For what it's worth, here are some of my own thoughts and questions on this subject.
I'm trying to understand how the fixed reimbursement price for a machine supplied through Medicare (and other insurers?), regardless of which machine, goes with my recent experience in getting a switch from an S9 Elite to the AutoSet. I'm confused because it was my DME's RT who told me that it was possible for me to make this change (assuming I could supply him with a doc's Rx). I responded by saying that my Elite was now beyond the initial 30 days. He said that did not matter, as long as it was still within the initial 13 months.
Although I was happy to hear his invitation to make the change to a more expensive machine, I do not understand how/why he was telling me about how to do it if it was going to reduce his company's profit?
Paula02 and SlightlySleepy are two members who recently commented on their experiences of having DMEs trying to direct them to a Respironics machine rather than a ResMed, saying the Respironics is better or as good. Paula posted that the motive of one DME contacted was really to make a larger profit by selling the cheaper machine. No problem following that, but it still leaves a question when I recall my initial visit to a sleep doc after "passing" a first sleep study five plus years ago. There I was in his office and he told me that I do have apnea and that I need a CPAP machine. Then, he put his hand on the Respironics machine sitting on his desk and announced to me that this will be the machine I will be using. There were no alternatives, no second choices. Of course, I was new to it all and didn't know then what I've learned since. So, I used that no data M-Series for five years!
Thinking back, I wonder if there was something going on between that group of docs and Respironics' salespeople that had locked those docs in to pushing only that brand of machine.
A couple years into my use of that first machine, I was planning an overseas trip and was visiting the DME where I saw a small ResMed machine in an RT's office. I asked about it, and he happily showed it to me and told me about its features. It turned out to be an S8, which the RT let me borrow for my upcoming trip. When I returned it, he suggested that I remember the model and look for one when I upgrade. Did I like the S-8 over my own machine? Yes!
Sorry this post got so long.