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What Will Insurance Do? - Printable Version

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What Will Insurance Do? - chazmofo - 02-06-2023

Does anyone know if there are any general "rules" or practices regarding when or if insurance companies will allow coverage for a new apnea device when a 5+ year-old device (Dreamstation 1) has been recalled/replaced by a new device? I'm asking because I just got a new Dreamstation 2, but I (along with my doctor) agree that a ResMed AirSense 10 would be ideal for my needs. He posed the question as to whether or not my insurance would support that when a brand-new machine had just arrived from Philips, or if they'd even know. Any thoughts?


RE: What Will Insurance Do? - Sleeprider - 02-06-2023

A Resmed Autoset provides essentially bilevel therapy thanks to the way EPR works. There is no question it has a therapeutic effect and many people do much better with the faster, more responsive pressure algorithm and EPR rather than Flex. Best bet is to disregard the new machine's existence and just have your doctor write a script for the new Resmed replacement, then let the DME sort out the insurance issues. If you still have your old DS1 then claim that as the machine being replaced.