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I just had a sleep study required by my insurance company to "re-establish" that I have sleep apnea. The night was a disaster of constantly waking up gasping for air. My AHI turned out to be a 78. I am already on CPAP at 20. Now that things have fallen past the new year I have a new insurance company with new deductible, etc. I cannot afford another sleep study to discover which type of machine I should be on and the level. I have hit the wall physically so much so that they thought it was my heart (congestive heart failure). My heart is fine though. Any suggestions for getting a sleep study inexpensively? Or any other suggestions?
01-05-2016, 04:25 PM
Welcome to the forum.
First off, ask for a copy of the sleep study you had. You have a right to that.
I know it stinks, new year, new insurance, new deductible! I would check with your insurance to see if they would cover the second study, which is probably a titration to see what your pressure needs are. Possibly from the first study, you may be able to find out the breakdown of your AHI numbers...hypopnea, Obstructives, clear airways. This would dictate the type of Cpap needed.
Also, see if your insurance would cover a home study, which would be cheaper.
If no luck with new insurance, and you end up having to pay for a machine, check back with us here, we can advise you on that.
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If you know you need PAP therapy at 20, then your best alternative is auto bilevel (BPAP, BiPAP, VPAP). This can give you a higher inhalation pressure (IPAP), while giving you more comfort with a lower exhale pressure (EPAP). These machines are much less expensive online than through the insurance provider durable medical equipment (DME) supplier. There is a good list of online suppliers at the top of the forum, including Supplier #2 who sells used, reconditioned, and open box equipment with a warranty.
All you need is a prescription. Your primary doctor, or the sleep center that did your diagnostic study can easily use the diagnostic information to write a prescription for CPAP and/or BPAP and related supplies. This option was available to you before the diagnostic study. I use my regular doctor who is an internist, not a sleep doctor; and I use my study from 2008 as proof of diagnosis. If you're not going to use the insurance, you don't have to follow their nit-picking unenforceable desires.
Let's just go with the fact you have obstructive sleep apnea and need a machine you can afford. Get the prescription. As a last resort, Supplier #30 will submit the results of your sleep study or a survey to a contracted physician and provide you with a prescription for a fixed fee of $99. Keep in mind, many insurance companies prefer patients to be issued Auto CPAP and to self-titrate. You don't need a titration study if you call your insurance and ask for their policy on self titrating auto CPAP. That was my original prescription. Auto CPAP and Auto BiPAP work well and in fact usually have better results than a single titration study.
The script (wherever you get it) is yours to use when and where you want. Shop for the best deal. Right now, the Philips Respironics System One Auto BiPAP is on sale (same for auto CPAP) at many places because the machine has just been discontinued due to the new DreamStation model. So, it is still a great machine, and is less expensive. Do a search, and consider alternative channels like Amazon.
You have been at this long enough you know what mask and supplies you need. The next step is take control from insurance and accept the fact you can probably do this better, cheaper and faster without them.
01-05-2016, 05:06 PM
I am learning that going sans insurance appears to be the best way to go. Thanks for the advice on both the machine and how to get the prescription!
01-05-2016, 06:31 PM
No problem. Let us know if you need machine model suggestions, or have other questions. Welcome to the A-board.
01-05-2016, 08:16 PM
WELCOME! to the forum.!
Much success to you as you continue your CPAP therapy and dealing with your new insurance company.
01-06-2016, 04:41 AM
You could always get a used machine off Craig's List to get started and some relief.
01-06-2016, 08:28 AM
Turns out my AHI is 78. Thanks for all of the advice!
01-06-2016, 02:38 PM
I have found a Philips Respironics System One BiPAP Auto with Bluetooth. Model 760P for about $350. Are there any concerns with going to Auto BiPAP route rather than the traditional sleep study titration route? When I suggested to the nurse this morning she said it wasn't a good idea and would still have to be "set". This didn't make any sense to me sense the machine is "auto".
01-06-2016, 03:31 PM
(01-06-2016, 02:38 PM)revpappy Wrote: I have found a Philips Respironics System One BiPAP Auto with Bluetooth. Model 760P for about $350. Are there any concerns with going to Auto BiPAP route rather than the traditional sleep study titration route? When I suggested to the nurse this morning she said it wasn't a good idea and would still have to be "set". This didn't make any sense to me sense the machine is "auto".
Your AHI is high. Do you have any idea as to the breakdown of events, because if you experienced a high number of clear airway events, then a bilevel isn't going to treat that.
Even if you do use the bilevel, your nurse is correct in saying that it will have to be set, and without a titration, she would be unwilling to set the machine. I'm sure that someone here will offer assistance with that. The only question being, is the bilevel the right machine for you.
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