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Buying a machine without Rx?
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mjbearit Offline

Preferred Members-2

Posts: 605
Joined: May 2012

Machine: REMstar Auto AFlex DS550
Mask Type: Nasal pillows
Mask Make & Model: RESMed Swift FX
Humidifier: Heated humidifier - 2
CPAP Pressure: 12.5-20
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: So Cal

Post: #11
RE: Buying a machine without Rx?
Hi Gaspnea,
You have a legal right to your prescriptions. If you choose to buy your machine without the aid of insurance, that is your business. I decided to go outside of insurance and i went to supplier number two on our supplier list and purchased a gently used model for a VERY cheap price. this allowed me to provide myself with therapy unfettered by the bounds of insurance! Do whatever you need to do to provide yoiurself with whatever you need!

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
09-18-2012 07:50 PM
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Sleepster Offline
Wiki Editor

Posts: 4,628
Joined: Feb 2012

Machine: ResMed A10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #12
RE: Buying a machine without Rx?
Supplier #1 has a form you can fill out with your doctor's contact info. They take it from there and get the prescription directly from your doctor. All you have to do is give the doctor your permission, but the doctor must release the prescription.

Apnea Board Moderator

09-18-2012 08:10 PM
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trish6hundred Offline

Advisory Members

Posts: 5,727
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #13
RE: Buying a machine without Rx?
Hi gaspnea, I would look at supplier #2 on the supplier list here on this board, I have heard a lot of great things about them. Best of luck to you and I look forward to reading more of your posts.

09-18-2012 08:22 PM
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archangle Offline
Wiki Editor
Advisory Members

Posts: 3,134
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #14
RE: Buying a machine without Rx?
(09-18-2012 06:22 PM)Gaspnea Wrote:  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!

The S9 Elite is a fine machine. It would be better to have an S9 AutoSet, but you may have trouble getting a DME to "upgrade" to the S9 AutoSet unless the doctor prescribes a pressure range.

Basically the AutoSet can do everything the Elite does, plus it has a few more options. The DMEs usually make a smaller profit on the AutoSet, so many of them will try to sell you the Elite. It will provide the therapy prescribed by the doctor, so this is "OK," as far as they're concerned.

Be sure to NOT buy an S9 Escape, Escape Auto, or a Respironics Plus machine. They have limited data.

Some years back, they started putting memory cards in CPAP machines to collect data. This is actually in your best interest. A good doctor or a smart patient can read the data on these cards and figure out a lot about how well the CPAP is working, and your doctor can even adjust your therapy remotely. (If you have one of the machines that records good data.)

The insurance "compliance" requirement has been in the CPAP machines for a long time. Even without the memory cards. The machine would track how many nights you use the machines over 4 hours and some other stuff. You'd have to phone in some numbers or bring the machine in to the DME to verify compliance.

Adding the removable memory cards makes it easier on the patient. You mail them the card, they check it, adjust your therapy settings on the card, then mail it back to you. It saves you time and money, and gets you better treatment if they do it right.

The wireless transmitter is called a "modem." It works through the cell phone system. ResMed and Respironics offer this option to all their DMEs for a monthly fee. It's actually in your best interest because it's less work than mailing in the card, and your doctor/DME can check your results nightly, find problems, give you advice, and adjust your therapy remotely.

If you go through your insurance, you will be monitored, at least for usage. Even if you don't have the modem. In theory, that is. Many of them never actually check.

You are right on one thing. The manufacturers consider the DMEs, doctors, and insurance companies to be their customers, not the patients. Most patients are sheep who take what the Godlike doctor gives them.

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.
09-18-2012 09:47 PM
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Gaspnea Offline

Preferred Members

Posts: 27
Joined: Aug 2012

Machine: ResMed S9 Elite
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 12.4
CPAP Software: SleepyHead

Other Comments: My pressure was prescribed by my doctor at 11 but I've upped it to 12.4 on my own.

Sex: Female
Location: Florida, USA

Post: #15
RE: Buying a machine without Rx?
As it turns out, we rent the machines for 90 days, which is the "probation" period. Our insurance pays 100% as long as we use the machine for 4 hours a night, every night. After the 90 days we can buy the machine, for which our insurance also then foots the bill 100%. Well, this is what they tell us over the phone. We shall see...
09-22-2012 02:29 PM
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