I want to be able to continue to get them to cover my supplies which unlike the machine I do think are cheaper via them than buying myself online.
I've never gone solo on these things, so any help appreciated.
Thanks,
Susan
AKA The Manse Hen
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Buying machine out of pocket question
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09-09-2018, 01:54 PM
Buying machine out of pocket question
So, if I were to buy my second machine out of pocket, buying the same model as I have now that I got from DME and paid for via co-pays and insurance. Will my insurance still pay for the monthly supplies as they do? I mean, if I don't have the machine they authorized and partly paid for, do they care?
I want to be able to continue to get them to cover my supplies which unlike the machine I do think are cheaper via them than buying myself online. I've never gone solo on these things, so any help appreciated. Thanks, Susan AKA The Manse Hen
09-09-2018, 03:01 PM
RE: Buying machine out of pocket question
Your insurance will buy replenishment supplies (consumables). This is usually handled through your DME, and they are the ones that usually stipulate that it is for your issued machine. If they don't know you have a backup machine that is identical to your issued machine, then it really doesn't matter.
I think the way to look at this is, you are buying a backup machine for "insurnace". You don't want to be without a machine in the event your older machine fails. I do the same thing. If the backup becomes your primary machine, it should not make a difference, however if you believe you have a failure in progress, then; 1. I think it's a good idea to have a backup before the failure occurs; 2. you should begin the process of acquiring a new machine under your coverage. Once you have a backup, it's easy to take your primary machine to the DME, have them check it out and wait fro repair or replacement while you use your backup. If the old machine checks out, then you can still use it, and compare its "feel" against the backup. If something is wrong, you're going to know it, and should continue to pursue repair or replacement. If it's okay, keep using the primary until you need the backup.
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
09-09-2018, 03:07 PM
RE: Buying machine out of pocket question
(09-09-2018, 01:54 PM)TheManseHen Wrote: Will my insurance still pay for the monthly supplies as they do? I doubt your insurance company keeps track of which machine you're using. They didn't for me. As long as the doctor reported compliance they were happy to keep the supplies flowing, even though the machine I bought was a different brand and therefore used different filters, water chambers, and heated tubing.
Sleepster
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.
09-09-2018, 11:57 PM
RE: Buying machine out of pocket question
That sounds like a really good idea. That is the direction I shall go!
Thanks, Susan
RE: Buying machine out of pocket question
Don't tell them? How else would they even know. Would you tell them if you bought a motorcycle or a new TV?
09-10-2018, 03:45 AM
RE: Buying machine out of pocket question
As part of your insurance cover they will provide you with consumables on a regular basis. From what I can gather, these consumables are available well before they are needed. So use your insurance cover to do what you want. You are not ripping them off as it's a legitimate part of your cover that you are entitled to.
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