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Changing health insurance with a rental CPAP machine
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GeoffD Offline

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Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #1
Changing health insurance with a rental CPAP machine
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?
12-11-2014 08:16 AM
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DariaVader Offline
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Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #2
RE: Changing health insurance with a rental CPAP machine
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.
12-11-2014 10:39 AM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #3
RE: Changing health insurance with a rental CPAP machine
(12-11-2014 10:39 AM)DariaVader Wrote:  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.
12-11-2014 01:34 PM
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Crimson Nape Offline

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Joined: Oct 2014

Machine: ResMed S9 Autoset
Mask Type: Other
Mask Make & Model: P-10 / F&P Simplus / DreamWear
Humidifier: H5i w/Climateline
CPAP Pressure: 8 - EPR 3
CPAP Software: SleepyHead

Other Comments: CMS-50F & 50IW

Sex: Male
Location: Georgia

Post: #4
RE: Changing health insurance with a rental CPAP machine
You might try calling Cigna and explain your situation and see what they recommend. . . I know, Don't hold your breath!

Statistics prove that people who have more birthdays live longer.
12-11-2014 01:49 PM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #5
RE: Changing health insurance with a rental CPAP machine
(12-11-2014 01:49 PM)sgearhart Wrote:  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.
12-11-2014 03:33 PM
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justMongo Offline

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Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #6
RE: Changing health insurance with a rental CPAP machine
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.

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.
12-11-2014 03:44 PM
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DariaVader Offline
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Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #7
RE: Changing health insurance with a rental CPAP machine
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. Smile 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.
12-11-2014 05:25 PM
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justMongo Offline

Monitors

Posts: 3,840
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #8
RE: Changing health insurance with a rental CPAP machine
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."

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.
12-11-2014 05:44 PM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #9
RE: Changing health insurance with a rental CPAP machine
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.
12-12-2014 06:59 PM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #10
RE: Changing health insurance with a rental CPAP machine
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.
12-17-2014 11:48 AM
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