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need some advive - Printable Version

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need some advive - Waldorbigbill - 06-12-2017

I found the machine I want to get is the AirSense™ 10 AutoSet™ some people say get the her model. any advice on this? Also why? The next part of my question I haven't gotten the prescrip yet from doctor. I know Horizon who I have will cover 50% I was told i need to speak with centrix i think the spelling might be wrong.  to get a DMR assigned to me. They told me the pricing is the same no matter which DMR i used when I called centrix is this correct? Last part was  how do I handle the doctor's office with the prescript tell them the machine I want and have them write it for that? This is all new to me and very frustrating. When I saw the doctor he was like oh they are going to come to your house next week with the machine.  Like I didn't have a choice. Then I told the lady at frond desk I want to shop around she said you can pick whoever you like to use.  Please advise me what my next step should be. Im not opposed to buy the machine out right if I can get it cheap than insurance. I already know DMR  inflated the machine to a crazy price.  The average price I have seen the machine is about $800 i have seen them for around 600 on amazon and I saw a guy who sells them on craigslist for $550 that ships. Im little worried about craigslist.  What are people's thoughts on buying a slightly used machine an I better off with new?


RE: need some advive - OpalRose - 06-12-2017

You will need to do your homework.  Call your insurance and find out exactly what your portion will be.  You may do better by buying yourself....all depends on your insurance coverage.

Know what you want and what you are looking for.  Amazon may be a good source, and Supplier #2 sells
good low hour used equipment and also new open box units.

Call your Doctor and tell him what machine you want.  Be sure your prescription reflects that and ask for a copy of the script.  

I know this is all new for you and can be overwhelming.  Here is a source of good information to help you.

http://www.apneaboard.com/forums/Thread-New-to-Apnea-Helpful-tips-to-ensure-success


RE: need some advive - Waldorbigbill - 06-12-2017

UPDATE: I call the doctor office and first she said the that the script was already sent out and that it would delay things . I told her I didn't care I wanted to be able to call around and feel comfortable using the medical place of my choice.  Then I asked about getting the prescript to use the auto set machine .   She told me I couldn't get it. I then questioned her why I could not. She said we already know you are at 15%.  The auto machine  searches for the proper one but since we know the straight cpap is a better choice and will provide me a better machine.  So frustrated.


RE: need some advive - OpalRose - 06-12-2017

Is your doctor afficiated with the DME?  What do they mean you are at 15%? Does she mean the pressure you were titrated with? That doesnt mean you can't use an AutoSet.
Doesn't sound quite right to me.

Understand that your insurance pays out the exact same amount to the provider regardless if you get a Cpap or Apap.  There is a profit to be made if they give you a Cpap.

Also understand that an Apap can be used in Cpap mode if desired, but a Cpap can only be used in Cpap mode.

Talk to the Doctor, not the receptionist.  Let him know what you want, and you are willing to use the machine in Cpap mode, but you need to look out for future needs, so you want to have the Apap available.


RE: need some advive - Waldorbigbill - 06-12-2017

Thank you yes 15% was my rate sorry still all new to this.  I explained to her you can set it straight but she said they wouldn't change it. She then called the DME who i didn't pick and said they already got it preapproved and and I had the choice of two machine  the medres 10 with auto set  (the one the doctor office told me I could not get) or a  reporantic with auto set.  This lady didn't know anything about either machine and couldn't even give me a price . so Now I have been on hold with insurance company trying to get a price.


RE: need some advive - OpalRose - 06-12-2017

ResMed 10 AutoSet or DreamStation Auto would be the best choices.


RE: need some advive - Sleeprider - 06-12-2017

The current price on Amazon is $539 and free shipping...it was $440 yesterday, and will probably be different again tomorrow.  If your 50% share is more than this, you should consider self-paying.  No delays, no oversight for compliance, no surprises or bait and switch. You can still use the DME for supplies no matter where you get the machine.  The For Her model has an extra mode of operation that is more responsive to flow limitations, but I sure would not make that a big priority.  

You should get a physical copy of any sleep study results and your prescription so that it is portable, and available wherever and whenever you need it.  Unless you have 100% coverage a DME may be the choice of last resort.


RE: need some advive - Waldorbigbill - 06-12-2017

after speaking with the DME they told me they can't give me a price i must speak with Centrix  who says they can't give me a price just an estimate.   I was told I owe 50% and have to take a ten month rental I could just pay for it upfront.

My first payment would be 163.89 this includes machine , and start up equipment  then I would owe nine months at 47.95 bring the total to $595.39  this would be for the Resmed 10 Auto version.  I have no clue mask and stuff need should I just bite the bullet pay that price or look around and see if I can get a better deal or a gently used machine?


RE: need some advive - quiescence at last - 06-12-2017

I think you know the price answer. however, to do that you'll need an official copy of the prescription.


RE: need some advive - kwhenrykerr - 06-12-2017

Startup equip sounds like the mask that may not come when you buy just the machine yourself. That would make it an OK deal. If you do not like the mask that comes with it you may be able to have the supplier exchange it. My insurance/supplier gave me 30 days to exchange my first mask. they did not want the old one back and just gave me another one. Will you need a heated hose also ?

Sleep-well