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Apnea Board Forum - CPAP | Sleep Apnea  /  Public Area  /  Main Apnea Board Forum v  /  Insurance coverage and RERAs

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Insurance coverage and RERAs
kittenmittons Offline

New Members

Posts: 1
Threads: 1
Joined: Jan 2022

Machine: Unsure
Mask Type: Nasal pillows
Mask Make & Model: unsure
Humidifier: unsure
CPAP Pressure: 5-15
CPAP Software: OSCAR

Other Comments:

Sex: Female
Location: Chicago, IL
#1
01-24-2022, 05:29 PM
Insurance coverage and RERAs
I was diagnosed with UARS last week after an in-lab sleep study. I had zero apneas or hypopneas (though I did have hypopneas in an at-home study just prior to the lab test), but my RERA index was 5.25. They also diagnosed me with PLMD. I've attached the basic results.

BCBS denied my coverage for an APAP. My question is, should I appeal or just go ahead and buy the APAP and supplies. My sleep doc will be sending me my prescription so I can order online. Has anyone successfully appealed a denial due to no apneas or hypopneas?

Thanks!


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Homerec130 Offline

Monitors

Posts: 1,072
Threads: 33
Joined: Mar 2012

Machine: ResMed AirSense10
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro FX or F20
Humidifier: AirSense 10
CPAP Pressure: 12
CPAP Software: OSCAR SleepyHead myAir

Other Comments: But it is a dry heat.

Sex: Male
Location: Tucson, AZ
#2
01-26-2022, 01:17 PM
RE: Insurance coverage and RERAs
Personally, I would go ahead and work with your doctor and file an appeal. My doctor has done it a couple of times with me, and we are starting the process of doing the same with my wife.
Homer

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