Options for buying new cpap mask

[Ticman1]

Somewhat confused on options for buying a new CPAP mask.

I have been on CPAP for 1 year.  I deal with the same DME and receive email quarterly for ordering new supplies which are mailed directly to my home in a timely manner.  My supplies are all covered by insurance. 

I have ONLY used the ResMed N20 nasal mask.  I would like to try the ResMed Mirage Swift II pillows.  When going online I see many companies selling this mask but am unable to purchase the mask without a Prescription.  I see postings from people who have purchased/tried numerous masks.  I have no idea if they pay out of pocket or have insurance.

The question is—do I have to get another perscription from my doctor; or wait for date of mask replacement from my DME and see if they will send the Swift mask.  The email process does NOT provide for making changes, just ordering supplies for existing equipment.

Any thoughts would be appreciated.

Thanks
Mike

[stanleydean]

Hi Mike,

Have you checked with any of the suppliers listed here  on the forum? You may be able to purchase without a Rx from some of those suppliers. Also try Amazon.

Can you visit or phone your DME to check on getting a different mask. A user friendly DME will help you with that and it sounds like yours might be user friendly. My DME is local so I can just drop in with a question and they have good coffee too.

By the way, how was your initial mask selection arrived at?

Wishing you success,

Stan

[Hydrangea]

Ditto to the above.

It's nice your DME emails you. Mine isn't in contact with me, so I always have to reach out to them.

I call my DME and let them know what I'd like sent next. "I'd like to try the P10 mask this shipment. Oh, and I'm having trouble keeping my mouth shut. Could you send me a chin strap? I'm going through filters every week or two, and I'm tired of ordering them on Amazon. Could you send me more?" That's how my convos with my DME go.

[Ticman1]

Stan,
Thanks for the reply.  

My DME was local but has moved and is at the other end of the state and consolidated operations. Telephone contact is sketch at best as I keep getting routed to a “national” call center.

First mask decision after sleep study where I had a nasal mask, was determined by research research and research and watching videos and reading reviews.  By the time I got to DME for set up of machine etc, I was pretty confident that the ResMed N20 was what I wanted.  I did try on a few others but stuck with the N20.  I have no real issues but would like to try pillows based on reviews and recommendations from friends.

I will try some of the other Suppliers listed on the forum.

Thanks again.

[Walla Walla]

You should have a copy of your prescription from your Doctor along with a copy of your sleep study. I highly recommend you get in touch with your Doctor and request these. They are required by law to give you a copy of these on when requested.

Depending on your insurance and deductibles, it may be cheaper to buy online out of your own pocket instead of using insurance and DME. Amazon is a good place to check.

[johndee]

Hi,
Good advice from Walla Walla. Another option is to see if your DME has a copy of your Rx. Almost for sure they do. Might be best to not mention the reason.

I gave up on my DME and find my masks and supplies on Craigslist. I've found some good prices too.
JD

[Ticman1]

Walla Walla and Johndee

Thank you both for mentioning I should have copies of sleep study and my RX perscription.  Made me check my folder and I have both which opens up opportunities for me.

My insurance covers 100% and my HME has been good in the past about sending supplies every 3 and 6 months.  

So if i decide to by from 1 of the suppliers listed in this forum, I assume it would mean that I would begin getting all supplies from them and they would handle insurance claims???   Supplies being masks, pillows, tubes, filters, and water chambers. OR do you have to go though a HME for insurance issues.

If I want to change HME do I just use existing prescription to start a new relationship?  Prescription is 1 year old.  I’m in compliance having met 6mos and 12 mos with doctor and in using CPAP equipment regularly.

Just want to understand the process

[Walla Walla]

If your going to use your insurance you need to contact them and find out which DME's they will pay in your area. I don't think the on line sites deal with insurance.

[Mosquitobait]

Most online suppliers do not accept insurance. You can get supplies from both your DME and your chosen online supplier. You just need a prescription (unless you buy from Amazon or buy mask in parts). If you have one of those accounts where you can reimburse yourself for prescription items, you can get the billing from the online supplier and apply that.

[Ticman1]

Sorry but one more quick question.

I have a copy of my sleep study with Doctor signature and recommendations.

I have a copy of the DELIVERY TICKET from the HME which I received at my first meeting for machine setup and use.  It shows the doctors name and what he wanted me to have as to machine and mask and the pressure to be set on the machine. Form was signed by HME as delivery agent.  Does this constitute a RX prescription?

Thanks all for your help.

Mike