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Picking a DME -- What is Best
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AndyB Offline

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Post: #1
Picking a DME -- What is Best
I'm about to get my first CPAP and commence therapy for OSA. I've learned a tremendous amount from this great forum in the last week, but one subject that I am unsure about is how to chose a DME.

My primary insurance is Medicare, and I also have supplemental Medicare insurance from WPS of Wisconsin.

There are 3 Medicare Contract Suppliers in my area who could be my DME: Lincare, Apria and American HomePatient. None of them seem to be highly regarded by the members of this forum.

My primary care physician, who I trust and respect, is part of a large Wisconsin healthcare organization (Aurora) that could also serve as my DME.

As a first-time CPAP user, I need to have good support from my DME, so I'm very interested in hearing the opinions of experienced folks on the forum regarding how to select a DME.

Thanks![/size]
05-30-2015 04:02 PM
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Crimson Nape Offline

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Machine: ResMed S9 Autoset
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Post: #2
RE: Picking a DME -- What is Best
Hi AndyB, welcome to the forum! Welcome

My sleep doctor acted as my DME when I had commercial insurance. When I moved to a Medicare replacement policy, due to Medicare rules, they can no longer act as a DME. Medicare doesn't allow a treating physician to act as a DME as well. You could go to an online DME, see the supplier links at the top of the website, and file your own claims.

Good Luck!

Statistics prove that people who have more birthdays live longer.
05-30-2015 04:21 PM
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trish6hundred Offline

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Post: #3
RE: Picking a DME -- What is Best
(05-30-2015 04:02 PM)AndyB Wrote:  I'm about to get my first CPAP and commence therapy for OSA. I've learned a tremendous amount from this great forum in the last week, but one subject that I am unsure about is how to chose a DME.

My primary insurance is Medicare, and I also have supplemental Medicare insurance from WPS of Wisconsin.

There are 3 Medicare Contract Suppliers in my area who could be my DME: Lincare, Apria and American HomePatient. None of them seem to be highly regarded by the members of this forum.

My primary care physician, who I trust and respect, is part of a large Wisconsin healthcare organization (Aurora) that could also serve as my DME.

As a first-time CPAP user, I need to have good support from my DME, so I'm very interested in hearing the opinions of experienced folks on the forum regarding how to select a DME.

Thanks![/size]
Hi AndyB,
I haven't heard good things about either Lincare, or Apria, but I have heard a little bit about the other one you mentioned but not enough to really say how they are one way or the other.
Hang in there for more suggestions and good luck with picking a DME.

trish6hundred
05-30-2015 04:27 PM
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k_ogre Offline

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Post: #4
RE: Picking a DME -- What is Best
Look for reviews online
05-30-2015 04:55 PM
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me50 Offline

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Post: #5
RE: Picking a DME -- What is Best
(05-30-2015 04:02 PM)AndyB Wrote:  I'm about to get my first CPAP and commence therapy for OSA. I've learned a tremendous amount from this great forum in the last week, but one subject that I am unsure about is how to chose a DME.

My primary insurance is Medicare, and I also have supplemental Medicare insurance from WPS of Wisconsin.

There are 3 Medicare Contract Suppliers in my area who could be my DME: Lincare, Apria and American HomePatient. None of them seem to be highly regarded by the members of this forum.

My primary care physician, who I trust and respect, is part of a large Wisconsin healthcare organization (Aurora) that could also serve as my DME.

As a first-time CPAP user, I need to have good support from my DME, so I'm very interested in hearing the opinions of experienced folks on the forum regarding how to select a DME.

Thanks![/size]

there are many complaints about the first two and I personally know that Apria is severely problematic enough that I told them to pick up their machine and I went out of network for my peace of mind!

My insurance company said they were working with Apria to correct their problems but there was no improvement and it got worse.
05-30-2015 05:01 PM
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Mike1953 Offline

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Post: #6
RE: Picking a DME -- What is Best
Medicare approved DME Medicare and your supplement will pay for your cpap and supplies. Non Medicare approved DME its all out of your pocket. You also must meet Medicare compliance for Medicare to pay the rental for the 13 months.

For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/directories/National/SHIP/
or here http://www.medicareinteractive.org/
05-30-2015 05:29 PM
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Mosquitobait Offline

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Post: #7
RE: Picking a DME -- What is Best
(05-30-2015 04:02 PM)AndyB Wrote:  I'm about to get my first CPAP and commence therapy for OSA. I've learned a tremendous amount from this great forum in the last week, but one subject that I am unsure about is how to chose a DME.

My primary insurance is Medicare, and I also have supplemental Medicare insurance from WPS of Wisconsin.

There are 3 Medicare Contract Suppliers in my area who could be my DME: Lincare, Apria and American HomePatient. None of them seem to be highly regarded by the members of this forum.

My primary care physician, who I trust and respect, is part of a large Wisconsin healthcare organization (Aurora) that could also serve as my DME.

As a first-time CPAP user, I need to have good support from my DME, so I'm very interested in hearing the opinions of experienced folks on the forum regarding how to select a DME.

Thanks![/size]

First, unless you are paying cash (and in that case, go with an online store), you are stuck with the Medicare options and they do not include your sleep doctor or even your primary doctor. Apria appears to have a pretty bad reputation nationally, so avoid them. Lincare is mostly office specific with an unconnected supply chain. I'm trying Lincare and if they don't work out, I will go to another place on the Medicare list that is over an hour away.

I am also a first time cpap user, and will be getting my new machine from Medicare.

The best advise I've seen is from a purported Lincare employee. Get names. Get numbers. Some of the numbers given out by employees might not be current, which causes a lot of problems. Supplies apparently all come out from a warehouse in Florida. Otherwise, keep a notebook, photograph stuff with your digital when it arrives, keep all paperwork for at least 3 years.

Find out how to get the run hours on your machine. Check immediately. If it doesn't say zero, tell them this is a used machine and you are supposed to get a new machine. Use a credit card, not a debit card. If you run into problems, your credit card will usually go to bat for you. Read everything before you sign it. I haven't seen their paperwork yet, so cant tell you anything on that.

I'm hopeful. Remember that you only see the complaints. People who have good experiences rarely post. Our local Lincare office had a couple of complaints, both here and online elsewhere, but they were older complaints, so perhaps new management. We have appointment next week for my family member to get replacement bipap and supplies.
(This post was last modified: 05-30-2015 07:09 PM by Mosquitobait.)
05-30-2015 06:06 PM
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AndyB Offline

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Machine: ResMed AirSense 10 Autoset with RERA
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Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
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Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

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Post: #8
RE: Picking a DME -- What is Best
The best advise I've seen is from a purported Lincare employee. Get names. Get numbers. Some of the numbers given out by employees might not be current, which causes a lot of problems. Supplies apparently all come out from a warehouse in Florida. Otherwise, keep a notebook, photograph stuff with your digital when it arrives, keep all paperwork for at least 3 years.

Find out how to get the run hours on your machine. Check immediately. If it doesn't say zero, tell them this is a used machine and you are supposed to get a new machine. Use a credit card, not a debit card. If you run into problems, your credit card will usually go to bat for you. Read everything before you sign it. I haven't seen their paperwork yet, so cant tell you anything on that.
[/quote]

Great advice!

However, I'm uncertain about your comment that Medicare won't allow my primary care doctor to provide a CPAP machine and supplies to me. I'll follow up on this, but the healthcare organization that my doctor works for is an integrated non-profit health care provider that provides home health care equipment to patients through its "Aurora at Home" division. I spoke briefly with an Aurora at Home representative a couple of days ago and i understood (possibly incorrectly) that they could be my DME provider and that Medicare would cover 80% of the cost of my prescribed equipment and supplies. The general logic of prohibiting a for-profit healthcare organization from prescribing DME and then selling it for a profit makes sense, but I wonder if there's an exception for situations like the one I'm describing.

For example, could the Mayo Clinic provide a CPAP to a patient under a prescription written by a Mayo doctor?

Anyway, I'll check into this further (I have an appointment with my doctor this week) and report back.

Thanks for the guidance and good suggestions.
(This post was last modified: 05-30-2015 07:56 PM by AndyB.)
05-30-2015 07:55 PM
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AndyB Offline

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Machine: ResMed AirSense 10 Autoset with RERA
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CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

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Post: #9
RE: Picking a DME -- What is Best
Sorry Mosquitobait -- I'm a rookie at posting replies . . . my post above was intended to reply to your preceding post.
05-30-2015 07:58 PM
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car54 Online

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Post: #10
RE: Picking a DME -- What is Best
Andy, If you are in the Milwaukee are Aurora does have a sleep center at 4131 W Loomis Rd, Greenfield, WI

Also there is The Sleep Wellness Institute
West Allis
2356 South 102nd Street
West Allis, WI 53227

I and probably most members of this site are probably their own best DME. Try a CPAP2GO store in the Milwaukee area. They have a 30 day trial on all their masks. It is important to get one that works for you.

Also, I hope I am not breaking any board rules for posting the above names. Just trying to help. I have dealt with both places.

Brad
05-30-2015 07:59 PM
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