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Does the 80/20 insurance really save over a self purchase?
#1
Was just wondering if going thru a local DME really saves anyone any $$$ as compared to an internet purchase. Your deductible and 80/20 deal with insurance and possible higher of a machine locally.
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#2
It depends on how much your insurance allows the DME to charge for the machine and equipment. If they go by medicare you can download the price chart that Medicare allows for your state. You can compare those costs with the online costs and get an idea.
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#3
(03-23-2018, 12:07 PM)Hellodare Wrote: Was just wondering if going thru a local DME really saves anyone any $$$ as compared to an internet purchase. Your deductible and 80/20 deal with insurance and possible higher of a machine locally.

Typically, if you had an 80/20 plan you'd pay around 40% of the cost of the best internet deals (for new machines). In other words, DME "retail" prices are typically double "internet" prices. That's still a savings with insurance (and counts towards a deductible).

That's leaving aside lightly used machines from a trusted retailer or the wild-west of something like Craigslist.

Bill
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#4
Thanks all!
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#5
Ya, I'm on 100%, but get an invoice that details what Apria is billing Kaiser.
For the most part, the billed amounts are the same as I'd pay, some items such as filters are a bit less.
Where they are screwing us is on the hoses. They are billing Kaiser $17 for a hose, which is half what it would cost to buy the Resmed Slimline tubing, but it's the same thin, crinkly, generic crap tubing that I can get online for $7.
-- Rich
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#6
Preferred provider prices should be less I thought.
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#7
(03-23-2018, 12:43 PM)Walla Walla Wrote: It depends on how much your insurance allows the DME to charge for the machine and equipment. If they go by medicare you can download the price chart that Medicare allows for your state. You can compare those costs with the online costs and get an idea.

Where can I download the price chart?

Thanks
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#8
Here's a link https://www.cms.gov/Medicare/Medicare-Fe...edule.html
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#9
Do you have any deductibles that need to be met first before insurance pays?
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#10
I had 100% of my deductibles met last year and I thought I could buy the machine. My doctor wrote a new prescription. I found out I can only rent to own. I ended up taking a risk by buying one from Ebay with a 160 hours on it. for $240.00. Its a gamble but our healthcare system is not patient friendly.

car54
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