Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Medicare and new CPAP device in future?
#1
Medicare and new CPAP device in future?
Although my ResMed S9 is still cranking along, I will eventually need to replace it. 

Last year, I got on Medicare. Does anyone have tips on using Medicare for CPAP gear?  The Medicare app tells me that CPAP is covered, but very few details. Related: Do they require a new sleep study?

Thx.
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Medicare and new CPAP device in future?
If you previously had a PSG sleep test, and you retained the records, it will likely be accepted as proof of your medical need for CPAP, especially if you have been under the care of your doctor and routine exams document the ongoing need and benefit of your therapy. A lot of sleep studies are recommended by the DMEs which seem to think it will make approval easier. Always ask them to put through the request and let any request for a study come from Medicare. A supplier should not be the one asking for a study. You will need a current prescription, so plan to discuss with your doctor at your next appointment. You do not need a specialist to prescribe CPAP renewal, but your doctor should discuss your CPAP use and benefit for your records.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#3
RE: Medicare and new CPAP device in future?
My Sleep doctor required a Sleep Test and scheduled a Split Study because I was going for a VAuto and the only Prescription I had was for a Brick CPAP set to 19 from 2003, this was 6 years ago. I was using a DV54 that I self-purchased long before I heard of AB and I had discovered SleepyHead, the predecessor to OSCAR. AB board helped me to understand what was going on and I presented my Sleep Doctor with many recent nights showing that the APAP was not working for me, along with a few nights where it was. Very few people would have ALL bad nights so it lent credibility to my arguments. Memory says 20-30 pages of charts, just to show it was frequent enough to take action.
The Split study was a nightmare because they needed 2 hours of sleep, they clocked me at 1hr and 59 minutes (The tech gave me the extra minute and said there is no doubt that I have OSA) and my split study became a diagnostic study indicating I was "vastly" improved with an AHI of 77 from my original of 93 in 2002. I went out to my car and rested for 2 hours before I felt awake enough to drive home. Rescheduled the Titration Study, the typical CPAP up to high pressures then he enabled BiLevel in a Square Waveform. That woke me up immediately because of the sharpness of the change. They should do these with the easy breathe feature enabled to ease the jolt. Doc said I did poorly on the BiLevel and I agreed but stated I would get used to the transition if I needed to. Got my first VAuto on Medicare. COST on Medicare depends on your supplemental insurance, Medicare has a 20% deductible after you meet the annual deductible and I always meet my deductible so no issue here, and my supplemental picks up the rest.
Medicare requirements include several appointments with the doctor managing your apnea to verify that it is working for you initially, then an annual verification after that.
Post Reply Post Reply
#4
RE: Medicare and new CPAP device in future?
I have been on Medicare for six years and am still using the Vauto I got from insurance before Medicare. I have purchased several used machines as backup and now use them regularly. I continue to get supplies from Medicare, but it is not worth the hassle for me to submit to sleep studies that will push me to an inferior machine. As long as this remains the case, it is worth self-funding the machines.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Medicare and new CPAP device in future?
First, I will take your advice about hazards of being forced to take substandard gear.

As to my original study, it seemed chaotic. The hospital specialist referred me to a local agency ("All Saints Home Medical"). They wanted to do my study onsite which I dreaded, because I'm phobic about sleeping in strange places. I would have been awake all night. But my insurance refused to authorize it. Home health instead sent me home with a CPAP and detailed instructions, which worked fine. After they read the memory from the device, they had the necessary data.

But, the hospital referral and all the paperwork went straight to the home health people, who shared none of that with me. I have never personally seen a "prescription" from the hospital. If I try to order several CPAP parts at once, there is a bunch of squawking about "Where is your prescription?" I tried logging into the hospital patient portal and my records to find it there (nope).

Is it possible after several years now to request documentation? Which document do I need?
Post Reply Post Reply
#6
RE: Medicare and new CPAP device in future?
You have rights to any medical record under HIPAA, and making a request is fairly simple. You should obtain the records of your sleep study including detail results, technician's notes, analysis and recommendation; physician's notes and prescription. These are your rights under HIPAA https://www.hhs.gov/hipaa/for-individual...index.html and thee is a link to filing a complaint on that page.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#7
RE: Medicare and new CPAP device in future?
That's it; what I needed to know!
Thank you!
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Any good home/DIY device for tracking breathing effort? PurchanceToDream 0 127 04-24-2022, 02:18 PM
Last Post: PurchanceToDream
  Medicare CPAP supply requirements car54 7 393 03-24-2022, 07:12 AM
Last Post: car54
  Is this new iNAP sleep device just as good as CPAP? Any of you try it before? WWu777 17 4,704 03-20-2022, 10:51 PM
Last Post: Phaleronic
  Medicare: DME questions Rgn3 13 530 03-13-2022, 08:11 PM
Last Post: thistle
  Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare? midwestguy 149 4,032 02-05-2022, 02:25 PM
Last Post: midwestguy
  Inspire Hypoglossal Nerve Stimulation device Rgn3 5 394 02-03-2022, 02:04 PM
Last Post: Sleeprider
  Medicare replacement for recall? david987 4 396 01-31-2022, 06:05 AM
Last Post: david987


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.