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You want what?
#11
RE: You want what?
If you paid your co-pays/rent, and it's been that timeframe, then you OWN it. I would not allow them to take from me the machine that sustains my life. They are not entitled to it. It's not theirs to take.

Do NOT take it in to them, not even if you think you won't let them take it from you.

Don't fall for it.
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#12
RE: You want what?
(12-04-2019, 01:55 PM)OpalRose Wrote: Medicare will require you to start over with a new machine, which isn’t a bad thing.  If you weren’t happy with what you were renting, you can request something different.  I’m pretty sure even if you met the 13 month rental, Medicare will require you to start over with a new machine.  But call them to be sure.

How can anyone dictate which exact machine we use?  I don't see that.  So suddenly a new insurance can say "we know you have sleep apnea, but we won't allow you to use a machine you obtained not from us."?  That doesn't make sense at all.

Granted, I'm not totally not-believing you, since I do know how grimey insurance companies and DMEs can be.
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#13
RE: You want what?
Insurance ad co-insurance varies widely. AFAIK Humana and Kaiser never grant ownership of DME to their patients. Other insurance pays off the machine in 3 to 13 months and it's yours. My machine was covered by BCBS in 13-months. c I have been on Medicare for a year and have not yet replaced the machine, and the DME indicates they won't be looking to do so until I've owned my last machine for 5 years. Medicare certainly does not take patient owned equipment and insist on a new machine.

Big Guy, it may be worth investigating whether your machine was paid off, and if not, what it would take to own outright. Logic never held much sway over medical coverage, but it sounds like you are closer to my situation, especially if you can get ownership. Out of curiosity, who is your DME?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#14
RE: You want what?
Well, I stopped by and signed some paperwork that Medicare required. I was told that Medicare took over before my insurance (BC/BS) could pay for the machine in it's entirety. 

It's still in my possession, but nothing was mentioned about getting a new machine. It sounds as if I should have been issued a new machine? 

The DME guy said something about the whole process starting over now that Medicare is involved. It was busy, noisy, and cramped in the DME outer office. People coming and going. 

Is the new machine an issue I should be following up on? I suppose I could call Medicare and ask outright, if they require me to have a new machine. 

Any additional info. that you all can give me will be greatly appreciated.

My DME supplier is AllCare / Rotech.
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#15
RE: You want what?
I did call BC/BS and spoke to a rep. I told her what is going on and she told me that she had never heard of Medicare stipulating that a new CPAP machine be issued to the patient when they take over medical coverage. 

She also went on to say that BC/BS doesn't require the DME provide a new machine when a prescription expires. 

I'm currently on hold w/Medicare. I was told that it will be at least a 20 minute wait.  Oh-jeez
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#16
RE: You want what?
I think the “catch” is that BC/BS didn’t pay for your machine in its entirety before Medicare took over.  

This is what you need to question...Will Medicare pay the balance of your current machine?  This is where I think that they may not.  I wouldn’t trust a DME to give you correct information, although depending on who you talk to with Medicare, you may not get accurate information there either.  

Remember that Original Medicare has different coverage than Medicare Advantage Plans and can vary widely.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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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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#17
RE: You want what?
After being on hold w/Medicare for over 40 minutes, I gave up. I'll try again tomorrow.  Rolleyes
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#18
RE: You want what?
When you go on Medicare you don’t need to get a machine if you already have one that is yours.

I would make sure with your old insurance if you already paid in full for your current machine. If it is yours, don’t give it back; and you can decide if you want to get a new one.

You will need a pre-evaluation letter, your sleep study, a prescription, and meet the medicare compliance requirements, including seeing your doctor between 61 and 89 days after getting the new machine.

You don’t want to go through that just to keep your old machine. Plus the DME could end up double-dipping if you already met your old insurance rental and now have a second rental to Medicare on the same machine. Easy money for the DME, but illegal.

John
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#19
RE: You want what?
Digging back in memory. When I turned 65 I had a fully paid machine and had no contact with DME or insurance or Doctor related to CPAP. Until several years later when I wanted/needed a new machine - more than 5 years had passed and old machine was getting noisy. I then had to go for a new sleep study - had been 20 years since my previous - I did a home study and was "rewarded" with new machine. Nothing had changed. I lived through the new compliance period and have gone on my way avoiding DMEs and Sleep Docs to the best of my ability. Wouldn't even think about sleeping without the machine, unless on a long flight.
Happily sleeping well on our motorhome wherever we happen to be traveling. Sleep-well
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#20
RE: You want what?
I don't envy you with dealing with Dingling Bros. DME shenanigans. Hope you navigate the stormy seas safely.

PS it wouldn't surprise me much if I hit stormy seas once Disability benefits are approved and I get on Medicare.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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