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Help! DME Over-Charging!
#11
RE: Help! DME rape!
Thanks for relocating, I'm a total newb. I bought the same machine that Lincare gave me: ResMed AirCurve 10 VAuto, refurbished, from 1800Cpap for $1,074.40, which includes new mask and a 1 year warranty. I probably overpaid, but really would rather not hear that from anyone; it was an impulsive, desperate purchase to free myself from Lincare as quickly as possible, and I had the money saved up for emergencies. I feel this qualified; I'm just beginning to feel the benefits of therapy after only six weeks, and really want to continue, and improve on it.

Next up: anyone got any suggestions for a cheap but durable oxygen concentrator? I'll be returning that to Lincare, as well. They're jackals...
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#12
RE: Help! DME rape!
Congrats on getting the best machine possible and escaping the medical mafia. Don't hesitate to ask for help if you want to improve its performance. You will want to download OSCAR. We have quite a few members that use concentrators. You might find the article on Oxygen Bleed with CPAP useful, http://www.apneaboard.com/wiki/index.php..._with_CPAP and you may want to get the Resmed ClimateLine Oxy heated tube. It has an integrated port for oxygen bleed and is available for $58 from the same place you bought your Vauto.

Here is a recent thread on oxygen concentors http://www.apneaboard.com/forums/Thread-...r-Purchase
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: Help! DME rape!
Congrats on the purchase.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: Help! DME rape!
Saw this, as I'm also shopping for a new DME after changing Medicare Advantage plans to a different insurer.  
Nearly all insurance companies will require that a new CPAP machine be rented for some period of time before it is possible to purchase the machine with the insurer's money.  During that rental period, the insurers  (and Medicare if you are on Medicare) will want to see your usage data for the CPAP to ensure that the machine is being used regularly.  If you are not in compliance with your insurance company / Medicare usage requirements, they will terminate and take back the rented machine.  

Medicare requires a 13 month rental period before you (or your insurance company) can purchase the CPAP.  DME's will frequently "forget" that you've been paying rent for 13 months, and they'll keep charging rent, so you've got to stay on top of this.  

If your insurance really only pays 50 percent of CPAP equipment costs, then yes, you're probably better off dumping Lincare and other high-priced DME outfits and buying online.  Many insurance policies - including Medicare, will pay 80 percent of the cost and you pay the remaining 20 percent.  In that case, even the rip-off prices from Apria or Lincare or other DME's of that ilk might be less out-of-pocket for you.  

The ongoing costs of CPAP can be reduced by regularly cleaning your equipment and making sure it is stored in a dark place when not in use (UV light kills CPAP masks).   Mask cushions are not generally cheap, but they need to be replaced when you are not able to stop air leakage that exceeds limits (generally over 24 L/min for a 95 percentile figure).  

Once you're on Medicare, you can probably find a reliable DME who will keep your supplies freshened in accordance with Medicare rules, as long as you are compliant with your CPAP usage.   I pay about $37 out-of-pocket every three months for a new mask, heated hose, and 3-4 replacement mask cushions, and a few air filters.  My Medicare advantage plan covers the rest.  (it's actually comforting to see the DME bills with those ludicrous  $450 mask charges and the column next to it says "Medicare Allowed Charge" is under $80.  )    That's the negotiating power of a very large single payer for healthcare costs.
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#15
RE: Help! DME rape!
howdy,

For those of us not in the US, what does DME stand for ?
Thanks,

Smile Atlas Smile

Brisbane 
Australia
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#16
RE: Help! DME rape!
DME, durable medical equipment, the supplier for our CPAP machine, mask, and other parts
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#17
RE: Help! DME rape!
Just as a side point... I don't think the title used for this thread is appropriate or necessary.  Thinking-about
- They are not spelling/grammar errors.. I live in Australia, we do it differently Down Under  Big Grin -
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#18
RE: Help! DME rape!
Moderators have my express permission to delete this thread as they see fit.  I was new to CPAP and this site when I posted, and pretty freaked out about the perceived cost of equipment.  I've since learned more about DME billing and my actual out of pocket expense.  Apologies for the "click-bait" title!
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#19
RE: Help! DME rape!
Keep in mind that the amount the DME is billing the insurance company for is not what they are actually getting paid. For instance, my DME billed Medicare for $182 worth of supplies, but got paid $82. The DME accepts what is agreed to in it's contract with the insurance carrier, not what they actually bill.
That said, I would rather order my supplies online as it is less expensive but don't because Medicare and my medigap policy wouldn't pay for it.
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#20
RE: Help! DME rape!
^This exactly--I saw the amount billed on my first Lincare statement and went directly to panic mode. When I realized their amount billed had nothing to do with my responsibility (my cheap insurance pays 50%) I calmed down about everything, and cancelled my order of a used machine. I'm renting a BiPap and a concentrator, so it's certainly not cheap, but I can afford the payments for a year, and do more informed policy shopping at Healthcare.guv next enrollment period. And maybe by then I'll be close to owning this machine? I really need to know my rental terms with Lincare...
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