(03-21-2016 02:00 PM)FrankNichols Wrote: I have Humana Medicare and they require that I rent the CPAP machine for 13 months - it is a rent-to-own process.
I have this too - Medicare 13 month rental (not Humana). My 'rental' ends in July. Unfortunately, I am in a bid area which extremely limits who I can get Medicare paid-for stuff from.
My question is, during that 13 months is it "normal" practice to REQUIRE me to replace the various parts (hose, humidifier, F10-Cushion) etc on the ResMed recommended schedule? Or is it up to me when to replace them?
No. You do not have to replace any of these items. I do recommend regular replacement of the filter, but how often depends on how dusty your home is. Other stuff, replace as needed. I have a couple of extra hoses, extra humidifier, and extra cushions. How long a hose lasts depends on your situation. My brother's ends up with cracks on the ends, so gets replaced every other year. I have yet to replace mine. With cushions, replace when torn or leaky. You can extend the life by boiling for 5 minutes.
Also, do most DMEs require you to purchase the parts through them?
They will push for it, but there is no requirement.
And last (for now ) does anyone know if medicare will reimburse me for those parts during the rental period if I purchase them online, or do I have to go through the DME I am renting the CPAP machine through?
Medicare will not reimburse you for anything you don't purchase from a pre-approved provider and online retailer's don't count. Getting them to reimburse for a covered item from an approved provider takes many, many hours of frustrating calls and paperwork and about 2 years. Ask me how I know this.
If you want to go through a different DME, then find that DME FIRST and then make arrangements to get them all the Medicare info needed. Medicare doesn't CARE how many places you are dealing with so long as you don't get more than you are allotted. The biggest problem that I've experienced is that DMEs interpret the Medicare supply allotment differently. Find out ahead of time what they consider a mask vs. just headgear or just a mask. While some of Lincare's supply representatives get it, their orders are often changed by some other jerk in supply to their own interpretation. [edited to add] The other DME told me that most DMEs get ONLY the sealed combo pack from the manufacturer. As a result, they don't offer headgear and masks separately. This is why you can only get them every 6 months and can't get the head gear separately.
I am trying to find a DME other than Apria in my area, and I am interested in what I can expect from a reputable company.
Medicare, with their bid process, has really limited the choices that patients have to move from a bad provider to a good provider. So, simply be prepared to pay for at least some of your supplies out of pocket.
A good supplier would give you a choice of masks (where you can return if it doesn't work out within a specified period). A good supplier will also let YOU choose to call to order supplies OR have them call monthly. I DO understand that Medicare doesn't let you order supplies 3 months in advance, although why some folks on this board are able to do that mystifies me (I'd like their supplier!). A good supplier understands that you have multiple masks and that this month you need a cushion for one mask, and next month, you might order a cushion for the other mask. They shouldn't give you crap about having to see a PT to make this change when you got your masks from them in the first place.
Now, the supplier I'm moving to does not have the wide selection (masks are limited to the Resmed and Respironics). But, at the same time, they are local, I can pop in and get a supply item or have it shipped and I can email them with my order every month instead of having them call me (usually interrupting me on something important). In addition, they are flexible for mask fittings - Lincare only did fittings on Monday and Friday during certain hours. Great if you don't have far to drive and can actually get there during those times.