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How often will insurance replace machine?
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johns019 Offline

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Posts: 74
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Machine: PRS1 BiPAP Pro
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Sex: Male
Location: Massachusetts

Post: #1
How often will insurance replace machine?
I did do a search first, but couldn't find my answer - sorry in advance if this is a dead horse.

I just got to use my machine again last night after a few days without it (due to a bloody nose) and I started wondering about what would it be like if my machine died.
Does anyone know how long a life to expect from the machine and how often most insurance will go for it?
When I got my machine last June, my insurance company said there was no $ limit on DME, but I have a $250 deductible each year.The company that did my sleep study and provided the equipment has gone out of business (Sleep Health Centers). Fortunately they contacted me just before they went out and said I was eligible for a new mask,hose,filters and water tank, so I have replaced them.
Just want to be preparedRolleyes
04-20-2013 07:54 AM
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SuperSleeper Offline

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Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
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CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

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Sex: Male
Location: Illinois, USA

Post: #2
RE: How often will insurance replace machine?
Hi johns019,

The useful life of most CPAP machines is considered to be around 5 years. But many folks have been using their machine for longer periods. Pretty sure most insurance and Medicare programs will not replace a machine unless it's older than 5 years as well.

Hopefully others can add to this. Smile

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04-20-2013 08:54 AM
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grumpycat Offline

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Posts: 27
Joined: Mar 2013

Machine: resmed S9autoset
Mask Type: Nasal mask
Mask Make & Model: wisp
Humidifier: H5i
CPAP Pressure: 5-20
CPAP Software: ResScan SleepyHead

Other Comments: In his house at R'lyeh, dead Cthulhu waits dreaming.

Sex: Male
Location: new jersey, u.s.a.

Post: #3
RE: How often will insurance replace machine?
Medicare authorizes replacement every 5 years. See also
"Your Guide to Medicare's Durable Medical Equipment, Prosthetics" which does not provide this rule, but includes other info about Medicare and DME. Note that if under warranty, you should be able to use that. Also, Google "Repair and Replacement Fast Facts" for an info sheet from Resmed.

Oops, just saw that you have private insurance. Most insurers follow Medicare guidelines, but you should check with them first.
(This post was last modified: 04-20-2013 09:51 AM by grumpycat.)
04-20-2013 09:48 AM
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johns019 Offline

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Posts: 74
Joined: May 2012

Machine: PRS1 BiPAP Pro
Mask Type: Nasal pillows
Mask Make & Model: PRS GoLife
Humidifier: PRS1
CPAP Pressure: 10 - 5
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Massachusetts

Post: #4
RE: How often will insurance replace machine?
Thank you!
I started thinking if 8 hrs / night x 365 day about 2900 hrs / year - how long is it good for?
5 years sounds like a pretty good life expectancy for my machine.
Who knows what will have happened with insurance by then Wink
04-20-2013 10:06 AM
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Shastzi Offline

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Machine: ResMed S9 Autoset
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CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

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Location: Florida, USA.

Post: #5
RE: How often will insurance replace machine?
From another standpoint: How fast can you get a replacement machine in if your current one breaks down, hit by lightning or the fan just has a seizure?

Will your current plan get you another machine going for you within 24 hrs or not?

I always keep a small emergency back up CPAP on the shelf, just in case. It's not great but it is better than no machine at all.

Cheers!

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
04-20-2013 01:22 PM
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imfletch Offline

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Joined: Apr 2013

Machine: ResMed S9 AutoSet
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Humidifier: ResMed 5i
CPAP Pressure: 16
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Pensacola, FL

Post: #6
RE: How often will insurance replace machine?
(04-20-2013 01:22 PM)Shastzi Wrote:  From another standpoint: How fast can you get a replacement machine in if your current one breaks down, hit by lightning or the fan just has a seizure?

Will your current plan get you another machine going for you within 24 hrs or not?

I always keep a small emergency back up CPAP on the shelf, just in case. It's not great but it is better than no machine at all.

Cheers!

Hmm, good point. I'm going to purchase an inexpensive "back-up" right now.
04-24-2013 01:11 PM
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Shastzi Offline

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Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #7
RE: How often will insurance replace machine?
I use the brick during stormy weather too, so I need not worry about blowing up the good machine.

Wink

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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04-24-2013 08:29 PM
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archangle Offline
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Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #8
RE: How often will insurance replace machine?
Keep an eye out for something on Craigslist, friends, family, etc. You might find a really good buy if you watch for a while. If you're looking for a backup, it may pay you to shop carefully.

You might even try your own ad on Cragslist or somewhere similar. There are a lot of people with CPAP machines gathering dust because they gave up on them.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
04-25-2013 01:36 AM
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dave.brendle Offline

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Machine: ResMed S9 Elite
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Mask Make & Model: RedMed Activa FX
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CPAP Software: Not using software

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Sex: Male
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Post: #9
RE: How often will insurance replace machine?
Just for the record, my ResMed S7 which was just replaced with an S9 Elite was 9 years old and just short of 25,000 hours. Never missed a beat. It is now on my shelf as a backup. Sleep-well
05-10-2013 09:12 PM
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Airstream Offline

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Posts: 147
Joined: Feb 2013

Machine: Resmed S9 Autoset
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CPAP Pressure: 10-20
CPAP Software: SleepyHead

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Sex: Male
Location: Smoky Mountains, East Tennessee

Post: #10
Smile RE: How often will insurance replace machine?
Geez, never though about a back-up or when my machine can be replaced. That's for posting the question.Thanks

To err is human, but to really mess things up, you need a computer.
05-12-2013 02:50 PM
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