Post Reply 
is this normal or is this Canada?
Author Message
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #11
RE: is this normal or is this Canada?
(10-31-2015 06:22 AM)cate1898 Wrote:  Unless you have a crooked doctor who is willing to somehow fudge your sleep study results, if your results don't indicate APAP is medically necessary, you won't get one in Canada.
Out of interest, what 'medically necessary' suppose to mean?

ramblingasian wrote "The DME won't get the money from ADP if there's no evidence that you need a certain machine"
What sort of evidence, whether you need CPAP known as brick, CPAP fixed pressure data capable machine, or APAP (fixed and variable)?

Thanks
(This post was last modified: 10-31-2015 06:52 PM by zonk.)
10-31-2015 06:37 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
foss Offline
Wiki Editor
Advisory Members

Posts: 203
Joined: Jun 2015

Machine: ResMed Autosense 10
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View FFM
Humidifier: Resmed
CPAP Pressure: 9 - 13.4
CPAP Software: ResScan SleepyHead

Other Comments: Marine Chemist, Science Teacher & Counselor, Internet Server Admistrator

Sex: Male
Location: Under The Rainbow

Post: #12
RE: is this normal or is this Canada?
I imagine with Obamacare the US will be going the way of Canada, eventually. Sad

Sleep is worth the effort.
10-31-2015 07:23 PM
Find all posts by this user Post Reply Quote this message in a reply
ramblingasian Offline

Preferred Members

Posts: 56
Joined: Aug 2015

Machine: Resmed Aircurve10 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Integrated
CPAP Pressure: IPAP 16, EPAP 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Toronto, Ontario, CANADA

Post: #13
RE: is this normal or is this Canada?
(10-31-2015 06:37 PM)zonk Wrote:  
(10-31-2015 06:22 AM)cate1898 Wrote:  Unless you have a crooked doctor who is willing to somehow fudge your sleep study results, if your results don't indicate APAP is medically necessary, you won't get one in Canada.
Out of interest, what 'medically necessary' suppose to mean?

ramblingasian wrote "The DME won't get the money from ADP if there's no evidence that you need a certain machine"
What sort of evidence, whether you need CPAP known as brick, CPAP fixed pressure data capable machine, or APAP (fixed and variable)?

Thanks

cate1898 posted the relevant documents below at 8:02 yesterday which I have posted for you in the past as well. Please read those documents. They contain the information that you need to answer your questions.

Like I said before, the findings of your in-lab titration is what will decide whether the ADP will fund a CPAP, APAP or BiPAP. The APAP and BiPAP have further requirements that need to be met, with the BiPAP requiring a BiPAP titration.

As for equipment, the Ontario government counts all CPAP machines (Data Capable or not) into one catagory.
10-31-2015 07:26 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
ramblingasian Offline

Preferred Members

Posts: 56
Joined: Aug 2015

Machine: Resmed Aircurve10 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Integrated
CPAP Pressure: IPAP 16, EPAP 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Toronto, Ontario, CANADA

Post: #14
RE: is this normal or is this Canada?
(10-31-2015 07:23 PM)foss Wrote:  I imagine with Obamacare the US will be going the way of Canada, eventually. Sad

I'm not going to get into an argument with you about the semantics of public insurance, but I'm not sure why you're sad about a public insurance plan that is cheaper than any insurance plan in the US yet covers more and also has a higher life expectancy as well as standard of care.

As an example, I'm about to purchase a Resmed Aircurve 10 Auto VPAP machine. I'm only going to pay $330 CAD for it based on the ADP plan. Looking at the vendors in the supplier list, the cheapest the same machine brand new in the US that I can find is over $1700 USD, which is roughly $2200 CAD. I'll take the $330 all day.
(This post was last modified: 10-31-2015 07:33 PM by ramblingasian.)
10-31-2015 07:32 PM
Find all posts by this user Post Reply Quote this message in a reply
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #15
RE: is this normal or is this Canada?
(10-31-2015 07:26 PM)ramblingasian Wrote:  Like I said before, the findings of your in-lab titration is what will decide whether the ADP will fund a CPAP, APAP or BiPAP. The APAP and BiPAP have further requirements that need to be met, with the BiPAP requiring a BiPAP titration.
Thank for refreshing my memory, a senior moment for me
Please bear with for a second, I'm trying to learn and educate myself ... who said, you cannot teach an old dog new tricks

I've looked what you've said in the other thread but still don't fully understand the meaning and who sleep like that in the sleep lab, wouldn't that rule out everyone from getting APAP
[The individual must have polysomnographically documented OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more; and the change must occur between REM vs. NREM sleep or supine vs. sleeping on their side]
10-31-2015 08:24 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
ramblingasian Offline

Preferred Members

Posts: 56
Joined: Aug 2015

Machine: Resmed Aircurve10 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Integrated
CPAP Pressure: IPAP 16, EPAP 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Toronto, Ontario, CANADA

Post: #16
RE: is this normal or is this Canada?
(10-31-2015 08:24 PM)zonk Wrote:  
(10-31-2015 07:26 PM)ramblingasian Wrote:  Like I said before, the findings of your in-lab titration is what will decide whether the ADP will fund a CPAP, APAP or BiPAP. The APAP and BiPAP have further requirements that need to be met, with the BiPAP requiring a BiPAP titration.
Thank for refreshing my memory, a senior moment for me
Please bear with for a second, I'm trying to learn and educate myself ... who said, you cannot teach an old dog new tricks

I've looked what you've said in the other thread but still don't fully understand the meaning and who sleep like that in the sleep lab, wouldn't that rule out everyone from getting APAP
[The individual must have polysomnographically documented OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more; and the change must occur between REM vs. NREM sleep or supine vs. sleeping on their side]

Basically the sleep lab records whether you're in REM vs Non REM and back vs side sleep. Because ADP requires a full night of titration, apparently those that do require an APAP get caught - apparently not many people do have a difference of at least 4cm though.

EDIT: I should be clear though, the DME can sell you an APAP even if you're only prescribed an CPAP. It's just that you can't use the ADP to cover the cost.
(This post was last modified: 10-31-2015 08:56 PM by ramblingasian.)
10-31-2015 08:33 PM
Find all posts by this user Post Reply Quote this message in a reply
eseedhouse Offline

Advisory Members

Posts: 879
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #17
RE: is this normal or is this Canada?
(10-31-2015 06:08 PM)ramblingasian Wrote:  +1. At least in Ontario, OHIP requires your titration scores from your sleep test to be included in the package that is sent to the ADP in order to get funding. The DME won't get the money from ADP if there's no evidence that you need a certain machine.

I frankly don't know if it's covered by the B.C. version of medicare. I was lucky enough to retire with a good private supplemental medical plan. Medicare covered the sleep study, but Blue Cross paid for the machine.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
10-31-2015 09:32 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
ramblingasian Offline

Preferred Members

Posts: 56
Joined: Aug 2015

Machine: Resmed Aircurve10 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Integrated
CPAP Pressure: IPAP 16, EPAP 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Toronto, Ontario, CANADA

Post: #18
RE: is this normal or is this Canada?
(10-31-2015 09:32 PM)eseedhouse Wrote:  
(10-31-2015 06:08 PM)ramblingasian Wrote:  +1. At least in Ontario, OHIP requires your titration scores from your sleep test to be included in the package that is sent to the ADP in order to get funding. The DME won't get the money from ADP if there's no evidence that you need a certain machine.

I frankly don't know if it's covered by the B.C. version of medicare. I was lucky enough to retire with a good private supplemental medical plan. Medicare covered the sleep study, but Blue Cross paid for the machine.

I believe that Ontario is one of the few provinces that covers the majority (75%) of the cost of a machine as long as you have a proper diagnosis. Most private insurance plans in Ontario then will cover a huge chunk (80-90%) of the remainder.
10-31-2015 09:45 PM
Find all posts by this user Post Reply Quote this message in a reply
Napmeister Offline

Preferred Members

Posts: 74
Joined: Jan 2015

Machine: Resmed S9 Elite
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10 Pillow mask
Humidifier: H5i
CPAP Pressure: testing 10.2 cm
CPAP Software: ResScan SleepyHead

Other Comments: Windows 8.1 64 bit

Sex: Male
Location:

Post: #19
RE: is this normal or is this Canada?
As someone mentioned, every province handles this differently.

Another example: in Saskatchewan my doc sent me for a test, took 2 weeks to get into a Sleep Center, failed the in-home test (small unit that reads breathing and oxygen levels) and was immediately given a S9 Apap to use for a 2 week trial. After the Sleep Center had the results from this trial they shared them with another gov't agency (SAIL - Sask. Aid for Independant Living). They sent me a free and new S9 Elite complete with new travel case. This delivery to the door took 2-3 weeks. Settings were based on Sleep Centers APAP tests. This gov't agency provides wheelchairs, walkers etc. to anybody that qualifies.

Humidifier and masks are purchased by me/us thru wife's work plan, everything fully covered. Nothing happened real fast but after x number of years with poor sleep I suppose this period is reasonable.
10-31-2015 10:00 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
cate1898 Offline

Advisory Members

Posts: 784
Joined: Aug 2015

Machine: PR System One 560BT Auto
Mask Type: Nasal pillows
Mask Make & Model: P10's/backup-DreamWear
Humidifier: PR attached
CPAP Pressure: 8.5 - 13. A-Flex 3
CPAP Software: SleepyHead

Other Comments: Began CPAP Therapy Sept. 11, 2015. Hx Hypertension, Post Graves Disease, chronic migraines.

Sex: Female
Location: Southern Ontario//SW Florida

Post: #20
RE: is this normal or is this Canada?
Napmeister how long did the whole process take from the time you originally spoke to your doc to receiving your own machine?

APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

-------------------------------------------------------------------------------------------------
EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
11-01-2015 05:38 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Is this sound normal? - Resmed Airsense 10 Autoset Ronberta 8 1,231 11-29-2016 07:59 PM
Last Post: sonicboom
  Oximeter Normal Graph shermantank45 14 590 11-03-2016 06:00 PM
Last Post: kwhenrykerr
  What is Normal Average Leak Rate? Lanco 44 2,943 08-24-2016 01:52 AM
Last Post: Lanco
  CPAP - Tired is that normal ? stephennic 9 734 08-21-2016 03:14 PM
Last Post: icyura10
  It this normal? theone 41 2,225 07-13-2016 06:34 PM
Last Post: theone
  Felt happy for one week, now back to normal hmucha 10 1,118 07-11-2016 06:00 AM
Last Post: OMyMyOHellYes
  Philips Dreamstation - Engine wine at 9cm is that normal stephennic 8 667 07-10-2016 03:28 AM
Last Post: stephennic

Forum Jump:

Who's Online (Complete List)