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Insurance and Cpap
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,815
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #11
RE: Insurance and Cpap
You are not locked to a DME, but your coverage may be different depending on the DME. Check who is "in network" to get the best ins benefit
12-18-2014 02:45 PM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #12
RE: Insurance and Cpap
(12-18-2014 02:45 PM)DariaVader Wrote:  You are not locked to a DME, but your coverage may be different depending on the DME. Check who is "in network" to get the best ins benefit

This. If the DME wants you to use a cheap machine, decline and say you're headed across town to see if their competition will give you an AutoSet machine. Get a hard copy of your Rx and shop around. You want the right machine and you want competent support/service.

You want a best-of-breed AutoSet machine so you can use the AutoSet feature and SD card data to fairly quickly figure out what your real setting needs to be rather than rely on one night's data at a sleep center. The latest ResMed machine has already been suggested. A ResMed S9 AutoSet is what I just bought with my own money since I'm in transition between insurance companies. Hopefully, I can talk my next DME into a ResMed AirSense 10 since it's a bit more portable for business trips.
12-18-2014 03:09 PM
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trish6hundred Offline

Advisory Members

Posts: 6,424
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #13
RE: Insurance and Cpap
Hi SD50,
WELCOME! to the forum.!
Check out this link: http://www.apneaboard.com/wiki/index.php...ne_Choices
It has great information on which machines to get and which machines to avoid.
Hang in there for more suggestions and much success to you as you start your CPAP therapy.

trish6hundred
12-18-2014 03:34 PM
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SD50 Offline

Members

Posts: 4
Joined: Dec 2014

Machine: airsence 10 Auto
Mask Type: Nasal pillows
Mask Make & Model: unsure
Humidifier: unsure
CPAP Pressure: 4-12
CPAP Software: Not using software ResScan

Other Comments:

Sex: Male
Location:

Post: #14
RE: Insurance and Cpap
Thanks, All,

Just found out that I've been slated for an Airsense 10 Elite at a pressure of 6, which doesn't appear to be too bad. Looks like I will be getting it Monday, so I'm somewhat exited but at the same time concerned how I will handle the therapy. Time will tell I guess. My sleep study wasn't too bad (thanks to Xanax, lol) but a hoping that the real thing will be tolerable. I travel for a living, so it looks like I have an extra piece of luggage to lug around.
12-18-2014 03:45 PM
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bwexler Offline

Advisory Members

Posts: 563
Joined: Mar 2012

Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
Mask Type: Nasal mask
Mask Make & Model: Sleepweaver √Član
Humidifier: Resperonics Heated Tube humidifier
CPAP Pressure: Max pressure 25.0 cm H20, Max
CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #15
RE: Insurance and Cpap
I absolutely meant for her even if the user happens to be a him.
12-18-2014 03:53 PM
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GeoffD Offline

Preferred Members-2

Posts: 194
Joined: Sep 2014

Machine: ResMed Airsense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integral + ClimateLine
CPAP Pressure: 14-17
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: New England

Post: #16
RE: Insurance and Cpap
(12-18-2014 03:45 PM)SD50 Wrote:  Just found out that I've been slated for an Airsense 10 Elite

I travel for a living, so it looks like I have an extra piece of luggage to lug around.

I haven't needed to travel in the 90 days I've had my ResMed AirSense S9 AutoSet. I'm flying tomorrow for the first time and the business travel picks up in January. I'm hoping I can work out either a combined laptop/CPAP bag or pack lightly enough to fit the machine in my roll-aboard.
12-18-2014 03:58 PM
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PollCat Offline
Apnea Board Polling Administrator
Monitors

Posts: 1,575
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #17
RE: Insurance and Cpap
I traveled for years, carrying a cpap - it really is not that big of a deal! It's actually gotten a lot easier in recent years; less TSA scrutiny and smaller, lighter machines. And the machines are not counted as part of your carry-on luggage. Just be prepared for a TSA looksie, if your machine includes a battery pack. oldman


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.
12-18-2014 05:47 PM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,815
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #18
RE: Insurance and Cpap
(12-18-2014 03:58 PM)GeoffD Wrote:  I haven't needed to travel in the 90 days I've had my ResMed AirSense S9 AutoSet. I'm flying tomorrow for the first time and the business travel picks up in January. I'm hoping I can work out either a combined laptop/CPAP bag or pack lightly enough to fit the machine in my roll-aboard.

having just stepped off the plane so to speak, if you carry it in a medical equipment bag by itself, it does not count against your carry-on limit. Mine came from the DME in its travel bag. Since you got yours online, it might be extra. If you get the covetted TSA-PRECHK on your boarding pass - all is well. Don't remove anything from bags, and leave your shoes on your feet! It is such a relief. If you don't tho, put the cpap machine into clear plastic bags, because TSA may just dump it into a dirty bin. They did mine Angry
12-18-2014 08:00 PM
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archangle Offline
Wiki Editor
Advisory Members

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: #19
RE: Insurance and Cpap
Sounds like you're doing good.

There are some hints in the links in my signature line.

The AirSense (A10) Elite is a good manual CPAP, can probably do a good job for you.

The A10 AutoSet is better in all cases. The A10 AutoSet for Her is better than the "plain" AutoSet. Each "higher" level model will do everything the lower level model will, and has some additional features.

Avoid the "plain" AirSense CPAP. The model name is in the lower right corner. Get at least the Elite, because the Elite and better machines have enormously more useful data to track your therapy and fix problems.

Good luck.

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.
12-19-2014 12:46 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: #20
RE: Insurance and Cpap
(12-18-2014 11:45 AM)SD50 Wrote:  I just finished my sleep study and am waiting for the DME to contact me regarding the equipment. I've got BCBS and was told by the staff that the machine is rented for a few months and then at some point it becomes mine. Other things I heard that I need to be compliant (certain number of hours, certain percentage) or they could take the machine away. Since I don't get a lot of sleep on a regular basis (5-6 hrs/night), I'm somewhat concerned that all this could be for naught. Any thoughts on this one?

Also, I'm slated for an Airsense 10 (so I was told) and I've researched the different models and expect them to give me the cheapest model. Any thoughts on how to 'push' them to a better machine if they want to 'cheap out'?

Finally, I was told that 8psi was the sweet spot for my apnia. Would this mean that 8psi would be the maximum pressure set on the machine?

Lots of questions, I know. Newbie here, so thanks for all your help.

When I got my first machine, I had BCBS MA PPO and they purchased the machine and humidifier outright from the very beginning. I didn't have to do the compliance checks with them.

Then I got a new insurance company, a PPO, and they rented the machine for 13 months but purchased the humidifier outright.

If you use the machine 4 hours a night for 70% of the time I believe is the criteria, you will be in compliance from their standpoint.
12-20-2014 11:03 AM
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