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Patient Balance = $0 !!!
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #1
Patient Balance = $0 !!!
I received my EOB for all of the charges relative to my equipment, and my insurance company (Blue Cross Blue Shield of Michigan) paid everything! (Well, as they're a participating vendor, they had to write off those amounts above what BCBSM allows.) So far, I've rented my CPAP for two months (I'm in my second month), and I haven't had any OOP expenses.
Shock-2

Of course, I've had enough health issues this year to have met my deductible and paid my max OOP.

Come January 1, however, it will be a different story on so many levels:
  1. My position has been cut, and I will be out of work.
  2. I will be starting over with deductibles and co-pays, so I'll have a lot of OOP expenses.
  3. I may be on Obamacare....whatever that means.


I'll need to look at which parts and pieces I can get replaced when, and if there's anything I can get before December 31, I'm certainly going to.

Lamb

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
12-14-2014 05:02 PM
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Crimson Nape Offline

Monitors

Posts: 1,332
Joined: Oct 2014

Machine: ResMed S9 Autoset
Mask Type: Other
Mask Make & Model: P-10 / F&P Simplus / DreamWear
Humidifier: H5i w/Climateline
CPAP Pressure: 8 - EPR 3
CPAP Software: SleepyHead

Other Comments: CMS-50F & 50IW

Sex: Male
Location: Georgia

Post: #2
RE: Patient Balance = $0 !!!
Good luck with Obamacare. In the South the deductibles are abut equal to the national deficit. Come January I'll be on a Medicare replacement that is much better than my current insurance.

Statistics prove that people who have more birthdays live longer.
12-14-2014 05:41 PM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,827
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #3
RE: Patient Balance = $0 !!!
so sorry to hear about the job loss - that really stinks, and I hope that you are able to find a new (and better) one quickly. It is to the benefit of your DME to sell you whatever they can before end of year, but it's about a month too early for most stuff, I think. depends on how they do 3 mo... maybe there is a grace period so that you can receive it at 3 mo... Individual plans have different schedules tho. some follow medicare and some don't.
12-14-2014 05:49 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: Patient Balance = $0 !!!
(12-14-2014 05:02 PM)Lambsydoats Wrote:  I may be on Obamacare....whatever that means.

I'll need to look at which parts and pieces I can get replaced when, and if there's anything I can get before December 31, I'm certainly going to.

Hi Lamb,

You're going to need to research "Obamacare" very quickly. I think the enrollment window for January may end tomorrow. You may need to find out how that is done in your state today, and enroll online today, or by phone tomorrow.

Talk to your CPAP supply place, to see what CPAP supplies your insurance will cover before January 1.

Perhaps a replacement or spare of:
1. one set of "mask cushions" for your mask
2. a couple air filters for your machine
3. heated hose
4. water tank

Good luck!

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-14-2014 07:56 PM by vsheline.)
12-14-2014 05:54 PM
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Slick7533 Offline

Members

Posts: 15
Joined: Nov 2014

Machine: Remstar Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: Respironics Trueblue w/hgr
Humidifier: none at this time
CPAP Pressure: 6.0
CPAP Software: SleepyHead

Other Comments: newbie to CPAP as of 11/04/14 but OSA for long time

Sex: Male
Location: Burbank, California

Post: #5
RE: Patient Balance = $0 !!!
Good for you! $0 is the best price!

I had not met my deductible so I just sent off about $850 for machine and headgear/mask (purchase all). I wasn't offered any other option - don't know why.

Sorry about the job loss. That's always a major thing.

I hope you'll find some suitable coverage somehow. If Obamacare I hope it works for you. I know some people who are using it and it's really good for them - but I'm in California where it was adopted and supported by the state. Someone I know in Georgia is not as happy - especially with the support for making changes.

Keep up on your therapy though. Every day new information points to the importance of good ventilation during sleep.
12-14-2014 06:06 PM
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Mike1953 Offline

Preferred Members-2

Posts: 134
Joined: Aug 2014

Machine: Resmed S9 Escape Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10
Humidifier: Resmed Hi5
CPAP Pressure: 12
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Kansas USA

Post: #6
RE: Patient Balance = $0 !!!
Affordable Care Act time frame is different when you loose your job. I believe you have 30 days once your job insurance is cancelled. The higher the premium the better the coverage but there will still be a deductible and co-pays. As far as supplies you can get now is none unless you pay for them yourself. Usual time frame for replacement items (filters, hose, ect) is 3 month for some 6 months for others. Check with your Ins. or your DME. As far as your job loss sorry to hear about that.
12-14-2014 06:15 PM
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Mike1953 Offline

Preferred Members-2

Posts: 134
Joined: Aug 2014

Machine: Resmed S9 Escape Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10
Humidifier: Resmed Hi5
CPAP Pressure: 12
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Kansas USA

Post: #7
RE: Patient Balance = $0 !!!
(12-14-2014 05:41 PM)sgearhart Wrote:  Good luck with Obamacare. In the South the deductibles are abut equal to the national deficit. Come January I'll be on a Medicare replacement that is much better than my current insurance.

If by Medicare replacement your talking about a Advantage plan you might want to rethink that and go with Medicare A and B with a medigap policy and a Part D prescription policy. See my signature for assistance.

For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/directories/National/SHIP/
or here http://www.medicareinteractive.org/
(This post was last modified: 12-14-2014 06:30 PM by Mike1953.)
12-14-2014 06:25 PM
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trish6hundred Online

Advisory Members

Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #8
RE: Patient Balance = $0 !!!
Hi Lambsydoats,
It's good that you have a 0 balance now but I'm sure sorry to hear about your job los, I hope you find another one, soon.

trish6hundred
12-14-2014 06:57 PM
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #9
RE: Patient Balance = $0 !!!
Thank you all for your concern and advice.

I enrolled in another Blue Cross Blue Shield plan through the ACA on Friday--to be effective January 1. I will have coverage despite unemployment.

I have been blessed this year with an outstanding health plan--just when I needed it! (Job environment, not so much. So I am fine with the loss of my job.) Shhh

Lamb

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
12-14-2014 07:01 PM
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justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #10
RE: Patient Balance = $0 !!!
I'm just reading my Rx plan formulary for 2014 2015. I'm so mad, I'd like to roll it up and... (you fill in the blank.)
They forget I know more than Snowden...

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.
(This post was last modified: 12-14-2014 09:08 PM by justMongo.)
12-14-2014 07:15 PM
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