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 or insurance?
#1
Medicare or insurance?
Finally found this board and discovered that my RemStar Plus is a brick and that the perfect AHI scores I'd seen on Sleepyhead are meaningless.  Since the brick has 10,000 hours on it, and my PCP is fine with ordering a replacement, seems like it's time for a DreamStation or AirSense 10.  But--I'm about 9 months away from retiring--is there an advantage to waiting for Medicare, or should I use my current employer insurance?  (Or is that too general of a question?)
Post Reply Post Reply



Donate to Apnea Board  
#2
RE: Medicare or insurance?
It depends on the coverage provided by yout current insurance.
Post Reply Post Reply
#3
RE: Medicare or insurance?
Does it matter? Try getting it now, what have you to lose if this insurance terminates in 9 months.
Post Reply Post Reply
#4
RE: Medicare or insurance?
I agree with the previous two replies and will add: Have you calculated your out-of-pocket expense in each case, given your current deductible, etc. and given the fine print of whatever Medicare plan you'll be on?

Also, there's the question of what you have to gain in the next 9 months, if anything, from getting a new, more modern machine ASAP rather than waiting. Are there features that you urgently need or want? If so, go for it, again if the short-term cost to you is easily manageable.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
Post Reply Post Reply



Donate to Apnea Board  
#5
RE: Medicare or insurance?
It really depends on how your sleeping. Are you waking up a lot at night? Tired during the day? Falling asleep at the wrong times? If the answer to any of those is yes than you need to get a new machine now no matter what! If on the other hand you feel like your being treated than you have the option of waiting. Sleep apnea is not something you want to wait 9 months on to treat properly.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



Post Reply Post Reply
#6
RE: Medicare or insurance?
Consider that your income is likely higher now, assuming that Medicare implies retirement, so likely financially it may be better now, and now certainly will not hurt your treatment.

But Walla Walla's response above is the best answer.  If it was me I would say now because I would want to know how effective my treatment actually is,  just the geek in me.
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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 or insurance?
Thanks, all.  I continue to sleep well and feel OK during the day, I just want to see my data to make sure all is well.   I was infuriated last night to realize that when Apria did a warranty replacement a few years ago on my original Remstar Pro they replaced it with a Remstar Plus, and of course didn't tell me.  I'll do some digging into insurance coverage, deductibles, etc., but since I've not yet entered the Medicare world, I was just wondering if there are any pluses or gotchas with it vs private insurance.
Post Reply Post Reply



Donate to Apnea Board  
#8
RE: Medicare or insurance?
One gottcha is that you will probably have less od a selection of DMEs you can us with medicare.
Post Reply Post Reply
#9
RE: Medicare or insurance?
I would wait. unless your insurance is 100%, you're paying a co-pay. normally machines are paid in full after 13 monthly payments. when you hit medicare after 9 months of payments will medicare take over your current contract or will you have to start over, because normally your present insurance will cut off at that point? If you wait til you're on medicare you'll probably buy an insurance plan that will cover what medicare doesn't pay, resulting in no co-pay, which is cheaper. just things to ask about and think about.
First Diagnosed July 1990

MSgt (E-7) USAF
Retired 1968-1990
Post Reply Post Reply
#10
RE: Medicare or insurance?
I would also wait. Seeing as you are most likely shifting to Medicare, they will require you to go through another whole sleep study before they will pay for consumables such as masks, cushions, and the like. I was faced with that and my insurer was a sister to Medicare. Waited until I was on Medicare and had a new sleep study (last one was 6 years ago) and now waiting on the results so I can get my new machine.

Homer
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply



Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  What part of Medicare covers CPAPs and supplies Crimson Nape 9 218 11-15-2018, 04:15 PM
Last Post: Crimson Nape
  Help with insurance justification for portable CPAP zippinbye 10 279 11-13-2018, 02:41 PM
Last Post: Stom
  Does Medicare Require a Yearly Visit with Sleep Doctor? SideSleeper 13 1,118 11-12-2018, 10:54 AM
Last Post: Mosquitobait
  Medicare and replacement schedule Lanco 16 1,381 09-16-2018, 08:48 PM
Last Post: Mosquitobait
  Fighting with Insurance Company theMezz 5 304 09-08-2018, 06:43 PM
Last Post: bonjour
  Medicare Replacement of Respironics Wisp Nasal CPAP Mask Replacement Frame Fabric Asparky 3 203 08-27-2018, 05:57 PM
Last Post: Mosquitobait
Question Weird ? About Insurance/DME Supplies Hydrangea 8 486 08-07-2018, 04:47 PM
Last Post: Mosquitobait


New Posts   Today's Posts






About Apnea Board

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