I have a prescription but now what?

[palerider]

I got my prescription and see that my doctor has specified a pressure setting of 8-12 on my machine. I also found out that the good DME doesn't work with Medicare, so I've decided to buy the equipment myself. I really want to get started on the road to success with cpap. The machine my doctor's chosen is the DreamStation Auto Cpap with heated humidifier DSX500T11 and modem. The mask I originally chose was an Eson nasal mask, but since an awful titration experience, I think I'd be happier with nasal pillows. On the prescription, it specifies the Eson or "mask of choice." I called the DME to get a quote, and they priced the above equipment at $900 and $120 for the nasal mask. This seems close to the price that's quoted on cpap.com, so I think the DME sounds fair, plus they offer a good support team, so I'm planning on buying from them.

you should probably *CALL* cpap.com before throwing your money away, if you read closely, you'll see "LIST PRICE: 639$ for the machine, and in rather large letters:
Call 1-800-356-5221 for pricing.
since respironics won't let them actually advertise the price they sell it for.

[Cardsfan]

If u bought it through Medicare approved supplier, how much would it cost you? Why would you not want to use your benefits? You know you don't have to stick with one DME, you can order supplies from several DME's, just make sure you keep a copy of your prescription to use where u want to use it.

If you can't start out at a pressure of 8, then your pressure can be adjusted upward slowly to allow you to adjust. That's what I did.

[bwexler]

Many people (like me) can not breath with the starting pressure of 4 or 5. My minimum pressure is 6.5. I often get up to 16.
But everyone is different. The machines are easy to adjust to different settings. If you monitor how you feel and what Sleepyhead says about your results, you can zero in on your best settings. I find a heated tube humidifier is a must. If you have one you can choose to turn off the heat. If you don''t it is impossible to turn ON the heat.

Find ou all of the DMEs that are in network with your insurance/Medicare, then choose the one that suits you best and begin therapy ASAP.

[chronic]

I think you should go with a dme that accepts medicare. You can always buy extra stuff from elsewhere, but, you will not regret it. Supplies get expensive as time goes by if you buy all that stuff yourself. My two cents.

[palerider]

I think you should go with a dme that accepts medicare. You can always buy extra stuff from elsewhere, but, you will not regret it. Supplies get expensive as time goes by if you buy all that stuff yourself. My two cents.

one doesn't have to buy the machine from the pain in the ass DME to get supplies from them should one choose to at some point. or even some other DME that would accept medicare.

[Uncle_Bob]

The F&P machines have had the sense awake feature for years.

https://www.fphcare.com/sleep-apnea/cli ... sensawake/

This manufacturer is underrated IMO, they also had heated hoses and ambient temperature sensing humidification long before the Resmeds or Respironics.

[Jeanne Ellen]

That Fisher Paykel system looks pretty nice. I may have to look into it. I'll give cpap.com a call tomorrow and get them to give me pricing on the equipment that my doctor ordered, but I'm still leaning toward the good DME, unless cpap.com has a super-dooper deal. I feel like I need a lot of support right now as a new cpap user, because I sense that I'm ultra-sensitive based on my experience with titration. I'd be more willing to use my insurance if they would allow me to go to a DME that I have faith in. My AARP United Healthcare Medicare supplemental plan gave me the impression that they'd accept any DME carrier when I talked to them, however, I've become aware of the "competitive bid area" situation, which awards contracts to the lowest bidders, and that's what I get to choose from. Even though there's 26 different DMEs on my list of contracted dealers, none of them sound very appealing and only a handful are in Northern California. The one recommended by my doctor is about an hour's drive from my town and gets really bad yelp reviews. I don't expect they'd give me a lot of support, but maybe all I need is for them to give me the machine. My doctor has a respiratory technician in his office and she might be great, except so far it's been very hard to get an appointment to see the doctor, if that's any indication of what it might be like to see her. The good DME is nearby and staffed with a technician who was really helpful to my friend. I like that it's a place where I could go and check out the machines, masks, and other equipment and try it on for size. The downside is that I'd have to pay out of pocket, but I think it might be worth it if it makes this experience less stressful and more successful. Also, I think that once I've got the equipment and have worked out the kinks (hopefully), that I'd probably be buying all my supplies on amazon or cpap.com anyway.

[Guest]

When I completed the sleep study, I was loaned an Auto PAP and configured with the default 4-20cm. That itself was able to push my AHI from 41 (during the sleep study) to average of 3.

Went to follow up with the doc and he simply says just continue with it.

Seems prescribing a pressure is not necessary with an Auto PAP

[Pugsy]

The good DME is nearby and staffed with a technician who was really helpful to my friend. I like that it's a place where I could go and check out the machines, masks, and other equipment and try it on for size. The downside is that I'd have to pay out of pocket, but I think it might be worth it if it makes this experience less stressful and more successful.

It may be worth the extra dollars to use a DME that you have faith in. The peace of mind thing is worth a lot.
For some people having good support available that they trust is worth a lot.
Not everyone feels comfortable doing things on their own just to save a few dollars.
Also...do the math even with Medicare and your supplement (depends on the supplement) there's a new deductible in Jan and depending on your supplement and out of pocket costs the final out of pocket amount might not be hugely different from the cost to just purchase out right from a DME you like and will give you the machine you want.

When you call cpap.com about pricing on the DreamStation be sure to check on the pricing for the humidifier too. It is separate item on the Respironics machines and included in the ResMed AirSense 10 machines.

My thoughts....if you were wanting the ResMed AirSense 10 AutoSet...get that machine.
The DreamStation Pro isn't an auto adjusting apap machine like the AutoSet is and while you may not need or want auto adjusting pressures in the future....it's a lot better to have something and not need it than need it and not have it.

Get what you want. Don't feel like you are "settling" for anything.
Yeah...it's nice to have insurance foot the big bills but it may be worth it to you to go with your gut on this one.
You can always used your insurance for subsequent cpap supplies. That's what I did...bought my machine privately (I have Medicare also) but I use a local DME for masks. Might as well let insurance pay for something.

[Jeanne Ellen]

I called cpap.com and talked to a very helpful lady who gave me a quote for the equipment my doctor prescribed that was about $100 cheaper than the good DME. She also gave me a lot of information about different models that might be cheaper and their pros and cons and told me that even though my prescription said "no substitutions," they didn't care, and I could get whatever machine I wanted! What a great website. I feel confident that they would give me a lot of help, but at this point, I'm going to invest in the good DME because I think the actual hands-on experience is something I need to have. Down the road, if I need a second machine, I'll definitely go to cpapcom. I've got an appointment to get my DreamStation next Tuesday and an appointment with my doctor on Wednesday, so I can ask him a million questions about pressure settings and so forth. I appreciate all of your advice and support.

[Uncle_Bob]

After your titration (which went south ) your doctor is not going to have any further credible advice for pressure changes at all. Ask a million pressure related questions and the doctor will probably respond with a million answers and associated bills.
IMO you need an APAP data compatible machine and you need to learn how to change the settings yourself and dial in your own therapy.
Did the "good DME" mention anything about a mask for you? You can have the best machine in the world but if your mask is farting all over your face then therapy is useless.

[grayghost4]

I have several new and used machines for sale

http://sfbay.craigslist.org/eby/hab/5789958898.html