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How do I maintain medicare compliance while in Mexico
#1
I am receiving an asv machine through medicare. I will be leaving to go to Mexico City after spending a few nights making sure that it works correctly and getting used to it. I will return to NYC in July and have already made an appointment to see my doctor when I return. I will be moving to Mexico and don't know the compliance requirements and how I will be able to satisfy them from Mexico. Does anybody have any experience or knowledge in maintaining compliance with medicare from outside the country? Thank you for your help
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#2
Once you meet the compliance required (30 days continuous use, 4+hours daily) and had your face-to-face with the doctor within the specified period (more than 30 days, less than 90), you have met compliance. You do have the option, if your DME wants, to mail your SD card in for them to read it. Talk to your DME about how best to meet their needs since they are the ones who won't get paid. Make sure that you have an extra SD card available so that you can continue to clock your information into Sleepyhead (which will store it all) in case the SD card gets lots or corrupts along the way.
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#3
I foresee some possible pitfalls. Under US Medicare, the machine is a 13 month rent to own.
That said, until 13 months, it is not the user's property, and subject to repossession. (Or a demand for payment in full.)

A second twist is: US Medicare does not pay for medical care outside the US (with the exceptions of some territories and US Possessions).
Whether that is a factor here, I have no idea. I am not a lawyer.

I think you would have to retain a legal residence within the US while in Mexico.

It probably comes down to the dispensing DME's policies.
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#4
Part of that does depend on the DMEs policies. Apria has you sign a contract with them when you first start and technically the possession of the machine never reverts to the patient but it is up to them whether or not they want to enforce it. I still have the machine that they replaced.

I am afraid that I am not up on the rest of the problem.

Best Regards,

PaytnA
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#5
Inform the DME of your travel plans. There are ways to verify compliance, even if you are not on the wireless phone network. Your machine produces a code they can use to verify use. As long as your stay in Mexico is not more than 90 days, by which time you are required to have a physician encounter to verify you are benefiting from the therapy, you will be fine.
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#6
Thank you all for your help. I will be leaving for Mexico after I get my residence visa and have used the asv a few days to get adjusted to it and make sure ir works. I will be returning to NY in July and have already made an appointment with my doctor to see how everything is working and for compliance purposes. I will return to Mexico, probably until the end of December, afterwhich I will be living in Mexico for several years and return to NY maybe once or twice a year. I don't want to have to return to NY just for compliance purposes. I have to find out if they would accept a compliance report from a Mexican doctor. I checked with Resmed and the wireless function of the aircurve 10 won't work in Mexico. i will talk to the DME when they deliver the machine. Hopefully it won't be a 12 or 13 month rental and they won't require face to face compliance meetings with an American doctor after my July appointment.
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#7
When I was facing a long-distance situation with my sleep dr/dme, a thought we bounced around was me mailing them my SD card (and using a 2nd card during the timeframe they had my original card).
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#8
(05-24-2017, 07:03 PM)PaytonA Wrote: Part of that does depend on the DMEs policies. Apria has you sign a contract with them when you first start and technically the possession of the machine never reverts to the patient but it is up to them whether or not they want to enforce it. I still have the machine that they replaced.

I am afraid that I am not up on the rest of the problem.

Best Regards,

PaytnA

Under Medicare, you rent the machine from Apria for 13 months and then it is yours free and clear. Apria will send you a letter of ownership if you request it. This happened with my S8 and now with my S10. The downside is that you are now responsible for your own maintenance. However, a call to ResMed will hook you up with a local DME for troubleshooting and possible replacement within the warranty period.

Also, you may wish to add your unit to your homeowners' or renters' policy as a scheduled medical item.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#9
I have to find out if the compliance requires face to face meetings with my doctor, and, if so, if a doctor in Mexico City will be acceptable, or if I can send the sd card in for review.  I had also discussed the possibility of sending sd cards with my doctor, but I don't trust the mail between NY and Mexico City. My wife applied for an absentee ballot in (I think) September and received it in February.  Another option I will explore is to find a sleep doctor in Mexico City, have him/her read the card and send it in either directly to the DME or my doctor to forward for compliance. I should be receiving my ASV on Tuesday and will know more then. Thanks again for all your help and feedback.
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#10
(05-26-2017, 12:37 PM)Sterling147 Wrote: I have to find out if the compliance requires face to face meetings with my doctor, and, if so, if a doctor in Mexico City will be acceptable, or if I can send the sd card in for review.  I had also discussed the possibility of sending sd cards with my doctor, but I don't trust the mail between NY and Mexico City. My wife applied for an absentee ballot in (I think) September and received it in February.  Another option I will explore is to find a sleep doctor in Mexico City, have him/her read the card and send it in either directly to the DME or my doctor to forward for compliance. I should be receiving my ASV on Tuesday and will know more then. Thanks again for all your help and feedback.

Since you are going to be using an ASV device, are you going to be taking any special precautions for the altitude in Mexico City which is approximately 7,300 feet above sea level? Will your ASV device need to be recalibrated? Will you be using supplemental oxygen or medication like VI*AGRA to help combat altitude issues?
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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