New script every year??

[KarenK]

I stopped at a different DME a week ago, as it is much closer to my home. I had been getting my supplies via a canned phone call and then receiving the items by mail.

So, the *new* place, which had a copy of my script from a few years ago, told me I need a new one every year.

Yesterday, I stopped at the original DME as I was in the area, and he just stared at me like I was crazy -- no need for a new script every year. This is a Medicare Advantage plan, by the way.

[Pugsy]

I think DMEs make their own "in house" rules so they can cover all bases when it comes to needing a new RX.
They can do that if they want to.

I also have a Medicare Advantage plan and I haven't even seen my sleep doc since Aug 2009 much less got a new script from anyone. Unless the first one has some sort of expiration date specifically written it has always been implied "for life".

Most likely the "new" DME has elected to adopt their own in house rules.
Now there may be some insurance companies that do require a RX and DMEs maybe choose to have a blanket policy to cover those that might need a new RX but when it comes to Medicare I have yet to see it in writing at a Medicare website that a new RX is needed yearly.

[CaptainRaven40]

I don't think a script expires, but my doctor said she wanted to see me at least once a year just to make sure everything is still going well. So I think it depends on the DME and the doctor that you have.

[LSAT]

I am on a Medicare Advantage plan and used the same prescription for 5 years. I did need a new one when I wanted a new CPAP 3 years ago and have used that one since. Pugsy is right...DMEs make their own rules.

[KarenK]

Thanks, all, for clearing it up.

[SewTired]

It may also depend on your state. Some. States do not permit lifetime prescriptions. Some, like mine, permit it only if it specifically says for the patient lifetime (or 99 years, something like that). If it does NOT say that, it is good only for a year.

I'm supposed to see sleep doc annually because my problem isn't completely resolved by CPAP, although I hear that they will just use the data from my machine and send me home with a rented oxymeter.

[sc0ttt]

You don't need a script at ALL for filters and hoses and masks and such. I'm surprised they said anything. I'm pretty sure anybody could walk into my DME and buy that stuff in cash.

[Wulfman...]

I uploaded my prescription to CPAP.COM in April of 2005. I've been "good to go" ever since.

They don't expire with online sellers UNLESS there's an expiration date on them.

The only things that require a prescription are machines and (complete/assembled) masks.


Den

.

[archangle]

The medical mafia loves to force you into having unnecessary office visits. They tend to work together on this.

Sometimes, insurance may require it before they pay for supplies.

[chunkyfrog]

The guv'mint is afraid you will use it as a bong.

[curems]

My original script specifically says LON (length of need)=99 months for machine and LON= 12 months for supplies. But my doc also gave me a script for a mask, etc. on a regular Rx pad.

I wouldn't waste time on the argument of whether or not a script is required for supplies - I've read a number of arguments about this and even my doc was shocked when I told her I needed one to order a mask online. Whether it is legally required or not is irrelevant - if your insurance requires it, they won't pay without one; and if it is the policy of the company you are wanting to purchase from, you won't be able to make the purchase without one (most online retailers do require it). I don't know about requirements for any particular insurance companies. Online retailers seem to have a policy that a script is required but a new one is never needed. I expect my DME is likely to want a new script for supplies after a year since that is the limit on the original one. Doctors, on the other hand, may want to evaluate your treatment annually the same as they generally do for any other chronic condition to see if you are stable, improving or worsening.

[KarenK]

There seems to be no consistency!!

The same Dr that wanted to know if I wanted the script for a machine or supplies, as I have only had a machine for two years....

At my recent annual checkup with my primary, at the end I mentioned CPAP was on my list. He asked why, and i told him I just wanted to report that my AHIs according to my machine were about 0.6 a night for the last six months, just in case he wanted to make a notation.

[Pugsy]

There seems to be no consistency!!

That's about the only thing consistent...there is no consistency.

I think the bulk of it comes down to the DME and their choice to have blanket in house rules that they apply to everyone no matter what insurance is used. It's easier on their part and lord knows that most aren't known to do anything extra for someone.

What irks me is that instead of being honest and up front about "it's their in house policy" they choose to put the blame on your insurance when that may or may not be the case.

[KarenK]

Pugsy, the odd thing is that I "inherited" a machine which needed to be calibrated and I took it to them, provided a copy of the prescription, and paid 50 dollars for them to recalibrate it. I also bought some mask parts, once. I get robo calls from the original DME, and i guess I will stick with them, as they mail the items right to the house. Sorry the other place lost my business [not really, they rejected me!] as it was just 2 miles from my house. Oh well, it is their loss.

[RogerSC]

The guv'mint is afraid you will use it as a bong. :mrgreen:

So that's what that bowl in the top of the humidifier tank is for, I was wondering about that. Thanks.