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[Equipment] How much does Aetna cover?
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USKiwi Offline

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Posts: 16
Joined: Dec 2012

Machine: ResMed S9 Elite
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: H5i
CPAP Pressure: 11
CPAP Software: ResScan

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Sex: Female
Location: Miami, FL

Post: #1
Question How much does Aetna cover?
I was diagnosed with Sleep Apnea and was told, yesterday, I need a CPAP machine. I have insurance with Aetna and I am wondering how much is covered. How much will I have to pay out of pocket. This is a new thing for me and I am trying to learn as much as possible about living with Sleep Apnea and using a CPAP machine.
Thanks
12-12-2012 03:44 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: How much does Aetna cover?
(12-12-2012 03:44 PM)USKiwi Wrote:  I was diagnosed with Sleep Apnea and was told, yesterday, I need a CPAP machine.
Thanks
welcome to the board and good luck
read here before getting your machine ... the right machine choice can make big difference
http://www.apneaboard.com/wiki/index.php...ne_Choices
12-12-2012 03:52 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: How much does Aetna cover?
Hi USKiwi and WELCOME! to the forum.!
I don't know the answer to your question but hang in there and someone will be able to help you soon.
Best of luck to you with your CPAP therapy.

trish6hundred
12-12-2012 04:07 PM
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TheWerkz Offline

Preferred Members-2

Posts: 261
Joined: Oct 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: H5i & ClimateLine Hose
CPAP Pressure: Auto-CPAP 11 - 20
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Dallas, TX - USA - Planet Earth

Post: #4
RE: How much does Aetna cover?
(12-12-2012 03:44 PM)USKiwi Wrote:  I was diagnosed with Sleep Apnea and was told, yesterday, I need a CPAP machine. I have insurance with Aetna and I am wondering how much is covered. How much will I have to pay out of pocket. This is a new thing for me and I am trying to learn as much as possible about living with Sleep Apnea and using a CPAP machine.
Thanks

Hi USKiwi,

I take it you're in the US but originally from NZ?

Your question is too one-sided for anyone to be able to give you any kind of legitimate answer.

In the past I've been insured several times with Aetna but, like all insurance companies they offer multiple group plans as well as self-insured group plans and their benefit for DME (durable medical equipment like CPAP) is probably different between their preferred providers and their in-network providers etc.

Your policy showing your elections from your employer's benefits package will have the name of your particular plan along with what they pay for DME and physician's and what your total out-of-pocket expenses or co-pay (flat-rate or percentage) should be.

If your doctor gives you a list of DME providers in your area, you'll give your Group ID and Member Number etc and they should be able to get authorization for you and then tell you what portion you'll be responsible for paying.

You could also call the customer service number (24 hours a day) on your Aetna card and just ask them, they may have a preferred provider which usually means less money out-of-pocket for you but, not always.

Good luck, and don't be afraid of CPAP, there's millions of people using it and living a better life because of it, you're not alone by any means and if you have questions that's why this board is here.

Ren
12-12-2012 11:06 PM
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