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How to get my father new CPAP?
#1
Question 
How to get my father new CPAP?
My father last got a CPAP over 5 years ago.  He probably hasn't seen that sleep doctor in the last 5 years either.  And he lives in a very small town.

Is there an online company that can actually use his healthcare insurance to pay for his CPAP to be shipped/ordered?  (My insurance paid for mine.)

His RX was not for an APAP last time (just for a standard CPAP), so I'm almost certain he will need a new RX to get an APAP, right?  Will most doctors write a new prescription without a followup visit after all this time since he obviously needs a new machine?  Or are they going to require an appointment first?

By the way, thank you for all the help you guys have been on this forum the past week.  This website is amazing!!!

Thanks guys!!!  Thanks
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#2
RE: How to get my father new CPAP?
He can ask his primary to write out a prescription for a new machine. A cpap and apap cost the same to Medicare, so he should tell the doc he wants a specific machine because it gives him some options that weren't available before. Make sure that you review which machines work with Sleepyhead so he gets the right one. Medicare will accept a copy of his sleep study within the last 10 years, so he's gold there.

If he is using Medicare, you need to check the Medicare site to see if he is in a Medicare bid area. Those are the only places he can go to and get a Medicare paid for machine. This is for Original Medicare. If he has an HMO, he will need to contact them directly. https://www.medicare.gov/supplierdirectory/search.html

If he is not in a competitive bid area, he can contact any local place and ask if they take Medicare assignment, but the directory at Medicare.gov can also give you a list. There is at least one online place that does Medicare, but I don't know which one that is. The rest do not deal with either Medicare or insurance.
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#3
RE: How to get my father new CPAP?
(03-28-2018, 10:12 PM)Mosquitobait Wrote: He can ask his primary to write out a prescription for a new machine.  A cpap and apap cost the same to Medicare, so he should tell the doc he wants a specific machine because it gives him some options that weren't available before.  Make sure that you review which machines work with Sleepyhead so he gets the right one. Medicare will accept a copy of his sleep study within the last 10 years, so he's gold there.

If he is using Medicare, you need to check the Medicare site to see if he is in a Medicare bid area.  Those are the only places he can go to and get a Medicare paid for machine.  This is for Original Medicare. If he has an HMO, he will need to contact them directly.  https://www.medicare.gov/supplierdirectory/search.html

Very helpful!  Although, he does have his insurance through his employer still.  Not Medicare.  Is there a website that allows people to order the PR DreamStation Auto and allows him to use insurance to pay for it?  Or for insurance does he have to find a local medical supply store instead?

And will a general primary care doctor be able (and knowledgeable) to write the script for humidifier, heated hose, the right pressure settings, etc etc?
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#4
RE: How to get my father new CPAP?
It can help if you are prepared to coach the doctor in the prescription. For example, "I want a Resmed Airsense 10 Autoset with heated humidifier, heated hose with an Airfit P10 mask and filters", it's going to be hard to get that wrong. I actually write out my prescription request with pressure settings and HCPS codes. It's no problem at all.
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#5
RE: How to get my father new CPAP?
(03-28-2018, 10:28 PM)Sleeprider Wrote: It can help if you are prepared to coach the doctor in the prescription. For example, "I want a Resmed Airsense 10 Autoset with heated humidifier, heated hose with an Airfit P10 mask and filters", it's going to be hard to get that wrong.  I actually write out my prescription request with pressure settings and HCPS codes.  It's no problem at all.

Does the doctor use his standard RX tab?

My doctor had a "CPAP form" that he signed for the CPAP prescription with check boxes to select from.
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#6
RE: How to get my father new CPAP?
You can actually download standardized prescription forms from vendors like Supplier #1. They provide them with the intention of helping customers easily get a complete prescription from their own doctors. All you need to do is cross out the vendor name, and the script would be good anywhere.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#7
RE: How to get my father new CPAP?
Your dad's insurance company will probably have a claim form. You'll pay first, then get reimbursed after the deductible. If you go to an online DME it will probably be considered "out of network".
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#8
RE: How to get my father new CPAP?
(03-28-2018, 09:47 PM)dk2011 Wrote: My father last got a CPAP over 5 years ago.  He probably hasn't seen that sleep doctor in the last 5 years either.  And he lives in a very small town.

Is there an online company that can actually use his healthcare insurance to pay for his CPAP to be shipped/ordered?  (My insurance paid for mine.)

His RX was not for an APAP last time (just for a standard CPAP), so I'm almost certain he will need a new RX to get an APAP, right?  Will most doctors write a new prescription without a followup visit after all this time since he obviously needs a new machine?  Or are they going to require an appointment first?

By the way, thank you for all the help you guys have been on this forum the past week.  This website is amazing!!!

Thanks guys!!!  Thanks

If he has his original Rx he is good to go. CPAP is CPAP whether it is auto or fixed.  Choose the one you want, and the old script will be fine.  Supplier #30 will work with insurance.  They may not be in-network which would mean out of network reimbursement may apply, but it's better than nothing.  If your dad is on Medicare, he has to use a Medicare provider and I'm not aware of an online vendor that does that. Once you get situated, with a new machine, we can help you to get dad dialed in.  I strongly prefer the Resmed Airsense 10 Autoset, so if that looks affordable, it's my recommendation, however there is currently a Philips Respironics Dreamstation DSX500T11 with humidifier and heated hose on Amazon right now for $375. You can't beat that price, and it's a fine auto CPAP machine.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#9
RE: How to get my father new CPAP?
If you're wanting to make sure insurance will cover it, I highly recommend you check with the insurance company about which DMEs they will allow you to use.

My insurance company will not allow me to use any online DMEs/suppliers.
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