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Medicare and Sleep Apnea
#1
Medicare and Sleep Apnea
I've been on Medicare since last October. I wasn't sure what to expect in regards to receiving new supplies. 

So far, it has been very good. No problems or issues of any kind. I received an email today from Sleep Central, my DME supplier. 

They sent me a survey to fill out in regards to what supplies I needed. Initially, I wasn't sure if it was a legit email or not, so I went directly to their site and to their chat room. I spoke to a supply specialist, and she confirmed that the email sent to me was legit. 

She told me that I could take the survey from her. She told me that Medicare required certain questions to be answered before they could ship the supplies. She more-or-less, gave me a tip as to how to answer in order to satisfy their protocol. 

The survey consisted of about 14 questions or so, carefully worded, as to justify the need for new supplies. All went well and I was told that my supplies would ship on or before April 19. 

This will be the 2nd shipment of supplies now covered by Medicare. Anyways, it's good to know that the process has actually became easier, and the fact, that my out-of-pocket expenses have dropped to a big fat zero. 

Is anyone else here on Medicare experiencing the same?
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#2
RE: Medicare and Sleep Apnea
Me, not yet. Medicare starts for me May 2020, next month that is. I've not been getting supplies via the current DME, and rightfully so as I can't truthfully say I'm logging hours on the ASV.

Supplies will start with a new DME and machine sometime after Medicare coverage starts.
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#3
RE: Medicare and Sleep Apnea
I get an email from my DME every three months telling me I am eligible to order supplies. Then I log on to their website and specify what I need. And, yes, for each item there is a multiple-choice question to answer about why I need the supplies, to make Medicare happy.

If I need to make any changes, such as a different mask, I call the DME directly and skip online ordering.

With a medicare supplemental plan, my out-of-pocket cost is zero.
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#4
RE: Medicare and Sleep Apnea
I was hoping that once I was on Medicare, my out-of-pocket costs would be zero.  like
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#5
RE: Medicare and Sleep Apnea
Medicare pays 80% of covered services from Medicare providers at an agreed to cost. Supplemental insurance will pay all or some of the remaining cost depending on the plan.

Advantage plans, HMO's, probably pay 100% but you need to stay within their network.

John
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#6
RE: Medicare and Sleep Apnea
FWIW I just got a SSA letter that my Medicare Part B will be paid for on my behalf and will not deducted from my monthly SSDI payments. I'm thinking somewhere in my stack of stuff that Medical Equipment such as CPAP, NIV, and supplies were mentioned. Guess I'll need to go through that stack.
Dave

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#7
RE: Medicare and Sleep Apnea
Medicare pays only 80% of the contracted price as stated above. Advantage plans differ in this respect. My Advantage plan pays 80% of a contracted price and there is no requirement to stay in network and out of network payments are the same as in network. My understanding is that most advantage plans are restricted to their network.
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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.

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#8
RE: Medicare and Sleep Apnea
I take it, that The Advantage Plan is an option offered by Medicare? 

I just have the basic Medicare, and I think that's just part's A & B. My BC/BS picks up whatever Medicare doesn't, 100%.
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#9
RE: Medicare and Sleep Apnea
That's my take on Medicare.

I will have A, B, D when mine starts in May. Then I have a supplemental via my County Assist Office called UPMC Community that takes effect then as well.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Medicare and Sleep Apnea
I hope that it works out well for you Dave.  Thumbs-up-2
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