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Severe Diagnosis, losing insurance
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Droosk Offline

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Posts: 3
Joined: May 2014

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Mask Type: Not using mask
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CPAP Software: Not using software

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Sex: Male
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Post: #1
Gross Severe Diagnosis, losing insurance
Hello everyone. I am brand spanking new to the board, so please forgive any missteps or ignorant questions. I've known I've had sleep apnea since I was 12 (I'm 33 now), but only recently took the steps to address it. I've done a total of 3 sleep studies done in the past 2 months, and here is, what I believe, the relevant info:

Rating of 130, both obstructive and central. Central represents about 15% of instances. Mild COPD. 50/50 mouth breathing/nose breathing due to medical issues as a child.

Unfortunately, I'll be losing my insurance at the end of the month (5 days) due to job separation. So what was once a sure thing insurance coverage for the machine, is no longer the case. I'm going to attempt to see my doctor this week for the final analysis (Last study was done to test for ASV usage due to the central apnea).

So, knowing that I'm going to be needing/using an ASV, and paying for it out of pocket, I'm hoping that there may be others on the board here that can recommend a quality product at a decent price. The only ones I can find that specifically mention the Adaptive quality are over 3 grand, and that simply isn't in my price range Sad

Thanks for any input you may have!
05-27-2014 12:59 AM
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vsheline Online

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Posts: 1,915
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: #2
RE: Severe Diagnosis, losing insurance
(05-27-2014 12:59 AM)Droosk Wrote:  I'm going to attempt to see my doctor this week for the final analysis (Last study was done to test for ASV usage due to the central apnea).

So, knowing that I'm going to be needing/using an ASV, and paying for it out of pocket, I'm hoping that there may be others on the board here that can recommend a quality product at a decent price.


Hi Droosk, welcome to the forum!

You want either the ResMed S9 VPAP Adapt or the Philips Respironics System One BiPAP autoSV Advanced.

Supplier #2 has these.
http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List

If the S9 VPAP Adapt is USA Model# 36007 then (like mine) it is the older model, made earlier than November 2012, which, unlike present USA model 36037, does not have the new ASVauto mode, able to automatically adjust both exhale pressure (EPAP) to optimally treat obstructive apneas and Pressure Support (PS) to optimally treat central events. On model 36007 only the PS auto-adjusts, and EPAP is manually adjusted. Both models support heated hose option and both models are fully data-capable.

If the Philips Respironics System One BiPAP autoSV Advanced does not have a heated hose option then it is the older "50 series" model, not the present "60 series" model. Both System One models can automatically adjust both EPAP and PS, and both are fully data-capable.

Take care,
-- Vaughn

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: 05-27-2014 02:46 AM by vsheline.)
05-27-2014 02:41 AM
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trish6hundred Offline

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Posts: 6,453
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: #3
RE: Severe Diagnosis, losing insurance
Hi Droosk,
WELCOME! to the forum.!
I'm sorry to hear about your insurance problem.
Hang in there for more suggestions and best of luck to you.

trish6hundred
05-27-2014 08:07 AM
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Marnid2014 Offline

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Posts: 187
Joined: Mar 2014

Machine: ResMed S9 Elite
Mask Type: Nasal pillows
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Humidifier: H5i
CPAP Pressure: 4
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Florida

Post: #4
RE: Severe Diagnosis, losing insurance
(05-27-2014 12:59 AM)Droosk Wrote:  Hello everyone. I am brand spanking new to the board, so please forgive any missteps or ignorant questions. I've known I've had sleep apnea since I was 12 (I'm 33 now), but only recently took the steps to address it. I've done a total of 3 sleep studies done in the past 2 months, and here is, what I believe, the relevant info:

Rating of 130, both obstructive and central. Central represents about 15% of instances. Mild COPD. 50/50 mouth breathing/nose breathing due to medical issues as a child.

Unfortunately, I'll be losing my insurance at the end of the month (5 days) due to job separation. So what was once a sure thing insurance coverage for the machine, is no longer the case. I'm going to attempt to see my doctor this week for the final analysis (Last study was done to test for ASV usage due to the central apnea).

So, knowing that I'm going to be needing/using an ASV, and paying for it out of pocket, I'm hoping that there may be others on the board here that can recommend a quality product at a decent price. The only ones I can find that specifically mention the Adaptive quality are over 3 grand, and that simply isn't in my price range Sad

Thanks for any input you may have!

You don't indicate where you are located, is it the US? Supposedly this is covered under Obama Care, have you checked with them? I don't have a lot of faith in it, but you never know, maybe this will be ok as you are insured under an employer and they are separating away from open enrollment??? It's worth a shot to call them. So sorry you are going through this.
05-27-2014 09:06 AM
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jaycee Offline

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Posts: 115
Joined: May 2014

Machine: S-9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quattro Air Large
Humidifier: 5i
CPAP Pressure: 9-13
CPAP Software: ResScan

Other Comments: RT at a DME

Sex: Male
Location:

Post: #5
RE: Severe Diagnosis, losing insurance
Most of the "affordable" Obamacare options carry VERY high deductibles so you'd be looking at paying the entire cost out of pocket.
Assuming you need the ASV machine but can not afford a new one, best options would be:

1) Used ASV
2) Used BIPAP
3) Used CPAP

Obviously the ASV would be best but in many cases, CPAP/BIPAP would be better than nothing (but talk to your sleep doctor about this before making this decision).
(This post was last modified: 05-27-2014 09:22 AM by jaycee.)
05-27-2014 09:19 AM
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diamaunt Offline

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Posts: 436
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Machine: S9 VPAP Auto 36006
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Mask Make & Model: mirage quattro/pilairo q
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Location: texas

Post: #6
RE: Severe Diagnosis, losing insurance
also, craigslist.
05-27-2014 10:14 AM
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Terry Offline

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Posts: 553
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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Humidifier: Integrated
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CPAP Software: SleepyHead

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Post: #7
RE: Severe Diagnosis, losing insurance
(05-27-2014 12:59 AM)Droosk Wrote:  Thanks for any input you may have!

Got friends?

The percentage of people who continue on CPAP is pretty low, and people with insurance get a new machine every 5 years, so if you told all your friends you need a really cheap/free machine, and have them ask *their* friends, I'd be really surprised if someone didn't have an extra machine for you.
05-27-2014 02:05 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
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Location: Калифорния

Post: #8
RE: Severe Diagnosis, losing insurance
I'm not a lawyer.. in the US, you can continue employer heath care under COBRA for up to 18 months.
COBRA is part of ERISA. You have to pay the premiums.

Now, you may not be in the US; or, you may mean your COBRA is running out...
If in the US, you might consider COBRA long enough to get a machine.

Or, do a cost analysis on getting a machine out-of-pocket.
vsheline has recommended some good sources.
I have insurance; and I went to #2 to get the machine I wanted.

Be sure to get a prescription from your last doctor visit. Required in the US.

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: 05-27-2014 02:30 PM by justMongo.)
05-27-2014 02:28 PM
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Post: #9
RE: Severe Diagnosis, losing insurance
(05-27-2014 02:28 PM)justMongo Wrote:  Be sure to get a prescription from your last doctor visit. Required in the US.

What's the deal with prescriptions? My doc just sent "something" over to the DME, and I got my stuff. Is he required to give me a copy if I ask? Will it p*** him off? Will he even care?

Right now I have insurance and everything is good, but I'd like a copy in case he retires or I lose my insurance or need to buy a machine somewhere else.
05-27-2014 02:37 PM
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jaycee Offline

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Post: #10
RE: Severe Diagnosis, losing insurance
Your DME should be able to print you out a copy of that order (usually at no charge).

It is YOUR medical record and your doctor can't deny it to you (but some offices charge a fee). I doubt your doctor would even care about giving you a copy of that order. You can take that order to any DME to get supplies with (assuming your insurance participates with your DME of choice).
05-27-2014 02:45 PM
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