Newbie, Health Net, sending me to Apria, please advise

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Blankenship2426

Newbie, Health Net, sending me to Apria, please advise

Post by Blankenship2426 » Wed Sep 17, 2014 7:06 pm

Hello Everyone,

So I've been diagnosed with OSA recently, and my insurance is sending me through Apria. I honestly don't know anything about machines or supplies, what questions I should ask, or what machines to stay away from, etc. I would really appreciate any information that you can pass down to a newbie. I have googled Apria and all i see if complaints and stay away...something tells me I don't have a choice with my insurance. Thank you very much, Jen

User avatar
chunkyfrog
Posts: 34378
Joined: Mon Jul 12, 2010 5:10 pm
Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: Newbie, Health Net, sending me to Apria, please advise

Post by chunkyfrog » Wed Sep 17, 2014 8:08 pm

Contact your insurance, and get a list of in-network DME's.
--from them!

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Airsense 10 Autoset for Her

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Janknitz » Wed Sep 17, 2014 8:10 pm

Ugh. My condolences. There are the occasional good local offices, but the nickname Crapria is well earned.

Do NOT do have anything to do with them before you read my blogpost "What you need to know BEFORE you meet your DME".

And don't ASSUME your only choice is Crapria. Call your insurer and ASK.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

User avatar
archangle
Posts: 9294
Joined: Sun Mar 27, 2011 11:55 am

Re: Newbie, Health Net, sending me to Apria, please advise

Post by archangle » Wed Sep 17, 2014 8:56 pm

Make sure they're not your only choice. Don't give them your credit card. Avoid Lincare too, if you can.

_________________
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Also SleepyHead, PRS1 Auto, Respironics Auto M series, Legacy Auto, and Legacy Plus
Please enter your equipment in your profile so we can help you.
Click here for information on the most common alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check for yourself.

Useful Links.

Guest

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Guest » Wed Sep 17, 2014 9:03 pm

Blankenship2426 wrote:Hello Everyone,

So I've been diagnosed with OSA recently, and my insurance is sending me through Apria. I honestly don't know anything about machines or supplies, what questions I should ask, or what machines to stay away from, etc. I would really appreciate any information that you can pass down to a newbie.
Search for things you want to know other than Apria. Lots of info on this forum and some starting pages right at the top of the Home Page. Or use the "Advanced search" to drill down your search areas.

Blankenship2426

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Blankenship2426 » Wed Sep 17, 2014 10:04 pm

Thanks everyone. I took a look at the blog and it was great. Thank you so much. I plan to call my insurance company tomorrow so I can see if there is another DME that I can go through, and find out whats covered and all the information I can find out. Thanks again.

User avatar
Sheriff Buford
Posts: 4080
Joined: Mon Aug 09, 2010 8:01 am
Location: Kingwood, Texas

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Sheriff Buford » Thu Sep 18, 2014 5:16 am

Again: DO NOT GIVE THEM YOUR CREDIT CARD!! You'll regret it...

Sheriff

Blankenship2426

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Blankenship2426 » Fri Sep 19, 2014 11:40 am

Well unfortunately I'm stuck with Apria for my CPAP equipment and supplies. So my insurance pays %50 and my co pay is the other 50% of all supplies and machines. I hate that I have so much out of pocket but I can't really do anything to change that. So let's hope I get someone good at Apria, so I won't be led to call them Crapria. haha.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Newbie, Health Net, sending me to Apria, please advise

Post by palerider » Fri Sep 19, 2014 11:52 am

Blankenship2426 wrote:Well unfortunately I'm stuck with Apria for my CPAP equipment and supplies. So my insurance pays %50 and my co pay is the other 50% of all supplies and machines. I hate that I have so much out of pocket but I can't really do anything to change that. So let's hope I get someone good at Apria, so I won't be led to call them Crapria. haha.
you should shop around, depending on the inflation of prices from them, it might be cheaper to get stuff from amazon, cpap.com or ebay

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

Blankenship2426

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Blankenship2426 » Fri Sep 19, 2014 11:58 am

Thanks Palerider, I will definitely keep that in mind. I have a question for everyone, is it important to have a humidifier on the cpap machine? Like I said, I have no experience with any of this as I am a newbie. Thanks.

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Wulfman... » Fri Sep 19, 2014 2:03 pm

Blankenship2426 wrote:Well unfortunately I'm stuck with Apria for my CPAP equipment and supplies. So my insurance pays %50 and my co pay is the other 50% of all supplies and machines. I hate that I have so much out of pocket but I can't really do anything to change that. So let's hope I get someone good at Apria, so I won't be led to call them Crapria. haha.
I second what "palerider" said. At that 50% rate, you'd probably come out ahead by buying out-of-pocket. Back when I started and "did the math", even at 80% reimbursement, it was about "six of one and a half dozen of the other". I opted to buy all of my stuff out-of-pocket from CPAP.COM and then submitted an invoice to my insurance provider. They DID reimburse me at the 80% rate because they considered me to be "in-network". I also checked with them beforehand and they agreed to reimburse me for going out-of-pocket. It saved both of us money.
I've NEVER used a local brick & mortar DME.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Wulfman... » Fri Sep 19, 2014 2:08 pm

Blankenship2426 wrote:Thanks Palerider, I will definitely keep that in mind. I have a question for everyone, is it important to have a humidifier on the cpap machine? Like I said, I have no experience with any of this as I am a newbie. Thanks.
I would definitely get the humidifier. Depending where you live and your relative humidity, you may not "need" it, but there are always times when it may come in handy. Better to have one even if you don't need it than to need one and not have one.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05

Blankenship2426

Re: Newbie, Health Net, sending me to Apria, please advise

Post by Blankenship2426 » Fri Sep 19, 2014 2:18 pm

Okay, so you've told me not to give Apria my credit card! They called me today and set up an appointment for a class to get my machine and made sure to tell me to bring my credit card for to secure my equipment and for services rendered?? I don't know what do!! Has anyone been to one of the Apria classes that can tell me what to expect? Can i deny the equipment until I'm sure what i want to do? I feel really overwhelmed right now.

User avatar
bwexler
Posts: 1507
Joined: Mon Nov 08, 2010 11:52 pm
Location: San Marcos, Ca. USA

Re: Newbie, Health Net, sending me to Apria, please advise

Post by bwexler » Fri Sep 19, 2014 2:23 pm

Get your Prescription and complete detailed sleep study report in you hand.
Determine exactly which machine and mask you want, by reading and asking questions here first.
For most I would recomend the new Resmed Airsense 10 for her or the PRS1 560TS.
If you require BiPAP or ASV then you need to use specialty machines.
Check the pricing at CPAP.com.
Then talk to Crapria. Never give them your credit card for any reason. Never expose your credit card number to them for any reason. I would also be cautious about using a personal check. Cash or money order is probably safest, since they can't charge those again.

Compare your Copay with Crapria to the online prices. Then make an informed decision.

Yes you can refuse the equipment. Do NOT let them intimidate you.

_________________
Mask: SleepWeaver 3D Soft Cloth Nasal CPAP Mask with Headgear
Additional Comments: AurCurve 10 ASV Also using Sleaplyhead 1.1, ResScan 6 and CMS50i

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Newbie, Health Net, sending me to Apria, please advise

Post by palerider » Fri Sep 19, 2014 2:27 pm

Blankenship2426 wrote:I have a question for everyone, is it important to have a humidifier on the cpap machine? Like I said, I have no experience with any of this as I am a newbie. Thanks.
As Den said, it's good to have, even if you don't use it often. I rarely put water in mine, sometimes don't even have it attached, but if I get a headcold, or sore throat or whatever, the extra humidity, for me, is sort of like a steamy shower, it helps things feel better, and helps to loosen up the crap in my sinuses. (at least, that's how I feel about it)

some folks like dry air (mainly me, what I breath the rest of the day, and some folks like to feel like they're sleeping in a swamp... most people are somewhere in between. humidty settings are a very individual thing, and they change somewhat during the different seasons

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.