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Kaiser Senior Advantage: CPAPs
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2PAPs Offline

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Posts: 58
Joined: May 2015

Machine: PR System One 750p
Mask Type: Full face mask
Mask Make & Model: ResMed Ultra Mirage
Humidifier: PR System ONe
CPAP Pressure: 8-20
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location: California

Post: #1
Kaiser Senior Advantage: CPAPs
Kaiser Senior Advantage is much different than most Medicare plans in regards to CPAP purchase. All CPAP DME goes through Apria. Purchases of CPAP DME formulary are 20% copay.

The CPAP, itself, is not purchased by the patient. It is rented by Kaiser to the patient, much like a cable box. I believe the rental payments are 13 months, after which the use remains with the patient but ownership remains with Kaiser.

At this point, not a problem unless the patient changes Medicare Advantage providers. The CPAP then reverts back to Kaiser. Not a problem for me, as I've been a Kaiser member for almost 50 years.

A Plus: the CPAP is warranted for four years.

Cloudy: After four years, who pays for repairs and how much? After five years, Kaiser appears not issue another CPAP unless there is a problem with the CPAP that cannot be repaired.

Also cloudy: I don't know if the CPAP issued is unused!

Apria is not a culprit in this scenario except they are trying to get me to get a new BiPAP immediately and are sketchy about what happens after four years. I might walk down to the Kaiser Business Office and talk to them.
06-12-2015 11:48 AM
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bwexler Offline

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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: #2
RE: Kaiser Senior Advantage: CPAPs
My brother in law is a Kaiser Senior Advantage member for many years, but not as many as you.
It appears he had a 20% copayment up front on a straight purchase.
This however was a second go round for him. The first machine never made it out of the trunk of his car. It was returned after several months.
The second machine he uses sporadically but seldom for 4 hours in one night. He does have insomnia and sleeps in sporadic chunks.
06-13-2015 02:36 PM
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2PAPs Offline

Preferred Members

Posts: 58
Joined: May 2015

Machine: PR System One 750p
Mask Type: Full face mask
Mask Make & Model: ResMed Ultra Mirage
Humidifier: PR System ONe
CPAP Pressure: 8-20
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location: California

Post: #3
RE: Kaiser Senior Advantage: CPAPs
I've been a Kaiser member since age 16 with my own membership, not as a dependent. I've only been a Senior Advantage member for a couple of months. My current BiPAP was purchased and is mine. I have to get the terms of the new BiPAP directly from the Kaiser Business office. Apria just wants to put a machine in my hand. They offered to send me one right now. But if it's not done right, I'll be out $2200.
06-14-2015 09:47 PM
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