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How long is a CPAP prescription good for?
#1
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.
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#2
Hmmm, I'm not positive as to the exact time frame. I do know that Supplier #1 has a copies of my latest script (which is about 5 years old) plus the previous script. And they've never asked me for a newer one when I order supplies.

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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#3
A nurse prac or dentist can write a script for a cpap auto pap etc with no study if your not worried about insurance.
If your original one says 99 or lifetime just get a copy if it.

Id get a pr 560 auto though. About 420 bucks new with heated hose etc.
Set it at 13 ,14 min since you are used to that pressure, and max at about 16 to give it a bit of wiggle room to handle residual apneas.
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#4
Around 6 years ago my CPAP machine started getting real loud but the pressure was still good so insurance would pay for a new one because of they would only replace it if it was 5 years old+. My DME loaned me a auto machine while they tested mine I loved the auto. so I got my doctor to fax a script to Supplier #1 and bought a S8 auto. Recently I needed a new mask which my DME said they couldn't get I contact Supplier #1 and they said all is good your script is a lifetime.
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#5
Most online suppliers will keep your scrip indefinetly, but local DME's have their own agenda.

My DME told me that my script is expiring this year, my Sleep Doctor said it is lifetime, but with a roll of his eyes, he faxed over another to my DME.
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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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#6
Welcome to the forum wml52! Hope you can work things out without having to pay for another sleep study etc!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#7
Hi wml52,
WELCOME! to the forum.!
My prescription says 99 months or lifetime.
Hang in there for more responses to your post and much success to you as you continue your CPAP therapy and good luck to you on getting your new machine.
trish6hundred
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#8
It depends on what the doctor writes on it and weather you keep a copy.
If he writes one year so be it. If you don't get and keep a copy you are at the doctors mercy, especially if he expires before you do.
Get your doc to write a new prescription for auto CPAP and supplies of patients choice and specify 99 months or lifetime on the expiration line. Then keep the original and send a copy to the supplier of your choice. As long as you keep your copy, it won't expire until you do.
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#9
(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!
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#10
Since my PCP was reluctant to give me a new Rx I decided to go back to the office of the pulmonary doctor that wrote the original Rx. I explained to the receptionist that my old CPAP machine no longer worked and I needed to purchase a new one ASAP since I did not have a back-up unit. I then asked the receptionist for a copy of my original CPAP Rx she asked me to wait while she spoke to the doctor. She then returned and said that the doctor would not give me a Rx for a new machine unless I had another sleep study done. I told the receptionist that I wasn't looking for a new Rx just a copy of my original Rx. She then rather rudely proceeded to tell me that she could not do that. I then explained to the receptionist that I had a right to have a copy of my file which would have included the original Rx and that I was prepared to wait until hell froze over but I wasn't leaving until I got that file. She then called the doctor and after a few minutes on the phone went a made copies of my file and gave it to me.

While I can understand to some degree the doctor not wanting to write a new script for a CPAP machine without another sleep study. I do not understand the reluctance in giving me a copy of my old script without having to get so insistent? Hmm could it be revenue driven? That was a rhetorical question...lol

In any case I have ordered a new PR DS560BT which should be arriving in a few days. My thanks to all who responded and special thanks to Ghost1958 for the 560 recommendation it was a much better choice then the 460 I was going to purchase. Total for the package was $469.00 through [link removed] Supplier #1

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