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Need New Machine
#1
Hi folks,

I've been on CPAP and VPAP for over two years, and none of these machine treats my apneas. I've recently been diagnosed with mixed apneas, but my insurance will not pay for an ASV machine. Is there somewhere I can buy one used? I have a prescription. I would prefer only a RESMED unit either and S9 VPAP Adapt, or AirCurve 10 VAuto. Can anyone advise? Thanks so much.
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#2
See supplier number 2 on the supplier list (top of page.)
I bought my S9 from them. They may have a zero hour, open box special at a deep discount.

I do not think the Aircurve 10 Vauto is an ASV, is a bilevel. In the 10 series, their ASV unit is called AirCurve 10 ASV

They have a New, Open Box ResMed S10 VPAP ASV w/ Heated Humidifier for $2149. Considering it's a $5125 machine, it's a good price.
As you have a prescription and the money -- you can buy it.
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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#3
Is you physician willing to challenge your insurance company to appeal their ruling? If you require an ASV machine, you may be able to compel your insurance company to provide one if it can be medically justified and other treatments have failed. I know of a few people who have successfully challenged denials using pro-bono or contingency representation. But, it is all based on having a reliable physician's opinion and possibly a second opinion. Even if the persist in the denial, can you get the company to make a partial payment in the amount of a lesser machine? Best of luck.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
Thank you for your good advice. My provider is Medicare, and they are sticklers. My doctor said he would stand up for my ASV needs, but apparently, he's become silent. Meanwhile my AHI numbers with standard Vpap auto are sky high and stay that way. I'm going to have to get loan and purchase one myself, although i'm living on my social security and a small savings I was able to put away for many years. It's so good to have such good medical care, and pay for it.
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#5
Fiur, are you working with a DME in addition to your doctor? Since your doctor is onboard with this change, you need to turn your focus to the DME provider. Be sure they have your prescription for ASV and ask what they are doing to get approval for ASV. It may be that the DME is actually the problem here. If they are not working hard to get approval for your new machine, you need to take your business to a Medicare approved DME that will work on your behalf. You can get a list of Medicare approved DME providers online. We can give you a link to look that up, but would like to hear what you have done with your current provider first. Who is your DME?
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#6
Medicare wants their paperwork, but they will approve the ASV so long as all the Is are dotted and the Ts are crossed (bureaucracy). Now, the DME doesn't really want the ASV to be approved (profits) because they are a very expensive machine and Medicare does not pay that much more for them over a regular xPaP, but to get the Medicare contract they have to provide them. So they are a bit of a loss leader and just factored into the overall bid for the contract. I wouldn't say that a DME might not put the right paperwork in, but stranger things have happened. If you have been prescribed an ASV, you should get one, and if I was you I would be screaming up and down the line between the DME and Medicare and insist on getting it or being told what paper is missing and by whom, and at every level ask for detailed written statements, make good notes of your phone conversations (tape them if you can), and make sure you get copies of whatever is submitted by your Dr. to the DME and the DME to Medicare. Expect a lot of finger pointing by everyone at the others.
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