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[Equipment] Used machines
#11
(02-05-2013, 05:05 PM)theosgirl45 Wrote: I was recently diagnosed with sleep apnea and my insurance has decided that they aren't going to pay for my machine.

Maybe I'm stating the obvious, but I'm pretty sure that unless you have only very basic "Major Medical" coverage, most private health care plans do cover CPAP, albeit at different levels and costs to you as the patient (with regard to deductibles, co-pays, and other limits etc). If they covered your overnight sleep study, it's likely that they will also cover CPAP.

Not sure who told you that your insurance policy would not cover CPAP, but it may be worth it to go to someone "higher up" or to look at your policy documents directly to see if what you are being told is "the whole truth" with regard to coverage for "Durable Medical Equipment" like CPAP.

But again, if it's a simple policy meant only to cover major medical events, they may be correct in what they told you.

When I had private insurance, many times I would get two completely different answers on a coverage issue, depending upon who I was talking to on the phone. But what really matters is your written policy terms (insurance contract), not what someone "told you" over the phone.

That said, keep in mind that many insurance companies have a habit of training their phone reps to tell you "Sorry, you're not covered for that" (when you contact them at first). There is no law that says they must be completely honest with you over the phone. What matters is the insurance contract, not a verbal conversation. Also, if you do decide to challenge them or appeal their 'decision', they make the whole process complicated on purpose-- it's designed that way to frustrate you into giving up (so that they can reduce their costs). Many times you have to be very persistent.

In addition, insurance companies may require you to submit a doctor's "Certificate of Medical Necessity" in order for them to pay for CPAP. Many times "borderline sleep apnea" is not sufficient enough to warrant a "medical necessity". A sleep study that determines an untreated AHI (Apnea Hypopnea Index) of less than 15.0 is often enough to be considered "borderline OSA", resulting in a denial for CPAP. Some insurance companies may set that limit slightly lower or higher, so you'll need to ask them at what point on the AHI scale do they consider CPAP to be a medical necessity, and also ask if there are any other criteria they use to determine coverage.

Coffee
SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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#12
I would think 1800 should be considered lightly used. If on average a person uses it 6 hours a day that would be 2100 hours a year. I recently purchased a S9 autoset with the humidifier off of CL for $100 with 2 hours of run time. I was shocked that no one beat me to it. I have seen several auto/recording types listed on CL in my area for under $400. BTW hi everyone, nice board here.
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#13
Hi Nate,
WELCOME! to the forum.!
trish6hundred
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#14
I realize that this thread is last year's, but since I found it by searching, I thought that I'd add a more current comment for others that find it by searching. According to "Supplier #2", their web site says that 1500 hours run time or less is currently their definition of "gently used". It's of course up to the customer to make their own decision on this.

I just got one from there with about 1,000 hours of run time, and am debating whether to keep it or not. I've been generously offered a refund if I want it, but I'm not sure that I'd be better off with the money in my hand or a backup machine with about 5 months of use (from the run hours on my cpap machine *smile*). Since this machine is just for backup at this point, chances are I'll keep it. It shouldn't be getting a lot of use in any case.
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#15
Dumb question, where do you see total hours on the machine. I got a S9 off CList and love it and think it was fairly low hours but don't see it listed unless it's the last part of model looking number I did see. I can get into and change the settings just don't know where hours are listed. I got mine for $350 w/ humidifier hose and a couple masks that I may never use and have been watching for another at reasonable price for back up since I have no warranty (and hate the thought of going through DME don't need no $3000 nothing from them). Love the idea of people getting around them and doing what they have to do to take care of themselves. Love the forum great info and info is KING. Good luck.
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#16
Here's another recommendation for Supplier #2. Their website is a little out-of-date and it's difficult for a newcomer to figure out humidifier compatibility among all the models, so I bought the wrong Respironics humidifier. However, they couldn't have offered better service - when I called, they immediately sent the correct humidifier at no charge, without waiting for me to return the incorrect unit.

My impression is that they have excellent pricing on non-current models, and good pricing on current models. Shipping was UPS Ground, 5 days or so. If you have an issue, I recommend calling them instead of email - nice folks.
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#17
Hi George_Miller,
WELCOME! to the Forum!
trish6hundred
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#18
Hi there,

Welcome to the forum!

I also have used Supplier #2 and the lady that answers the phone is so sweet. BUT I have gotten three machines now that were either not working when I got them or they have broken after a few months of use. My original one was an unused open box. There has never even been a question from Supplier #2 at all, as to what is wrong with the machine that I was returning. But since purchasing my first machine with #2, I have been without a working machine for 6 weeks.

I have never heard of a person, other than myself, who has had a problem with Supplier #2. And can't tell you enough that the lady that I speak to on the phone was very, very apologetic. I almost felt like I was taking advantage of them.

Kate
:Using cpap then vpap since Feb.2013,
Kate
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#19
I also picked up 2 machines from supplier no.2

Being a newbie to CPAP related stuff, before I purchased there were many emails back and forth with dopey questions from me - and excellent answers from them.

Eventually I bought myself a current model "new - open box" Philips with humidifier, and a second Philips "gently used" older model as a back-up.
[IIRC] The first was well under $600,
The second unit [$200] looked brand new - and when I checked it out there was only 40 hours on the clock, my Father liked it so much he nicked it from me.

From placing the order to arriving here in Western Australia was a week. [days quicker than a similar sized parcel from within our own country....]

No complaints from me at all - I highly recommend the crew @ no.2

stephen
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#20
You want to be very careful when buying used machines. I certainly would not buy or sell on Craigslist. The liability is too high to be messing around with that, not to mention it's illegal. You want to make sure the machine is professionally tested before using it. I used CPAPDEALS and had a great experience. Just google search "CPAP Deals" and it should come up. They process prescriptions and guarantee everything sold on their site. They will even adjust, calibrate and clean the machine for the buyer. I told them I would write a review for them since they treated me so well. They are still a new company as of April 2015, so their selection isn't very large but hey, it's legal and it's a way to buy and sell directly to other users. Hope this helps.
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