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Picking a DME -- What is Best
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Mosquitobait Offline

Advisory Members

Posts: 746
Joined: Apr 2015

Machine: Resmed AirSense 10 For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: integrated, Climate line tube
CPAP Pressure: 9-12
CPAP Software: ResScan SleepyHead

Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #31
RE: Picking a DME -- What is Best
(06-01-2015 08:46 PM)me50 Wrote:  
(06-01-2015 03:47 PM)2PAPs Wrote:  All I really know at this point is that I will be getting a Philips Respironics machine, as that's the only brand on the Kaiser formulary and that I will be purchasing it with a 20% copay from Apria. That I know more about what's going on now, I won't be snookered by Apria with a used machine, etc.

I didn't know that insurance companies had a formulary for CPAP machines.Learned something new today. So glad that mine wasn't that way. Anyway, just watch Apria like a hawk or two and let us know how it goes.

I'm not surprised Kaiser has a formulary. Mostly, it is HMOs and PPOs that have formularies for medical equipment whereas Medicare and other insurance companies use the codes.
06-02-2015 07:27 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #32
RE: Picking a DME -- What is Best
(06-02-2015 07:27 AM)Mosquitobait Wrote:  
(06-01-2015 08:46 PM)me50 Wrote:  
(06-01-2015 03:47 PM)2PAPs Wrote:  All I really know at this point is that I will be getting a Philips Respironics machine, as that's the only brand on the Kaiser formulary and that I will be purchasing it with a 20% copay from Apria. That I know more about what's going on now, I won't be snookered by Apria with a used machine, etc.

I didn't know that insurance companies had a formulary for CPAP machines.Learned something new today. So glad that mine wasn't that way. Anyway, just watch Apria like a hawk or two and let us know how it goes.

I'm not surprised Kaiser has a formulary. Mostly, it is HMOs and PPOs that have formularies for medical equipment whereas Medicare and other insurance companies use the codes.

I have Humana PPO and they use the codes.....no formulary for medical equipment. It is a good thing because I cannot use PR. I tried with my first CPAP and although I knew nothing about machines, etc. because just like today, they don't educate you, I just quit using the machine. I still have it in the closet. When I got the Resmed, I have never gone without using it.
06-02-2015 08:30 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #33
RE: Picking a DME -- What is Best
(06-02-2015 07:27 AM)Mosquitobait Wrote:  
(06-01-2015 08:46 PM)me50 Wrote:  
(06-01-2015 03:47 PM)2PAPs Wrote:  All I really know at this point is that I will be getting a Philips Respironics machine, as that's the only brand on the Kaiser formulary and that I will be purchasing it with a 20% copay from Apria. That I know more about what's going on now, I won't be snookered by Apria with a used machine, etc.

I didn't know that insurance companies had a formulary for CPAP machines.Learned something new today. So glad that mine wasn't that way. Anyway, just watch Apria like a hawk or two and let us know how it goes.

I'm not surprised Kaiser has a formulary. Mostly, it is HMOs and PPOs that have formularies for medical equipment whereas Medicare and other insurance companies use the codes.

I have Humana PPO and they use the codes.....no formulary for medical equipment. It is a good thing because I cannot use PR. I tried with my first CPAP and although I knew nothing about machines, etc. because just like today, they don't educate you, I just quit using the machine. I still have it in the closet. When I got the Resmed, I have never gone without using it.
06-02-2015 08:30 AM
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AndyB Offline

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Posts: 71
Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

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

Sex: Male
Location: SE Wisconsin

Post: #34
RE: Picking a DME -- What is Best
I have confirmed with my non-profit healthcare provider that it is unable to be my DME under Original Medicare because it is not a designated Medicare Contract Supplier of CPAP devices and related accessories and supplies for the Competitive Bidding Area where I live (SE Wisconsin). Since I want my CPAP and related accessories and supplies to be covered by Medicare, I must use a Contract Supplier. The American HomePatient facility in my area gets very good reviews from my healthcare provider, so that's where I intend to start out. Will update this thread after I get going with AHP.
06-02-2015 07:46 PM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #35
RE: Picking a DME -- What is Best
(06-02-2015 07:46 PM)AndyB Wrote:  I have confirmed with my non-profit healthcare provider that it is unable to be my DME under Original Medicare because it is not a designated Medicare Contract Supplier of CPAP devices and related accessories and supplies for the Competitive Bidding Area where I live (SE Wisconsin). Since I want my CPAP and related accessories and supplies to be covered by Medicare, I must use a Contract Supplier. The American HomePatient facility in my area gets very good reviews from my healthcare provider, so that's where I intend to start out. Will update this thread after I get going with AHP.

too bad the one I told you about didn't work out.
06-03-2015 12:56 AM
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lmoretti Offline

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Posts: 75
Joined: May 2015

Machine: PR System One 60 with AFlex
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10
Humidifier: PR
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #36
RE: Picking a DME -- What is Best
May not help you, but I'm in the Madison area and so far have had a great time dealing with UW Home Health. They have a location on the east side of Madison (I use their Middleton office). Granted, just got my machine today, but every phone call/interaction I've made has been super friendly and informative.
06-03-2015 01:58 PM
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AndyB Offline

Preferred Members

Posts: 71
Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

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

Sex: Male
Location: SE Wisconsin

Post: #37
RE: Picking a DME -- What is Best
I decided to use American HomePatient, and so far I've been very satisfied. Everyone at AHP I've talked with -- both locally and at their U.S. national office -- has been friendly and helpful, and they filled my prescription promptly, correctly and without any hassle. Like Imoretti, I've just gotten my APAP, so it's early in this relationship, but first impressions are extremely positive.
06-13-2015 03:41 PM
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sprite60 Offline

Members

Posts: 7
Joined: Jun 2015

Machine: ResMed S9 VPAP COPD
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: ResMed H5i
CPAP Pressure: 26/20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: St. Louis, Missouri USA

Post: #38
RE: Picking a DME -- What is Best
Among the other suggestions, I checked with the Better Business Bureau. Apria serves Missouri, where I am located, but they have an "F" rating from the BBB nationally. Fortunately for me, there are two DME's with "A+" ratings in my area. Good luck!
06-13-2015 04:55 PM
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SleepyWabbit Offline

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Posts: 40
Joined: Jun 2015

Machine: DS560S (PRS1 REMStar Auto)
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: DS6H
CPAP Pressure: 12cm
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: descensus in cuniculi cavum

Post: #39
RE: Picking a DME -- What is Best
Anybody know anything about RoTech? I'm getting my first CPAP and I was told by the American Sleep Medicine (where I did my study) that NeighborCare was the only DME that UHC (my insurance) covered In Network. When I looked up NeighborCare, it looks like they were bought by RoTech back in 2011?
06-13-2015 05:05 PM
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