Medicare Coverage for Travel CPAP Supplies
Although I own both a (Resmed) home APAP and a (Phillips) travel APAP, I exclusively use the Phillips Dreamstation Go travel APAP both at home and on very frequent international trips. My CPAP supplier under Medicare for hoses, masks, and filters can bill Medicare for the proprietary supplies for the Resmed home unit but not for the proprietary supplies for the Phillips travel unit. The travel unit gives me higher sleep hours and lower AHI scores and, therefore, clearly is medically preferable in my particular case.
I have searched without success Google and Medicare's site for information about how I can get Medicare to pay for its 80% of proprietary Go supplies -- specifically, hoses and filters -- that I actually can use.
Does anyone know how to approach Medicare on this issue and, even better, how to prevail?
Many thanks in advance for any help.
RE: Medicare Coverage for Travel CPAP Supplies
I think your out of luck.
RE: Medicare Coverage for Travel CPAP Supplies
My experience is that Medicare and/or insurance will not cover costs of travel supplies.
RE: Medicare Coverage for Travel CPAP Supplies
They may have a "problem" paying for supplies with a machine they did not purchase for you. They have no proof you own this machine so are reluctant to pay for supplies for it. Your DME may be able to convince them you have a second machine and are no longer using the Resmed. They will NOT pay for supplies for two machines.
PaulaO
Take a deep breath and count to zen.
RE: Medicare Coverage for Travel CPAP Supplies
(08-03-2018, 12:08 AM)PaulaO2 Wrote: They may have a "problem" paying for supplies with a machine they did not purchase for you. They have no proof you own this machine so are reluctant to pay for supplies for it. Your DME may be able to convince them you have a second machine and are no longer using the Resmed. They will NOT pay for supplies for two machines.
I purchased two machines (5 years apart) outside of Medicare and they provided supplies for each. (One at a time)
08-07-2018, 04:22 PM
(This post was last modified: 08-07-2018, 04:24 PM by Mosquitobait.)
RE: Medicare Coverage for Travel CPAP Supplies
Medicare pays by the code. What's working against you is that the cost of the travel machine supplies that are exclusive to that machine are more than what the DME gets paid. Until there are knockoffs available for that machine, you won't get them. Why would anybody sell you filters for which they are only paid $4.90 when they cost the company $5.50 wholesale?
We had the same problem with my brother's lymphadema wraps. The standard wraps don't fit him primarily because he is over 6'. To get the ones that do fit him, he had to go to premium upgrade and Medicare won't pay EVEN THOUGH the cheaper ones don't fit him. So he has to shell out $840 plus tax every other year for new wraps. Believe me, your supplies cost peanuts compared to his.