08-21-2016, 01:10 PM
After trying numerous CPAP masks from different companies over the years, I finally found one that fits and doesn't leak: ResMed AirFit full face mask.
Medicare and AARP covered the cost with no copay by me.
However, when I went to get my 3-months replacement, my Medical Equipment supplier told me that Medicare no longer covers so-called Premium masks. Starting now, I would have to pay the full cost to the supplier who then would file the claim for me and in due time Medicare would send me a check for the amount they covered.
According to the supplier it would amount to a net cost to me of about $80 where I paid nothing before.
However, the supplier had the 3B Elara Full Face CPAP mask which would be fully covered by Medicare/AARP without any cost to me.
A look at the mask shows the flimsy construction and trying it for several nights, I cannot get a proper seal no matter what I try.
My question is: Did Medicare in fact made changes in the last 3 months regarding coverage of CPAP masks by classifying ResMed and other well known brands as Premium masks?
They're making up a story.
Medicare did another round of competitive bids for DME suppliers. Many lost their Medicare contracts; including mine.
Things changed on 01 July 2016. I can find no mention of so called premium masks. I am however, finding it difficult to find a new 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.
Sounds like a tall tale to me, I would report them to Medicare.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping