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new trend in insurance payments on machines
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #1
new trend in insurance payments on machines
Hi everyone. I am on Medicare with Supplemental policy- this year Anthem, next year Humana and I bought into my partners work health insurance. But the thing is both Humana and Anthem (don't know about my policy through my partner's insurance) are not paying the machines off in 13 months. Medicare only pays for 13 months and then I don't know what happens- my medicare supplements state they will continue to pay as long as you posess the machine. Now my DME doesn't seem to know this so maybe...

Another weird thing. I have not gotten a bill from my DME since April. We have talked at length about this "computer glitch" and they assured me they would start billing in November. I guess that bill will come this month. Truthfully I have worked so hard to get them to start billing me (fearing they would ask for all the unbilled months would be due at one time) that if I don't get a bill I will assume I've fallen off the grid and leave it alone. (Gosh, someone picked that machine months ago and neglected to give me paperwork).

Also has anyone with Medicare found that you cannot get your machine from one DME and your supplies from another? I'll call and try to find out, but thought someone might know.
Mary
12-05-2012 10:12 AM
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JJJ Offline

Advisory Members

Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #2
RE: new trend in insurance payments on machines
(12-05-2012 10:12 AM)zimlich Wrote:  Also has anyone with Medicare found that you cannot get your machine from one DME and your supplies from another? I'll call and try to find out, but thought someone might know.

I got my machine and my first two masks from one local DME, then returned it, bought a used machine on Craigslist, then bought a new mask from another local DME. Medicare had no problem with any of it. Except for the machine on Craigslist, all I ever paid was the co-pay.
12-05-2012 12:53 PM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #3
RE: new trend in insurance payments on machines
I called Medicare and they said I could buy from any DME that took Medicare.
Thanks for your response.
Mary
12-05-2012 01:00 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #4
RE: new trend in insurance payments on machines
After the 13 mos, the machine is yours. There used to be a continuing rental policy to cover any problems with the machines but Medicare actually got smart and realized the error. My S7 fell into that policy and when I got my S9, they (the DME) actually took the S7 from me because it technically wasn't mine after 7 yrs.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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12-05-2012 01:26 PM
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