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Cheap tools and the most capable CPAP machines
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Sleeprider Online
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Posts: 3,315
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #11
RE: Cheap tools and the most capable CPAP machines
Mark, keep in mind there is the Craigslist option. While I have a prescription, both of the machines I have came from there. You can extend your search range by using Search Tempest which gives you access to all local listing across the U.S. There is a lot of junk, but a few properly priced gems out there. I'm sure you can find one.

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04-10-2015 07:11 PM
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trailrider Offline

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Posts: 304
Joined: Feb 2015

Machine: A10 Autoset for Her
Mask Type: Nasal mask
Mask Make & Model: Eson or P10
Humidifier: autoset
CPAP Pressure: 6-12 DME, 7-13 me
CPAP Software: SleepyHead

Other Comments: engineer. EPR at 3, unheated hose, humidity at 2. Routine hose entanglement.

Sex: Female
Location: Ontario

Post: #12
RE: Cheap tools and the most capable CPAP machines
For me it was getting the mask right that was the critical to getting along with my machine. And the pressure. And not getting tangled up in the hose. Did I mention the cat playing with it, while attached to my face?
04-10-2015 08:43 PM
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iSnore Offline

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Posts: 148
Joined: Apr 2015

Machine: Phillips-Respironics DS560TS REMstar Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Phillips-Respironics DS6T Heated Tube
CPAP Pressure: 9-13 A-Flex 2
CPAP Software: SleepyHead EncoreBasic

Other Comments: SYSTEM ONE resistance set to X1 for P10

Sex: Male
Location:

Post: #13
RE: Cheap tools and the most capable CPAP machines
I know how you feel, Mark. If they didn't require a prescription, I'd have probably already bought one impulsively out of pocket. But I've decided to go through the drill first. It's more fiscally responsible to let the insurance pay as much as they will, plus I really hope to get a good sleep study and titration out of it (yeah, I'm probably asking too much).
04-10-2015 09:01 PM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,315
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #14
RE: Cheap tools and the most capable CPAP machines
(04-10-2015 09:01 PM)iSnore Wrote:  I know how you feel, Mark. If they didn't require a prescription, I'd have probably already bought one impulsively out of pocket. But I've decided to go through the drill first. It's more fiscally responsible to let the insurance pay as much as they will, plus I really hope to get a good sleep study and titration out of it (yeah, I'm probably asking too much).

Actually, many DMEs seem to get away with charging about $2500 for a CPAP. Consider a 20% copay would be $500, plus any deductible, the cost of buying looks pretty good. Add in the cost of studies, and the nuisance of demonstrating compliance, and insurance may not look like such a good deal compared to roughly equal costs to buy a unit outright from an online provider.

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04-10-2015 09:55 PM
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iSnore Offline

Preferred Members-2

Posts: 148
Joined: Apr 2015

Machine: Phillips-Respironics DS560TS REMstar Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Phillips-Respironics DS6T Heated Tube
CPAP Pressure: 9-13 A-Flex 2
CPAP Software: SleepyHead EncoreBasic

Other Comments: SYSTEM ONE resistance set to X1 for P10

Sex: Male
Location:

Post: #15
RE: Cheap tools and the most capable CPAP machines
(04-10-2015 09:55 PM)Sleeprider Wrote:  
(04-10-2015 09:01 PM)iSnore Wrote:  I know how you feel, Mark. If they didn't require a prescription, I'd have probably already bought one impulsively out of pocket. But I've decided to go through the drill first. It's more fiscally responsible to let the insurance pay as much as they will, plus I really hope to get a good sleep study and titration out of it (yeah, I'm probably asking too much).

Actually, many DMEs seem to get away with charging about $2500 for a CPAP. Consider a 20% copay would be $500, plus any deductible, the cost of buying looks pretty good. Add in the cost of studies, and the nuisance of demonstrating compliance, and insurance may not look like such a good deal compared to roughly equal costs to buy a unit outright from an online provider.

I looked up the Jan 2015 reimbursement rates at CMS.gov for the CPAP, Bilevel, and Bilevel with rate backup codes. Medicare/caid and TriCare require a 13 month rental. Here's what I found:

E0601 $106.47 x .2 = $21.29 x 13 = $276.82 patient (DME gets $1,384.11 total) AutoSet online = $883
E0470 $245.48 x .2 = $49.10 x 13 = $638.25 patient (DME gets $3,191.24 total) VAUTO online = $1,726
E0471 $614.34 x .2 = $127.65 x 13 = $1,659.44 patient (DME gets $7,986.42 total)
No wonder Health Net doesn't approve ASVs!

New
Nasal Mask (A7034) $112.53 x .2 = $22.51 patient
FF Mask (A7030) $180.47 x .2 = $36.09 patient

I think I'll put up with proving compliance (I have no deductible).
(This post was last modified: 04-11-2015 10:34 AM by iSnore.)
04-11-2015 10:15 AM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,315
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #16
RE: Cheap tools and the most capable CPAP machines
iSnore, that is fine as far as you have taken it, however the DME bills separately for the humidifier, hose, fine filter, foam filter in addition to the CPAP/BiPAP/ASV main unit. And in addition to the mask, they bill for the mask cusion and headgear. Even though you buy those as complete units through online sources, they are itemized for maximum billing by every DME I'm aware of.

You are indeed fortunate to have no detectible. Many people I have met on this board have deductibles that require anywhere from $500 to $3000 out of pocket before ANY coverage kicks in, and then the coverage is 80% until the total out of Pocket ($6000) is met. These kinds of high deductible insurance policies are no longer rare. For those people, I strongly suggest looking at alternative avenues for purchasing these things outright. The costs through DME is unquestionably higher, even given the allowable. I think for some people the services provided by a conventional DME can be important, but for many of us, it is both unnecessary and financially burdensome.

______________________________________________
Organize your SleepyHead Data
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(This post was last modified: 04-11-2015 01:38 PM by Sleeprider.)
04-11-2015 01:33 PM
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iSnore Offline

Preferred Members-2

Posts: 148
Joined: Apr 2015

Machine: Phillips-Respironics DS560TS REMstar Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Phillips-Respironics DS6T Heated Tube
CPAP Pressure: 9-13 A-Flex 2
CPAP Software: SleepyHead EncoreBasic

Other Comments: SYSTEM ONE resistance set to X1 for P10

Sex: Male
Location:

Post: #17
RE: Cheap tools and the most capable CPAP machines
I certainly don't disagree that everyone should consider all the options in their situation, including just buying outright. That's the responsible thing to do.

Here's what I'm looking at (at 20% of the allowed amount):
$21.29 first month AutoSet rental + $12.78 heated hose + $22.51 nasal mask = $56.58

12 more payments of $21.29 = $255.48
(This post was last modified: 04-11-2015 03:51 PM by iSnore.)
04-11-2015 03:48 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #18
RE: Cheap tools and the most capable CPAP machines
(04-11-2015 10:15 AM)iSnore Wrote:  Here's what I found:
...
E0470 $245.48 x .2 = $49.10 x 13 = $638.25 patient (DME gets $3,191.24 total) VAUTO online = $1,726


An example of fair price for premium but slightly used machine (professionally cleaned, with 6 month warrantee) would be the premium model below, from Supplier #2 (a link to the Supplier List is located at top of each forum page):

[start ad]

Gently Used Respironics System One DS760 BIPAP Auto Machine
Optional heated humidifier available for $70.00 at the bottom of this page.
Low hour, gently used, 6 month warranty.
$649.00

[end ad]

Would need to add at least the $70 (heated humidifier) and would need to call before ordering to find out how much more (if any) would would be needed for the heated tube and the larger power supply (80 Watts instead of 60 Watts, I think) needed for the heated tube (which I strongly recommend).

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-12-2015 06:43 PM by vsheline.)
04-11-2015 09:19 PM
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