(02-17-2016, 11:48 PM)wml52 Wrote: I am new to this site and my first post, so hello to all I will try to keep this as brief as possible.
How long is a CPAP Rx good for? The reason for my question is this; My CPAP machine stopped working recently so I am looking to have it replaced.
If I go through my insurance companies in-network supplier it will cost me $1,300.00 for a new CPAP machine, I have to pay the first $750.00 out of pocket and then the insurance will pay 80% of the balance.
I can get the same CPAP machine on-line for $375.00. However they need an Rx before they will ship it and here in lies the problem. My doctor wants me to go through another sleep study before he will give me a Rx. I have been using CPAP at 14 CM/H2O for the past 5 years and have had no issues at that pressure setting. I sleep through the night and feel great in the morning. I don't feel it necessary to have another sleep study done.
Can I ask for a copy of the Rx I got when I had my original sleep study done or does it have an expiration date?
Any info would be appreciated.
Thanks to all.
It's clearly less expensive for you to self-finance a new machine than to use your insurance. You should first of all obtain copies of any records you don't have in your possession like the results and recommendations of your original sleep study and a copy of any prescriptions. This information can be used by ANY doctor, but preferably by your primary care provider to write a new prescription. Prescriptions for CPAP can be good for life, but most insurance carriers will require you to demonstrate continuing medical necessity and a new prescription when they are buying the equipment. On the other hand, I still use my 2008 prescription at Supplier #1
to buy masks and supplies, and I could buy a machine for that matter.
You can buy a new "PR System One 60 Series Auto with Heated Tube Humidifier DS560TS" for $499 complete with free shipping on Amazon, and you probably won't need to show a prescription. That is a significant upgrade to your machine, and you'd have it in days instead of weeks. Just search for it.
Meanwhile, talk to your regular doctor about setting an appointment to discuss your sleep apnea needs. You do NOT need a specialist to write your prescriptions and support your care. Provide him with any records you have and discuss your needs and the benefits you derive from PAP treatment. Be prepared to provide him with an outline of your prescription needs (machine type, pressures, mask etc). If you're not using insurance, a prescription simply consists of "CPAP machine, humidifier, tubing, mask and supplies no expiration". Insurance prescriptions may need more detail. If you have any
old prescription, you can use it NOW at an online DME. Good luck!