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Weird ? About Insurance/DME Supplies
#1
Question 
Weird ? About Insurance/DME Supplies
This is weird.  But is it?

I own and use both a DreamStation and a ResMed Air-something 10 Autoset (sorry, I can never remember that long name).  

I'm ready for more supplies, so I'm going to call my DME and place an order (which my insurance will pay on, and I'll pay my cost-share).  

I would like to get filters for my DS, but water chamber for my ResMed.  Will that be okay?  Or will they give me push back?

Also, I want to order a new FFM.  If they don't offer a fit pack, will it be alright if I order the FFM in a medium, but order the extra cushions in a large (to sort of jimmy-rig a fit pack)? Or could I order the AirFit F20 mask (silicone), but then the extra cushions could they be for the AirTouch F20 (memory foam)?

I sure wish I lived closer to a good DME where I can just go in and try things on and really know what I'm getting.  (sigh)
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#2
RE: Weird ? About Insurance/DME Supplies
If you have Medicare, then no, you can't do that.  Medicare only supports one machine - any other is on your dime.  Insurance typically isn't as picky. Provided your prescription allows you to have supplies for each machine, which machine you get it for shouldn't matter.  You would still be subject to your insurance schedule.

Don't know what to tell you about the fit pack as the only time I did get one was when I ordered on my own dime.
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#3
RE: Weird ? About Insurance/DME Supplies
ResMed does have a card you can hold up to your face to see if the dimensions of the cushion are roughly right. Vendor number #1 has PDFs you can print at 100% and cut out to check. Not as nice as a fit pack or extra cushions, but it will at least get you in the ballpark.
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#4
RE: Weird ? About Insurance/DME Supplies
Sizing guides here:
http://www.apneaboard.com/wiki/index.php...ask_Primer
OpalRose
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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.
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#5
RE: Weird ? About Insurance/DME Supplies
Depending on your rapport with your DME, you might ask if they "have any extra filters just lying around" for your DS. Not sure the cost of the DS filters, I have the airsense and the filters are not that expensive. They've tossed in a few before. The last DME I had, well... since I live near the beach, I gave them directions to get there and go pound sand. We're no longer doing business with each other. I mail order all my supplies.

Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie

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#6
RE: Weird ? About Insurance/DME Supplies
Filters and even humidifier chambers are inexpensive on Amazon or Ebay and don't require prescriptions. Even buying through the online DME it might be cheaper than using your insurance and copay. Masks are another story. I would just choose which machine you are going to use as your insured and get supplies through insurance for that, and replace consumables for the other machine on your own. The mask can work with either machine.
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#7
RE: Weird ? About Insurance/DME Supplies
I have purchased Dream Station filters from Amazon, less than $10 for a package containing one of the reusable filters and several of the disposable micro filters. My "walk in" DME isn't picky, my machine of record is a ReSmart brick that sits on a closet shelf and I use a self purchased Dream Station. I get filters there for my Dream Station. A walk in DME can be quite helpful but a remote DME is more likely to "walk the line". That's understandable because they don't know you. BTW, I have Medicare advantage insurance.

Stan
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#8
RE: Weird ? About Insurance/DME Supplies
Just my two cents on this subject:
I tried playing by the insurance and Medicare rules for a couple of years and finally threw up my hands in disgust. Now I pay for everything out of pocket and then file the paperwork to get Medicare and/or health insurance to reimburse me. I realize most patients probably can't afford this approach, but it works for me. oldman
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#9
RE: Weird ? About Insurance/DME Supplies
(08-03-2018, 08:52 PM)PollCat Wrote: Just my two cents on this subject:  
I tried playing by the insurance and Medicare rules for a couple of years and finally threw up my hands in disgust.  Now I pay for everything out of pocket and then file the paperwork to get Medicare and/or health insurance to reimburse me.  I realize most patients probably can't afford this approach, but it works for me.  oldman

I'm guessing you have an Advantage program because getting reimbursed for durable medical equipment is generally quite difficult.  Took a year for my brother to finally get reimbursed for his walker.  Due to his height, he required a premium walker, which Medicare denied, and had to appeal for payment, so bought out of pocket.
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