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Cost and hassle comparison. Have you obtained a machine both thru ins And without?
#1
After years of denial I have essentially collapsed and forced to consider treatment for my OSA. After finding this place and what it has taught me I went the other way and now a believer and planned to buy a used machine to save some $ but more importantly to get started as fast as possible. Wife points out we do now have excellent ins so use it. After originating this thread http://www.apneaboard.com/forums/Thread-...P-machines and the extremely great replies and reading this http://www.apneaboard.com/forums/Thread-...e-provider I am inclined to believe my original plan was valid. By the time it is all over I may spend as much or more $ as just buying a machine outright.
ARRRRGH! Decisions decisions.

Rant off .



I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#2
Mark: I got my first machine through insurance. 13 months paid by insurance to own it.
It was 2009; and they gave me an S8 VPAP S. I didn't have the knowledge or empowerment that this forum has given me.
I think it was used; but, I didn't know how to check for run hours.

About a year ago, I wanted an S9 with data capability; and the ability to go auto.
So, I bought an open box special from one of the suppliers on the list. I am very happy with the machine and the price.
(I did have a written Rx to get my machine.)

I still use my DME to get supplies under insurance. You should have seen their face when I told them I needed S9 filters and an H5i tank.
I think they were irritated that they didn't get the chance to sell me a new machine at an inflated price.

Only you can decide which way to go. You are aware of how the DMEs will try to give you a dumb brick to maximize their profit.
If you go the insurance route -- stand your ground on what you want; and be willing to walk away. It's like dealing with a used car dealer.
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.
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#3
(04-11-2015, 02:45 PM)Mark Douglas Wrote: After years of denial I have essentially collapsed and forced to consider treatment for my OSA. After finding this place and what it has taught me I went the other way and now a believer and planned to buy a used machine to save some $ but more importantly to get started as fast as possible. Wife points out we do now have excellent ins so use it. After originating this thread http://www.apneaboard.com/forums/Thread-...P-machines and the extremely great replies and reading this http://www.apneaboard.com/forums/Thread-...e-provider I am inclined to believe my original plan was valid. By the time it is all over I may spend as much or more $ as just buying a machine outright.
ARRRRGH! Decisions decisions.

Rant off .

Mark,

I got my Resmed S10 Autoset and Respironics Wisp mask through insurance, my share of the purchase price was $236.xx which they exchanged for the Autoset for Her within the first 30 days. Some people rent to own for 15 months, I insisted in wanting a straight purchase so I would not be bothered sending a payment every month/having them charge my credit card.

I also purchased (to take during travel overseas) from my DME a used Resmed S9 with H5i humidifier, climate line hose, slimline hose in the resumed bag they come in and a Resmed N10 mask they threw in. the machine only had 306 hours usage for $350.00 dollars.

So, if your insurance is a lot like mine, it is cheaper to purchase using your insurance. But if you want a second machine, you might just ask your DME if they have one someone had to return because of non-compliance.

Hope the above helps you. Good luck with your therapy!




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#4
Depends.....

If you ahve a plan with deductible and copay limits, and have met those or otherwise expect to meet those within the year before considering the CPAP purchase, then it's a freebie. If you don't think you will have other expenses to meet the deductible, then it may be cheaper, and by far less frustration, to just buy your own if you have or can get a script.

OMMOHY
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#5
I could drop $2000 on an outright purchase of a bilevel machine, mask and heated hose, and have forgotten about the expense by the next month. But what would really bother me was that I let the bastards win. If all I need is an APAP and can get that for ≈ $300 with mask and heated hose through my good insurance, I'll play their game. If it doesn't work out and I really need a bilevel, my payments will double meaning a total investment of < $700. If you've got good insurance, slow down and listen to your wife. Otherwise, you're just playing into their hands.
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#6
I got my original machine, sleep study and everything using excellent insurance back in 2008. No regrets and the copay was negligible. I still remember worrying about what machine I would be issued, and it took 2-1/2 months from the time i started being evaluated, going to sleep studies, ENT and receiving a diagnosis, until I was finally issued a machine. So all that extra time with no treatment for severe apnea, and a bunch of stress and seeing doctors and sleep centers.

I still had this machine in December 2014 and realized, I was on borrowed time. Meanwhile my insurance had high deductibles and substantial copays. So I started looking for deals on good machines to replace my nearly 7 year old M-Series Auto with 19000 hours.

I picked up a deal for $200 for a PRS1 60 series Auto 560 off another forum that cannot be named, where they talk CPAP. A month later, I found BiPAP 760 locally on Craigslist for $350. I have prescriptions and could have gone through insurance but the BiPAP would have cost me more than twice out of pocket going through insurance, and it would have been time consuming and a hassle to deal with a DME, Insurance approvals, and all the B.S. I bought a mask and got the heated hose attachment from one of the onlne suppliers on January 2, and filed for the out of network reimbursement from my insurance. At least I didn't pay for a R.T. to evaluate and fit me for something I can buy in two days online. I bought filters on Amazon.

So I have a machine and backup, and it turns out BiPAP is better for me. I wasn't told go get a new sleep study, I don't rent, I don't send in compliance reports, and I didn't spend as much.

Insurance is great as long as it's not a hassle or too expensive. Get a machine, but you're still wise to get a backup, and that won't be covered.
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#7
What you need to consider is that it doesn't matter what the DME charges for the machine, it is what the contract price is through your insurance company.

when I got my first machine, BCBS paid 100% of it and bought it outright.

Now I have a different insurance plan and if I had been really smart, I would have gotten a machine at the beginning of the year when they paid 100%. But, I had to change to a VPAP so I had to pay 20% of the allowed amount which was less than $300 total price. My insurance company paid for the humidifier outright.

YMMV

(04-11-2015, 02:45 PM)Mark Douglas Wrote: After years of denial I have essentially collapsed and forced to consider treatment for my OSA. After finding this place and what it has taught me I went the other way and now a believer and planned to buy a used machine to save some $ but more importantly to get started as fast as possible. Wife points out we do now have excellent ins so use it. After originating this thread http://www.apneaboard.com/forums/Thread-...P-machines and the extremely great replies and reading this http://www.apneaboard.com/forums/Thread-...e-provider I am inclined to believe my original plan was valid. By the time it is all over I may spend as much or more $ as just buying a machine outright.
ARRRRGH! Decisions decisions.

Rant off .

Post Reply Post Reply
#8
Hi Mark,
I'm with your wife on this one, although unless I missed something while reading through this thread, I didnt think you said what your deductible was, only that you have good insurance.

In my case, I have good insurance too, with only $150.00 deductible on Durable Medical Equipment,
with 100% coverage on supplies after the deductible is met. I'm certainly not saying this to brag or anything, especially when I read on these posts about the high deductibles and out of pocket expenses some people have to pay.

Now with that said, if you do have good coverage, play their game and let them pay....even though it is a pain to deal with insurance and DME's. Then you will have some extra cash to spend on all the different masks you will probably try, which is the hardest thing to adapt to.

Good Luck with your decision! Thinking-about
Waiting to hear what you decide.



OpalRose
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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.




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#9
(04-12-2015, 08:52 AM)OpalRose Wrote: Hi Mark,
I'm with your wife on this one, although unless I missed something while reading through this thread, I didnt think you said what your deductible was, only that you have good insurance.

In my case, I have good insurance too, with only $150.00 deductible on Durable Medical Equipment,
with 100% coverage on supplies after the deductible is met. I'm certainly not saying this to brag or anything, especially when I read on these posts about the high deductibles and out of pocket expenses some people have to pay.

Now with that said, if you do have good coverage, play their game and let them pay....even though it is a pain to deal with insurance and DME's. Then you will have some extra cash to spend on all the different masks you will probably try, which is the hardest thing to adapt to.

Good Luck with your decision! Thinking-about
Waiting to hear what you decide.

I am just so !@## tired and I want to feel better....

Thanks to all of you for your concern.
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#10
My insurance covers 50% of DME equipment, so I start there. If I need extras that aren't insurance eligible yet I go online.
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