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Medicare & CPAP: Just Curious
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Ross Offline

Members

Posts: 14
Joined: Mar 2013

Machine: ResMed Airsense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX; AirFit N10
Humidifier: integrated
CPAP Pressure: 5-18
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Connecticut

Post: #1
Medicare & CPAP: Just Curious
I just got a Medicare Summary Notice showing a supplier charge of $874.72 for my replacement Res Med CPAP device and a Medicare approved amount of $34.43. I have little sympathy for my supplier (Apria), but $34.43 for the device is hard to understand. There is one footnote saying the amount is based on the DMEPOS competitive bidding program, and another saying payment is reduced by 25% beginning with the 4th month of rental. Is $34.43 merely a recurring rental charge, rather than a one time charge? If not, how can a supplier make a profit selling a device at this price?
02-01-2016 12:49 PM
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justMongo Offline

Monitors

Posts: 3,845
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: #2
RE: Medicare & CPAP: Just Curious
Medicare does a rent to own over 13 months. The supplier will gross about $450 on the machine.

Medicare reimbursements have been going down; especially under their competitive bid program.
Seems like every year I have to find a new supplier of test strips because suppliers go out of business.

Cost control is one thing. Tearing down the system is another.
Write to your representative and tell them: "Thanks a bunch."

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.
02-01-2016 01:08 PM
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