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CPAP Machine Replacement - Printable Version

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CPAP Machine Replacement - FozzyDaBear - 02-23-2021

Hi all,

Are there any insurance experts out there? I initially was diagnosed in 2017. I got a Resmed Airsense 10 and I was on a Cigna HRA insurance plan through work at the time.  About 2 years, I switched to a Cigna HSA plan through work. Same carrier just a different plan. Looking at my Cigna account online, I don't see my previous claims from when I was originally diagnosed.

I know the replacement schedule for a machine is every 5 years. 2021 would be year 4 so based on that I wouldn't be due for a replacement until 2022. Due to unfortunately circumstances, I'm getting a cardiac loop recorder in the next week. That will cause me to meet not only my deductible but my max out of pocket for the year. I would love to get a new CPAP machine this year and not have to pay anything about of pocket. Does the replacement schedule still apply since I'm with the same carrier but on a different plan?

Thanks!


RE: CPAP Machine Replacement - Sleeprider - 02-23-2021

The lengths that insurance seems willing to go to to avoid paying for a $500 CPAP are insane. They will send you for a $3000 sleep study and doctor visits worth more than the CPAP then try to decline the coverage. There has to be some reason for this irrational behavior. Fozzy, the best approach is just to ask your doctor for an updated prescription and let the DME work to get it filled. My Aircurve 10 Vauto is at over 17000 hours, and I am not looking forward to the hassle of getting a replacement.