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How often to change P10 pillows
#21
(04-13-2017, 10:56 PM)Mosquitobait Wrote:
(04-12-2017, 06:08 PM)Cuppa Wrote: I don't understand 'deductible' or 'copay'.

Deductible:  What you pay before insurance will start paying. For instance, if you have a $500 deductible, you are responsible for the first $500.  After that, insurance comes into play.

Copay: You pay a portion of the product/service and your insurance pays a portion.  On durable medical goods (our Medicare scheme), Medicare pays 80% and I pay 20%.  Medicare determines what the initial price is (contracted). 

I don't have a deductible on durable medical goods - I pay a straight 20%.

Yeah, it sucks to be the captive audience especially when the price difference is so horrendous!  One of my quilting friends is former Aussie and when her daughter and son-in-law visited from Sydney, they bought Resmed machines through Craigslist and brought 3 home with them for people they knew who needed machines. I hadn't realized until then that your medical system doesn't pay at all for the cpap machines - it's all out of pocket!

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That's not quite correct, our free  Medicare (which all Australians have) will pay for machines as mentioned by the OP above, but there is a waiting list and a limited variety available, and it is means tested, so only those who are deemed to be unable to afford their own will get one.

When I got my A10 Autoset, my private insurance paid $800AUD towards the cost.
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#22
(04-13-2017, 10:56 PM)Mosquitobait Wrote:
(04-12-2017, 06:08 PM)Cuppa Wrote: I don't understand 'deductible' or 'copay'.

Deductible:  What you pay before insurance will start paying. For instance, if you have a $500 deductible, you are responsible for the first $500.  After that, insurance comes into play.

Copay: You pay a portion of the product/service and your insurance pays a portion.  On durable medical goods (our Medicare scheme), Medicare pays 80% and I pay 20%.  Medicare determines what the initial price is (contracted). 

I don't have a deductible on durable medical goods - I pay a straight 20%.

Yeah, it sucks to be the captive audience especially when the price difference is so horrendous!  One of my quilting friends is former Aussie and when her daughter and son-in-law visited from Sydney, they bought Resmed machines through Craigslist and brought 3 home with them for people they knew who needed machines. I hadn't realized until then that your medical system doesn't pay at all for the cpap machines - it's all out of pocket!

Save
That's not quite correct, our free  Medicare (which all Australians have) will pay for machines as mentioned by the OP above, but there is a waiting list and a limited variety available, and it is means tested, so only those who are deemed to be unable to afford their own will get one.

When I got my A10 Autoset, my private insurance paid $800AUD towards the cost.
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#23
(05-12-2017, 06:24 AM)tml Wrote: I hadn't realized until then that your medical system doesn't pay at all for the cpap machines - it's all out of pocket!

Save
That's not quite correct, our free  Medicare (which all Australians have) will pay for machines as mentioned by the OP above, but there is a waiting list and a limited variety available, and it is means tested, so only those who are deemed to be unable to afford their own will get one.

When I got my A10 Autoset, my private insurance paid $800AUD towards the cost.

This is correct, but the means testing means that there are plenty of folk like me who cannot afford private medical insurance premiums, and do not qualify for any form of social security benefits who must pay 100% of the cost themselves.  The private insurance industry is probably responsible in part for the high prices folk like me have to pay. Recently a friend's relative in Horsham was quoted a figure of $6000 to set them up with a mask & machine!  I paid around $1500 by purchasing from the US. Even if I avoided the blatant gouging by companies like those who quoted $6000, I could still easily have had to pay $3000+ if I had purchased in Australia.
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#24
(05-12-2017, 08:11 AM)Cuppa Wrote:
(05-12-2017, 06:24 AM)tml Wrote: I hadn't realized until then that your medical system doesn't pay at all for the cpap machines - it's all out of pocket!

Save
That's not quite correct, our free  Medicare (which all Australians have) will pay for machines as mentioned by the OP above, but there is a waiting list and a limited variety available, and it is means tested, so only those who are deemed to be unable to afford their own will get one.

When I got my A10 Autoset, my private insurance paid $800AUD towards the cost.

This is correct, but the means testing means that there are plenty of folk like me who cannot afford private medical insurance premiums, and do not qualify for any form of social security benefits who must pay 100% of the cost themselves.  The private insurance industry is probably responsible in part for the high prices folk like me have to pay. Recently a friend's relative in Horsham was quoted a figure of $6000 to set them up with a mask & machine!  I paid around $1500 by purchasing from the US. Even if I avoided the blatant gouging by companies like those who quoted $6000, I could still easily have had to pay $3000+ if I had purchased in Australia.

$6000 is about the going rate for some of the ResMed Lumis machines (as i understand it, these aren't for OSA however). Ive not seen a CPAP/APAP anywhere near that price.

As far as private health goes, whilst we are in a position to be able to afford it, I don't accept the claim that it is responsible for the higher prices others have to pay. On the contrary, during numerous hospital admissions over the years, myself and my family have always gone private, thus alleviating the burden on the public system. If it wasn't for private health, the public system would very nearly collapse and you could guarantee that it wouldn't be free, so unfortunately a strict means testing on medical devices like these means that funding can be directed towards the greater public health system. The pot of cash is only so big.

For the record, I pay just shy of $6000 per year in private health.
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#25
In Canada (Province of Ontario) if you get a prescription for a cpap the OHIP will cover 75% of the cost of the machine/mask when you get it. My work insurance covered the rest. I think I maybe payed $20 as i added a few things that exceeded my coverage. I bought filters and a p10 mask out of pocket from monstercpap.

My dad also has sleep apnea and he was using a old Sullivan V. He saw my Dreamstation and decided to get one him self. He didn't want to do the sleep study so he looked on kijiji and found a brand new Dreamstation Apap, unused one for $600 in Toronto. I am trying to convince him to get p10 mask as it seems to be a must have mask until the p20 comes out.
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#26
(05-12-2017, 07:57 PM)tml678 Wrote:  If it wasn't for private health, the public system would very nearly collapse and you could guarantee that it wouldn't be free, so unfortunately a strict means testing on medical devices like these means that funding can be directed towards the greater public health system. The pot of cash is only so big.

For the record, I pay just shy of $6000 per year in private health.

I guess we will have to agree to disagree. Obviously our politics are different. I have seen first hand how insurance pushes up the price for work completed under a claim & have no reason to think the process would be any different under medical insurance. The old argument of private health funds holding up the public system simply doesn't wash for me. It is precisely what governments with leanings to the right want us to believe whilst they continue to cut services available to the disadvantaged sector of our community whilst increasing the billion dollar perks to their profit making buddies in the big end of town.

If  yourself (or anyone) want to pay $6000 a year that is your prerogative & I hope you get good value for your outlay, but this should, in my opinion be obtained from private services funded entirely from folk like yourself. Unfortunately this is not what happens much of the time. A great deal of 'private medicine' occurs within the public system, essentially giving those with insurance precedence over those without. This only adds to the the public waiting lists & represents a two tier system where those with money can bypass the queue. I do not believe that one's health should be dependent upon wealth. That it is I have to accept, but not within the public health system.

Anyway, I've made my point, & don't wish to engage in further 'argument'. It is not you, or any individual I take issue with, it is a system which doesn't need to be the way it is.

Oh, and for readers not in Australia, our private medical insurance is clearly very different to the medical insurance you are familiar with.
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