Changing health insurance with a rental CPAP machine

[GeoffD]

The Taiwanese overlords just traded me to South Korea for cash considerations and no player to be named later. My last day at my former employer was yesterday and my health insurance is paid through the end of the month. I'm on payroll with my new employer beginning today and their benefits kick in on January 1.

I started this CPAP thing in September and my ResMed S9 AutoSet is a rental. I'm going from an Aetna plan where I paid 50% of a steeply discounted fee (I pay $26/month rental) to a very gold-plated Cigna plan that pays 100% for DME so I'm making out on the deal, I hope.

My machine is 3 months old. My AHI score rarely exceeds 1 per hour so it's working perfectly. I'm happy with the DME. How should I play this? Just give the DME my new insurance and let them deal with it? Return the machine and get a new one, possibly with a different DME?

[DariaVader]

is the DME "in-network" for the new insurance? I don't know what you signed when you got your rental, but I signed a thing that said if Insurance doesn't pay (for reasons of non-compliance) then I do, and *not* at a steeply discounted price either.... I am not sure what different DME companies do, as I am a n00b myself and was assembly-lined thru this process. I too have the Cigna 100% for DME, but I haven't seen it paid yet.

[GeoffD]

is the DME "in-network" for the new insurance?

Very good point. I called them and they don't deal with Cigna. I asked them to give me a price on a buyout of my ResMed S9 AutoSet. I already own the humidifier and the hose.

[Crimson Nape]

You might try calling Cigna and explain your situation and see what they recommend. . . I know, Don't hold your breath!

[GeoffD]

You might try calling Cigna and explain your situation and see what they recommend. . . I know, Don't hold your breath!

I'm not enrolled yet since today was day #1 on the job and I telecommute. I just found out about this job change 3 days ago. This CPAP rental thing is a PITA in this kind of situation.

Worst case, I can get a new replacement machine that includes humidifier and has a 2 year warranty from Suppler #2 for $699 or a lightly used one with a 1 year warranty for $479. $479 would be my max price I'd pay my DME to buy my 3-month-old machine. I can then let Cigna buy me a 2nd new machine. I'm now so married to this machine that I'd really like to have a spare.

[justMongo]

Different situation than Daria describes. You are compliant. If the new insurance will not pay, give them back the machine and get another through new insurance. or, offer a buyout at $479 -- I would think they would jump at that. Get them to sign a receipt that says:
"In full accord and satisfaction." The magic words in contract law.

[DariaVader]

I wonder if Cigna will buy you a machine at all if the continuous insurance information that they receive from the previous says you have one... (can they still get that????) It's new territory, since with the ACA they cannot refuse to cover pre-existing without proof of previous coverage. I like your idea of buyout and have a spare though, I think you might also have the option to stop renting it at the same time a new DME in the Cigna Network comes through with one. I will be curious to know how this ends up - its an interesting dilemma.

[justMongo]

Even before the ACA...
"The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits a health benefit plan from refusing to cover an employee's pre-existing medical conditions in some circumstances. It also bars health benefit plans from certain types of discrimination on the basis of health status, genetic information, or disability."

[GeoffD]

The DME called. They want some outrageous amount of money to buy my machine. $700-something. With Supplier #2, I can buy a brand new one plus the humidifier for $699.00 with a 2 year warranty or a used, low time one with a 1-year warranty for $479.00. I may change my mind but I think I'm going to buy a used one as a spare while I sort this out with my new insurance carrier.

[GeoffD]

An update.

I just called Supplier #2. They're shipping me a new ResMed S9 Autoset, humidifier, and ClimateLine hose. My useless DME still won't budge on their $700-something price so I'll be returning that machine. I have business travel coming up, I don't have a new insurance card, and I likely won't have time to sort this all out with a new DME and Cigna. This will become my spare machine/travel machine and I'll rack up the hours on a DME rental machine once I get it.