplish. You can keep track of the hours as well and, if at the halfway mark there's going to be problems, you can call the insurance co. and ask for an extension. If you give them enough warning and be honest, they probably will. Check each week with the supplier to make sure they are getting the data and that the data matches what you have.

Confirm that after the trial and they buy the machine, that the wireless crap be removed.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#5
Ask the doctor for a copy of the prescription ... For you to keep
Its your legal right to have copies of both the sleep studies and the prescription






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#6
Nobody says you have to use insurance to buy your machine as long as you can get an Rx from the doctor. Most people do so because they don't want to pay the full price. I paid for my travel machine because i knew insurance wouldn't pay for two machines; and, I apparently have bought my S9, as neither Medicare not BC/BS appear to be willing to reimburse me.
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.
INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#7
Insurance usually requires compliance for 70% of the nights, but yours might be different. Ask the insurance company directly.

If you get a copy of your prescription, you can order online. Check the suppliers list here.

You're lucky you stopped in here first. Many DMEs will try to screw you with a machine that doesn't collect any real data, just whether your use the machine or not. For the same cost to the patient, you can usually get a machine that will collect data on every breath, so you can monitor your therapy.

Post here first with the exact model of CPAP machine before buying one and we can help you avoid the land mines.

Do you know what model machine they were trying to give you?

Once you go from purchase to rental, you can take the modem off and they can't monitor your compliance any more, but you or your doctor can still monitor your treatment by reading the data stored on the SD memory card that comes in the machine. If you have a good doctor, the modem is actually a good thing for you, because the doctor can check and adjust your therapy without a visit. Most doctors are too lazy or stupid to do anything more than what is required to get paid, though.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#8
Wow, thanks guys. Lots of different things here to consider. The machine they would have given me today was a ResMed Elite S9 with a humidifier that can be used optionally. The wireless transponder or whatever you call it hooks onto the back of the machine, which means that machine has built-in little hooks where it attaches. So does that mean that ResMed is in kahoots (sp?) with Blue Cross and Carecentrics? Hah! I didn't think of that 'til now. Like...hmmm...why would that machine have those attachment hooks? Anyway, I'll ask my doctor for the actual Rx and then check out of those supplier sites you posted. I'm bummed about this because I really wanted to start using the machine tonight and start to get my brain back! I'll post back when I have answers so maybe others can benefit from the info. Thanks again!
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#9
S9 Elite is full data capable machine
As I don,t have insurance or beck and call doctor ... I would insist on the AutoSet (Not Escape Auto) so the machine can adjust the pressure as needed which can vary from one night to the next and its only few dollars more than the Elite.
Also its better long term investment and can be used in either modes (CPAP or AutoSet) TWO machines in ONE
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#10
Before you buy from Craigslist, get your prescription (you can be nice and ask for it but if they say no, demand it) and check the prices with Supplier #2. They sell 'gently used' and open box machines and great prices.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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