Post Reply 
Severe Diagnosis, losing insurance
Author Message
herbm Offline

Preferred Members-2

Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #11
RE: Severe Diagnosis, losing insurance
Doc should NOT be po'd if you ask for prescription OR you can just let (another) DME do the asking on your behalf -- that's what I did when ordering from vendor #1 or my other (extra) DME.

re-read justMongo on COBRA.

COBRA can be expensive but if you can get all your stuff paid it might mean you should do it AT LEAST a couple of months.

Since you have significant health problems in addition to OSA, it might argue for you staying on COBRA or finding out what provision there is for moving from Empl/COBRA to a TOP ObamaCare policy.

Losing a job, we have no idea what your financial situation is reguarding buying your own insurance -- WE bought cobra for 17 years* until Obamacare forced them to cancel our policy (had policy 20 years total, including as employee.)

Technically it was only COBRA at beginning and converted to non-COBRA without losing coverage -- even that didn't force them to cancel us like ObamaCare did.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
05-27-2014 02:51 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
becker44a Offline

Advisory Members

Posts: 181
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus Lg
Humidifier: ResMed H5i
CPAP Pressure: Rx 10 - 20cm, Usually 10-14cm
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: NE Ohio, USA

Post: #12
RE: Severe Diagnosis, losing insurance
(05-27-2014 02:37 PM)tcarmen Wrote:  
(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.

Hi tcarmen,
EVERYONE who has been diagnosed as an apniac should have a hard copy of their own PAP prescription. No Exceptions.

For example, if you travel by air, the PAP device is classified as "Medical Equipment" and cannot be counted against your carryon allowance. The airline folk may ask to see your prescription, to prove that you are entitled to this. I recently went to the hospital ER for a few tests, and unexpectedly ended up staying for 2 days. I could have needed to show the hospital people the Rx to have them provide equivalent equipment w/ appropriate settings. It doesn't really matter why you want the prescription, you or your insurance have paid for the diagnosis, etc. and you are entitled to that proof.

In my own case, I asked my GP for a copy. I got runaround. I asked again when I was in for another reason. He said "There is no paper prescription - it was transmitted electronically to Apria. Get a copy from them". This, of course, was more runaround, but I was able to get a copy from Apria (the DME), and I have it carefully stashed. I have also scanned it and have a .JPG image that I can email or fax as the case may be. I later found that this is actually the procedure from my healthcare provider.

This has already been of benefit, as follows. I inquired of Apria their policy on mask trials. I was told "You can order a new mask. You have 30 days to decide if you want to return or accept it. If you want to return it, you can do so FOR EXCHANGE, ONCE". So, if you try out a mask under Apria's scheme, you will end up with either Mask A or Mask B. Consequently, I ordered a new mask from Supplier #26, not Apria, and I emailed the PAP Rx to them, or they could not have accepted my order. I now have 30 days to decide to keep it or return it FOR A FULL REFUND. I can do this as many times as it takes to find the right mask.

The takeaway: Get a copy of your prescription, and guard it carefully. You might need it at anytime, for a variety of purposes.

Good Luck,
A.Becker
05-27-2014 03:31 PM
Find all posts by this user Post Reply Quote this message in a reply
justMongo Offline

Monitors

Posts: 3,847
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: #13
RE: Severe Diagnosis, losing insurance
(05-27-2014 03:31 PM)becker44a Wrote:  
(05-27-2014 02:37 PM)tcarmen Wrote:  
(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.

Hi tcarmen,
EVERYONE who has been diagnosed as an apniac should have a hard copy of their own PAP prescription. No Exceptions.

For example, if you travel by air, the PAP device is classified as "Medical Equipment" and cannot be counted against your carryon allowance. The airline folk may ask to see your prescription, to prove that you are entitled to this. I recently went to the hospital ER for a few tests, and unexpectedly ended up staying for 2 days. I could have needed to show the hospital people the Rx to have them provide equivalent equipment w/ appropriate settings. It doesn't really matter why you want the prescription, you or your insurance have paid for the diagnosis, etc. and you are entitled to that proof.

In my own case, I asked my GP for a copy. I got runaround. I asked again when I was in for another reason. He said "There is no paper prescription - it was transmitted electronically to Apria. Get a copy from them". This, of course, was more runaround, but I was able to get a copy from Apria (the DME), and I have it carefully stashed. I have also scanned it and have a .JPG image that I can email or fax as the case may be. I later found that this is actually the procedure from my healthcare provider.

This has already been of benefit, as follows. I inquired of Apria their policy on mask trials. I was told "You can order a new mask. You have 30 days to decide if you want to return or accept it. If you want to return it, you can do so FOR EXCHANGE, ONCE". So, if you try out a mask under Apria's scheme, you will end up with either Mask A or Mask B. Consequently, I ordered a new mask from Supplier #26, not Apria, and I emailed the PAP Rx to them, or they could not have accepted my order. I now have 30 days to decide to keep it or return it FOR A FULL REFUND. I can do this as many times as it takes to find the right mask.

The takeaway: Get a copy of your prescription, and guard it carefully. You might need it at anytime, for a variety of purposes.

Good Luck,
A.Becker

I'd fire that doctor. He may send the Rx to a DME by electronic means.
But, you have a right to a copy; and you may fill that RX at any supplier. Now, insurance may not cover it if you use just any supplier; but, you still have that right.

THe last doctor I fired was an orthopedist. He was punching me in the back and asking me if it hurt -- I told him, "Turn around and we'll find out." Then I walked out.

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 08:49 PM by justMongo.)
05-27-2014 08:47 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  advice for diagnosis steps to take odoyle 14 517 Yesterday 08:44 PM
Last Post: Sleeprider
Smile [CPAP] Diagnosis + prescription = Frustration... ApneaBoard + experimenting = Salvation! OldVet 8 274 11-28-2016 08:24 PM
Last Post: OldVet
  Insurance won't pay for power cord? CharlotteYork 13 885 11-17-2016 11:58 PM
Last Post: tzk321
Sad Help Finding A Machine, No Insurance SJGino 23 760 11-17-2016 09:03 PM
Last Post: SJGino
Angry INSURANCE RECORDS: DO YOU REALLY WANT TO KNOW? srlevine1 5 550 11-15-2016 06:31 PM
Last Post: Galactus
  [CPAP] Insurance / Getting first CPAP rjbbjr 14 620 11-11-2016 01:06 PM
Last Post: Mosquitobait
Question [Diagnosis] ISO Second Diagnosis Advice headpeace 5 301 10-10-2016 03:19 PM
Last Post: headpeace

Forum Jump:

Who's Online (Complete List)