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Heated Tubing and Insurance
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Mosquitobait Offline

Advisory Members

Posts: 718
Joined: Apr 2015

Machine: Resmed AirSense 10 For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: integrated, Climate line tube
CPAP Pressure: 9-12
CPAP Software: ResScan SleepyHead

Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #11
RE: Heated Tubing and Insurance
(06-23-2015 02:42 PM)rx77310 Wrote:  
(06-22-2015 06:42 PM)OpalRose Wrote:  If you have only had you machine and humidifier a month, you should be able to switch out the heated humidifier for a humidifier with heated hose. You will need to ask your doctor to give you another script stating a heated humidifier with heated hose. Don't know if your insurance would pay for it. You will have to call them.

So, it sounds like I should ignore what the sleep clinic said about Kaiser not paying for a heated tube and just schedule an appointment with my doctor(primary care provider) and get a prescription directly from my doctor?

I received a letter with my CPAP saying I should contact the sleep clinic for any problems with the CPAP therapy, but I understand doctors don't necessarily need to work with the sleep clinic to write a prescription. That said, once you have your top and hose, you should be able to order the heated hose as your hose every month. However, you have Kaiser, and they call the shots because they are their own DME.

A local shop said I could order the heated tubing upgrade directly from them without a prescription, but I would like to investigate the possibility of going through Kaiser/ insurance/ DME provider (Apria) or other entity that eats cost for me to save money.

With Resprionics, it isn't just a tube, but a new humidifier top plus tube. Unless you got it when you originally got your machine, you are SOL if you want someone else to pay for it. You'd best order the top from one of the suppliers listed here. The cost through the local shop is likely a good deal higher, but you can ask. You will need a new script, but you probably don't actually have to see the doctor for it. Just leave a message with his office, that you need a script for a heated humidifier and hose for the Resprionics unit. You can then fax that to any supplier you want.

Please note: If you do decide to go to the shop, make sure that you put a maximum dollar amount that you will pay for this if insurance doesn't cover it. Otherwise, you could look at a huge mark-up from what it would have cost you from an online retailer.
(This post was last modified: 06-24-2015 06:13 PM by Mosquitobait.)
06-24-2015 02:34 PM
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