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Insurance (Medicare) and Machine Choices
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justMongo Offline

Monitors

Posts: 3,847
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #11
RE: Insurance (Medicare) and Machine Choices
My doc is located next to the DME. He reads the sleep studies -- he obviously gets paid by them for that.
I wonder if he has a financial interest in the DME????

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.
10-21-2013 03:13 PM
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djjwilly Offline

Preferred Members-2

Posts: 62
Joined: Mar 2013

Machine: Elite S9
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and chinstrap
Humidifier: Resmed Elite H 5i
CPAP Pressure: 10
CPAP Software: ResScan

Other Comments:

Sex: Female
Location:

Post: #12
RE: Insurance (Medicare) and Machine Choices
Sid, you need a close DME. You'll be going there to try masks, which can be a royal pain and take several trips. Please do not use an out of state one. Use a very close one if you can. Mine is 30 miles away and I've gone there many times this past year before I settled on a mask. I hope you read this before you decide. Good luck to you. Love, DJ
10-22-2013 02:09 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #13
RE: Insurance (Medicare) and Machine Choices
(10-22-2013 02:09 AM)djjwilly Wrote:  Sid, you need a close DME. You'll be going there to try masks, which can be a royal pain and take several trips. Please do not use an out of state one. Use a very close one if you can. Mine is 30 miles away and I've gone there many times this past year before I settled on a mask. I hope you read this before you decide. Good luck to you. Love, DJ

you are fortunate. My DME only has masks that we can look at but not try on. They only stock the Quattro FX but you cannot try them on as they say they don't have a way to clean them.
10-22-2013 02:19 AM
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djjwilly Offline

Preferred Members-2

Posts: 62
Joined: Mar 2013

Machine: Elite S9
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and chinstrap
Humidifier: Resmed Elite H 5i
CPAP Pressure: 10
CPAP Software: ResScan

Other Comments:

Sex: Female
Location:

Post: #14
RE: Insurance (Medicare) and Machine Choices
Sid, I'd try to find another DME that let's you trail masks. How can you tell what's comfortable without trying them on? You're on Medicare, right? Give them a call and see what they say about this. My DME lets me take samples home for a week. Sure, the cushions are always worn out and it's unfair testing them that way, but at least I can do it. Just an idea. I can't understand how your situation would be that different from mine. I'm in NY. Love, DJ
10-22-2013 03:45 PM
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sir_sleeps_alot Offline

Preferred Members-2

Posts: 58
Joined: Oct 2013

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Mirage FX
Humidifier: Hi5
CPAP Pressure: 14 cm h2o
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: New England

Post: #15
RE: Insurance (Medicare) and Machine Choices
Man, oh man, what a mess. My insurance is changing 11/1 and this is what was supposed to happen:

The DME was supposed to provide my cpap in a reasonable amount of time so that I could get started on treatment. When my insurance changes on 11/1, the new insurance was supposed to provide coverage for the old DME for 90 days to give me time to line up a new DME. This was supposed to prevent me from going too long without treatment.

What happened instead:
The DME had my Rx and prescription info for 3 weeks and never got far enough to even schedule an appointment with me. I had to call and "fire" them because they took too long. I figured that if that hadn't been able to even schedule my appointment by 10/28, they weren't going to be able to provide the cpap by 10/31 and for them to do so after that date would be pointless as they are not covered by my new insurance plan.

I looked at the provider directory for my new insurance and discovered that they have no DMEs in my area. I called member services for my new plan and was told to call a company in a town that was 3 hours away!!! I called them and was told they didn't even do CPAPs. On my own, I managed to find a DME within 45 minutes that does do cpap and is covered by my new insurance plan. But they told me they can't even start processing my paperwork until after 11/1. So......... more hurry up and wait.

The little bit of phone contact I've had with the new DME makes me think that they are a much better company than the other. I believe they are going to come to me which is really great. The woman I spoke with was very nice and helpful and said she would mark my file as high priority. I'm still frustrated it's taking so long, but I feel much better about this new DME.

*crossing my fingers*

Thanks for the input.

Sid
10-30-2013 06:55 PM
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