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[Equipment] How much does Aetna cover?
12-12-2012, 03:44 PM
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.
12-12-2012, 03:52 PM
(12-12-2012, 03:44 PM)USKiwi Wrote: I was diagnosed with Sleep Apnea and was told, yesterday, I need a CPAP machine.welcome to the board and good luck
read here before getting your machine ... the right machine choice can make big difference
12-12-2012, 04:07 PM
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.
12-12-2012, 11:06 PM
(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.
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.
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