[Equipment] When do you own your CPAP?

[Rcgop]

Here is the email from my insurance company. I have a Medicare Advantage Plan. Does this mean I will only make 13 payments or will continue to make my copayment and the insurance will stop making their 80%?  I will find out next month if they bill me and/or my insurance company.

Quote:
In Original Medicare, people who rent certain types of durable medical equipment own the equipment after paying co-payments for the item for 13months.  ......  however, you usually will not acquire ownership of rented durable medical equipment items no matter how many copayments you make for the item while a member of our plan. Under certain limited circumstances we will transfer ownership of the durable medical equipment item.

The deleted part (......) was a reference to my specific plan.

[Sleeprider]

Maybe it's a way of saying you don't have the right to resell it?

[dosco]

Here is the email from my insurance company. I have a Medicare Advantage Plan. Does this mean I will only make 13 payments or will continue to make my copayment and the insurance will stop making their 80%?  I will find out next month if they bill me and/or my insurance company.

Quote:
In Original Medicare, people who rent certain types of durable medical equipment own the equipment after paying co-payments for the item for 13months.  ......  however, you usually will not acquire ownership of rented durable medical equipment items no matter how many copayments you make for the item while a member of our plan. Under certain limited circumstances we will transfer ownership of the durable medical equipment item.

The deleted part (......) was a reference to my specific plan.

What are the "certain limited circumstances" where they'd transfer ownership of the DME?


+++++
Interesting thread. I have 2 CPAP bricks, the 1st I was issued in 2008 and the second I was issued in 2009 or 2010. I have no idea if I "own" them (other than possession being 9/10ths of the law) ... when I get a new unit (should be in the next couple of months) I'd gladly donate or sell my original unit. I have to say, though, the old-old unit is acting a bit funny, I use it as my backup/travel CPAP and sometimes when I plug it in the control system starts blinking and it throws an error. I'm guessing something is getting wonky with the circuit card assembly (maybe dendrites or tin whiskers or somesuch).

The second unit has over 5,000 hours on the blower motor ... it's pretty well used.

-Dave

[SarcasticDave94]

I feel very fortunate how mine is handled. My DME said I'd own mine after insurance completes 13 month rental. I've got zero co-pay for rental or scheduled replacement supplies like the tube, filters, etc. This is thru welfare - United Healthcare Community Plan - as I'm disabled and have zero income as well, and the social security disability claim is in Molasses-land AKA slow enough to be going backwards.

Even though that's good news, I'd rather have SS Disability approved even if that meant I'd pay for the pending need for (in my opinion & doc 2 at my pulmonary office) ASV myself. Hate being a state sponge, no offense to anyone else in similar circumstances.

[Hydrangea]

Hate being a state sponge, no offense to anyone else in similar circumstances.

That's great you have to pay zero.  As it should be, in your situation. 

No state sponge. The systems are set up specifically for that reason. <3

[SarcasticDave94]

Thanks. Fortunate to have it. FWIW the insurance customer service and then afterwards my DME and I had phone conversations about switching to a ResMed ASV. Insurance: if it's on the script then you're getting that. DME: we're contracted to Respironics but if it's on your script ResMed it is. Yay! Just gotta get it "on the script".

Stand your ground with these fights, folks. They are winnable! 

[Sleeprider]

"like"

[KCFLY]

I was given the option of purchasing thru insurance or doing a 13 month rental and then owning it.

The cost of purchasing up front was $160 and to rent was $175 + $22/month until it was paid off.

Obviously I chose to purchase it.

The DME did not give me the option, they told me I had to rent "per insurance guidelines". I called my insurance and asked them if I could purchase it instead. They had no issues with it so I pushed the DME until they processed the purchase.

[SarcasticDave94]

Yep it works that way. Gotta keep them in check. That's why it's important to check what the DME is intending to do versus what the insurance allows. I'd recently called my insurance on what they'd think on the change from BiPAP to ASV..."if that's what you need that's what you get" was the reply. And to follow that, if I need a new sleep study and/or a 2nd Dr. opinion for ASV, they said it's handled as if it were a new claim. Just pre-authorize and/or get referral. Done.

[kdmorris410]

I have Aetna and will never own my machine. I only have to pay a rental fee every 6 months, but I can't change DMEs without starting over with a new machine and begin thw whole payment monthly up to the purchase price of the new machine. This actually angers me greatly and is the #1 reason I'm trying to find a machine to purchase outright to stop the insanity.