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[Treatment]  Recompliance period of 90 days with new insurance.
#1
Sad 
LolaboveHas anyone else had this happen? I had to switch medicare advantage plans due to loss of husbands insurance because of obamacare and have to go through an other compliance period with a smart stick. I've used a cpap for 5 years and have had the same Drs but i'm on my 3rd DME supplier. Because of new Medicare advantage plan. Is this normal. I just now got my new icon premo + after 3 week wait with a heated hose and am sleeping great.Sleep-well I figure it may because the other DME suppliers didn't send compliance records but i'm neither a Dr or RT just a confused patient and what do I know?
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#2
Hi Mamakrip50,
WELCOME! to the forum.!
It's good to hear that you are sleeping well with your new machine.
Hang in there and someone will be able to help you with your insurance question, soon.
Best of luck to you.
trish6hundred
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#3
Although it sounds unusual and unnecessary to go though another monitored compliance period, things at Medicare are changing.
So, what normal is seems to be a shifting landscape.

My DME is messing with me over seeing a doc every 6 months to continue to get supplies under traditional Medicare.
(I saw the doc about 7 months ago.)

It's an extra couple of steps to pull the compliance data -- it would seem to be worth it to get continued coverage for CPAP.


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#4
(03-04-2014, 10:39 AM)Mamakrip50 Wrote: LolaboveHas anyone else had this happen? I had to switch medicare advantage plans due to loss of husbands insurance because of obamacare and have to go through an other compliance period with a smart stick. I've used a cpap for 5 years and have had the same Drs but i'm on my 3rd DME supplier. Because of new Medicare advantage plan. Is this normal. I just now got my new icon premo + after 3 week wait with a heated hose and am sleeping great.Sleep-well I figure it may because the other DME suppliers didn't send compliance records but i'm neither a Dr or RT just a confused patient and what do I know?

I switched from BCBS to a medicare advantage plan in 2013. I have been on CPAP since 2011. In 2013 I got a CPAP Auto machine and I had to go through compliance again because the insurance company wants to make sure that we are compliant or they don't want to pay for the machine. In 2014, I was switched to a VPAP machine and I had to go through compliance again even though I am insured with the same company. Now that doesn't make sense to me in a way b/c they know I am compliant. I figure that I had to do this just in case the VPAP doesn't help me anymore than a CPAP Auto because they are much more expensive for the insurance company and for me. I still can't figure out why Medicare won't just buy the machine outright after 90 days as it would save a lot of money but it is helpful for me to be able to pay out my part over a period of time and not all at once.

The only thing I have to say is that I never had to go the full 90 days for compliance b/c I was compliant in the first 30 days. I can understand your insurance company doing this as they are the one that is going to be paying for the machine and they don't want to pay for something they can't verify that you are using.

Hope this makes sense.
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