Generally, how many mask replacements do you get during your initial 30 day window?
I recently went to the DME for the first time to pick up my equipment. I am certain that the technician said I could exchange the masks during my 30 days to find something I liked. The clear implication was that I could try multiple masks as long as it was within the 30 days.
I called into today, and spoke with the billing department that is in charge of mask ordering. They said I only get one replacement during the 30 days, but whatever I pick, I'm stuck with for 3 months (when I can order a new one via insurance).
I do have insurance right now (PPO).
I can't tell which individual is right here. Are mask exchanges during the initial 30 days limited to one? In fact, the billing lady even said that many places won't even exchange masks for you during the first 30 days.
What do you guys think? I'm a bit worried to order something like the Dreamwear with either nasal pillows or just nasal mask since I'd be stuck with it for 3 months.
RE: Generally, how many mask replacements do you get during your initial 30 day window?
There is no set rule that a DME has to let you try multiple masks during the first 30 days.
It’s usually at their discretion. Some DME’s may let you exchange a mask once or twice during that time period, but there is no rule for them to do this.
The mask that you took home with you the day you picked up your machine is the one that they submitted to insurance for payment. So insurance will not pay for another mask until the 3 months is up.
Some online suppliers will let you trial a mask for 30 days. You would have to pay up front, then wait for reimbursement if it didn’t work out.
I know, it stinks...finding the right mask is the hardest part of therapy.
03-07-2019, 08:56 PM
(This post was last modified: 03-07-2019, 10:22 PM by Big Guy.)
RE: Generally, how many mask replacements do you get during your initial 30 day window?
When I picked up my CPAP equipment, the RT asked me several questions in regards to how I breathe when I sleep, and how I position myself when I sleep.
When I took my two in-lab sleep study tests, I used an F20 mask the 2nd time and did well, for being the 1st time I ever slept with a mask on. The sleep study lab attendant was even surprised that I didn't struggle very much with it.
Anyways, I told the RT that I wanted the AirFit F20 mask. He made sure it fit properly and then sent me on my way with my CPAP.
He never implied that I could try one and return it if necessary. Then again, I didn't ask.
RE: Generally, how many mask replacements do you get during your initial 30 day window?
Thanks everyone. I am disappointed that the tech was not clear and pretty much implied I had 30 days to try out as many masks as possible, but it seems that does not appear to be usual case. But, at least I'd only be stuck for a max of 3 months even if I got the "wrong mask"
RE: Generally, how many mask replacements do you get during your initial 30 day window?
It may be worthwhile to talk to the tech again. The billing department may not be up to speed on the policy for new users. It sounds like they are giving you a canned response for replacement intervals. My DME let me try four masks before we found one I was comfortable with.
03-08-2019, 06:58 AM
(This post was last modified: 03-08-2019, 07:02 AM by OMyMyOHellYes.)
RE: Generally, how many mask replacements do you get during your initial 30 day window?
Trying "as many masks as possible" is not an economically realistic assumption. Retail prices from $70 to over $100 a mask, which would then be thrown away because you didn't like it (don't know how much lower wholesale cost is, but even at 50% it would get expensive). Unless you'd be happy with taking a used mask in trade. Insurance is not gonna cover that so who would be paying? Some DMEs may figure they have enough margin in the sale/set up/ consult fees for the machine that they can eat the cost of a few masks. Or to avoid return of a machine after a few months due to non-compliance.
I would expect the DME to have a supply of masks to try on in the office to find one that would be suitable/comfortable. I could see maybe making one trade, say if you took a nasal mask only to discover you're a mouth breather that needs a FFM.
Maybe I'm lucky - I used the first mask I walked out of the DME with for 5-6 years (model, not same physical mask) and now the upgrade that I got with my second machine for all those years since. Well, except when I had to have skin cancer cut off the line where my nose meets my face and had to use pillows (ugh) for a few weeks.
There. I said it.
OMMOHY
Contrarian in Residence
RE: Generally, how many mask replacements do you get during your initial 30 day window?
I agree... Just trying as many masks as possible to find one that you like is not economically feasible.. However the provider should be willing for you to try a few different styles of mask to be sure that you have the best one for your situation. My provider I believe has a few trial ones that they offer to try, and then clean and sterilize and repack for the next person wanting to try. I tried a full face first, then went to a nose mask, and finally settled with pillows.
RE: Generally, how many mask replacements do you get during your initial 30 day window?
Good question. How many do I get? Or how many did my DME say I'd get? Because promises are useless when they're broken.
My 1st DME said I could try a 2nd mask for free during the 1st 30 days. I naively thought that meant they'd give me 2 masks to keep. Nope. So I received 1 mask. When I went to ask for a 2nd mask, they said I'd have to trade my 1st mask for it. I didn't want to do that. So then I had to wait 3 months for a new mask.
The DME I recently have found, they told me I can exchange the mask for a new mask within 30 days, and I can continue that as naseum. So I could get one mask, and as long as I called them within 30 days, they'd send me a new mask and I could send the original one back. And then the 30 days started again... and if I decided to send back that 2nd mask, I just needed to call them within 30 days of having received that one. And so on.
But I'm a mask hoarder. So I've kept each mask. And every 3 months I reevaluate of I want a different one. Sometimes I can't wait 3 months, so I order one online out-of-pocket.
RE: Generally, how many mask replacements do you get during your initial 30 day window?
(03-09-2019, 03:55 AM)Hydrangea Wrote: Good question. How many do I get? Or how many did my DME say I'd get? Because promises are useless when they're broken.
My 1st DME said I could try a 2nd mask for free during the 1st 30 days. I naively thought that meant they'd give me 2 masks to keep. Nope. So I received 1 mask. When I went to ask for a 2nd mask, they said I'd have to trade my 1st mask for it. I didn't want to do that. So then I had to wait 3 months for a new mask.
The DME I recently have found, they told me I can exchange the mask for a new mask within 30 days, and I can continue that as naseum. So I could get one mask, and as long as I called them within 30 days, they'd send me a new mask and I could send the original one back. And then the 30 days started again... and if I decided to send back that 2nd mask, I just needed to call them within 30 days of having received that one. And so on.
But I'm a mask hoarder. So I've kept each mask. And every 3 months I reevaluate of I want a different one. Sometimes I can't wait 3 months, so I order one online out-of-pocket.
Wish my DME was as bountiful 
RE: Generally, how many mask replacements do you get during your initial 30 day window?
I was able to try and keep three masks because they couldn't do anything with the mask after I had used it. I thought it was a very generous policy and they'll keep me as a customer for my cpap supplies.
I estimate that if I order supplies to the extent my insurance lets me, it will easily exceed the cost of a new auto cpap each year. Just four new masks w/ headgear could easily total $500. Add new hoses ($160), filters ($30), humidifiers ($50) and mask cushions in between new masks ($400).
That's the only way I can see it working out for the DME.
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