Getting a CPAP for the first time

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 9:46 am

New guy here, had my first sleep study last week. The study found moderate sleep apnea and I go back for my 2nd study (with the CPAP this time) this week. My doctor's office has an in-house DME provider and I stopped by to talk to him. He is recommending a phillips CPAP machine but I wanted to check with outside sources for what is best.

I have good insurance (tricare), but according to the DME guy I will have to pay ~$600 to meet my yearly deductible. Of course, I made sure I can take my prescription elsewhere.

Anyways, I wanted to check with the community here and see what advice you have for dealing with the DME folks. Is there a particular machine I should be trying to get? Any certain features? Any specific items (masks) etc that I need to be aware of?

I suspect the DME guy will try to sell me whatever makes him the most money and I want to be educated before going into this purchase.

FWIW, I am a stomach/side sleeper (which made the sleep study fun).

Thanks!

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LSAT
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Location: SE Wisconsin

Re: Getting a CPAP for the first time

Post by LSAT » Tue Jul 28, 2015 9:51 am

Call your insurance...don't necessarily believe the DME. Find out what DMEs are in network. You don't have to use the doctor;s DME. Make sure you get a copy of your sleep study and a prescription for the machine for your records.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

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TexasTom
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Re: Getting a CPAP for the first time

Post by TexasTom » Tue Jul 28, 2015 10:07 am

Lots of DME's Out there.

CPAP.com is one of the favorite non-insurance providers out there. Apria gives me such a headache and heartburn, I'd rather pay $800 out of pocket and buy a new
machine from CPAP.com than deal with Apria. You need your Doctor's script, but they also are happy to point out it is cheaper to buy mask components than the mask set (doesn't make any sense, but they are good guys who answer my questions.... Apria... I get a better response asking my Golden Retreiver).

Irony is in the first 30 days you can exchange the whole face mask to find what works best for you. Apria told me that after 45 days (gee, thanks). Took me a month to get used to the wisp nose mask. It helps my wife sleep much better.

steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 10:36 am

OK, after talking to my insurance the in-house DME was wrong about my cost. I will pay 20% of the tricare allowed cost for an in-network DME. They also gave me a list of all in-network DME that I am looking through...there are more than 200 to sort through.

Is it better to go with a local DME (vs. an internet) when you are first getting started so they can fit you and show you how to operate the machine?

steeltiger
Posts: 12
Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 10:44 am

Another update; it looks like the phillips REMstar CPAPs are the most common here. Is that something I should be comfortable with or should I investigate further and find something better?

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LSAT
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Location: SE Wisconsin

Re: Getting a CPAP for the first time

Post by LSAT » Tue Jul 28, 2015 10:49 am

steeltiger wrote:OK, after talking to my insurance the in-house DME was wrong about my cost. I will pay 20% of the tricare allowed cost for an in-network DME. They also gave me a list of all in-network DME that I am looking through...there are more than 200 to sort through.

Is it better to go with a local DME (vs. an internet) when you are first getting started so they can fit you and show you how to operate the machine?
YES......Much better.....Like you said, you can try on masks and develop a relationship. Interview them before you commit. Be sure they are willing to give you the machine and masks that you want.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

Cardsfan
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Joined: Wed Apr 29, 2015 3:02 pm
Location: Close to St. Louis, MO

Re: Getting a CPAP for the first time

Post by Cardsfan » Tue Jul 28, 2015 10:50 am

Is Lincare one of your choices? I went with them because we travel a lot and they have locations all over the US.
When I was choosing a DME, I called a few and asked basic questions. Trying to get an idea of how helpful each co. was. Apria told me it would be 2 weeks before someone "would call me back" to make an appt. , that's odd because the office is 1 mile from my house. So I crossed them off the list.
Overall, I'm not thrilled with Lincare. But their respritory therapist is smart and helpful. Their billing dept is questionable. (I've only gotten 1 bill in 7 months,
and the day after I got it, I received a late payment notice from them)
The main thing is- talk to your insurance co. and get an In network provider.

Did you ask your insurance co about meeting any deductible before they pay 80%?

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  CPAP 10 cmH20., User since 1/1/15.

steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 10:57 am

Cardsfan wrote:Is Lincare one of your choices? I went with them because we travel a lot and they have locations all over the US.
When I was choosing a DME, I called a few and asked basic questions. Trying to get an idea of how helpful each co. was. Apria told me it would be 2 weeks before someone "would call me back" to make an appt. , that's odd because the office is 1 mile from my house. So I crossed them off the list.
Overall, I'm not thrilled with Lincare. But their respritory therapist is smart and helpful. Their billing dept is questionable. (I've only gotten 1 bill in 7 months,
and the day after I got it, I received a late payment notice from them)
The main thing is- talk to your insurance co. and get an In network provider.

Did you ask your insurance co about meeting any deductible before they pay 80%?
No deductible, just the 20%.

The bad info from the in-house DME at the sleep doctor makes me question him even more. He is a very nice guy, but I still like to be educated.

steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 11:02 am

Search brings up 209 DMEs in the tricare network within 100 miles. Here are the "recommended" DMEs according to tricare:

Image

Cardsfan
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Location: Close to St. Louis, MO

Re: Getting a CPAP for the first time

Post by Cardsfan » Tue Jul 28, 2015 11:08 am

If I was just starting out- I would figure out which machine I wanted- with the help from this forum- then contact DME's and tell them what machine you want and ask if they provide it. I'd make it my main goal to get the best possible machine for my needs.
There are some pretty sharp people here who can guide you. It would help if you had test results to share.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  CPAP 10 cmH20., User since 1/1/15.

steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 11:11 am

Cardsfan wrote:If I was just starting out- I would figure out which machine I wanted- with the help from this forum- then contact DME's and tell them what machine you want and ask if they provide it. I'd make it my main goal to get the best possible machine for my needs.
There are some pretty sharp people here who can guide you. It would help if you had test results to share.
I agree 100%! I'm hoping I can figure out what machine to pursue rather than go in blind and just take whatever they give me. It looks like most people keep at CPAP machine for 4+ years so I want to make sure I get the best machine possible even if it cost more. I will see if I can get a copy of the test(s).

Cardsfan
Posts: 1509
Joined: Wed Apr 29, 2015 3:02 pm
Location: Close to St. Louis, MO

Re: Getting a CPAP for the first time

Post by Cardsfan » Tue Jul 28, 2015 11:15 am

I'd narrow my search down to 10 to 20 miles radius, and verify they handle CPAP. Not all DMS's handle cpap.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  CPAP 10 cmH20., User since 1/1/15.

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Krelvin
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Re: Getting a CPAP for the first time

Post by Krelvin » Tue Jul 28, 2015 11:19 am

steeltiger wrote:Another update; it looks like the phillips REMstar CPAPs are the most common here. Is that something I should be comfortable with or should I investigate further and find something better?
Good machines, but there are a number of them that fall under that name.

The current ones:
https://sleep.tnet.com/cmd.class?class=series60

Note some of them are NOT data capable and should be avoided. Which one you need, depends on what your Study shows etc.. .most common would be the PR System One REMStar 60 Series Auto CPAP Machine.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) - Resmed S9 VPAP Auto w/h5i Humidifier - Quattro Air FFM
TNET Sleep Resource Pages - CPAP Machine Database
Put your equip in your Signature - SleepyHead v1.0.0-beta-1
Kevin... alias Krelvin

steeltiger
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Joined: Tue Jul 28, 2015 9:38 am

Re: Getting a CPAP for the first time

Post by steeltiger » Tue Jul 28, 2015 11:28 am

Krelvin wrote:
steeltiger wrote:Another update; it looks like the phillips REMstar CPAPs are the most common here. Is that something I should be comfortable with or should I investigate further and find something better?
Good machines, but there are a number of them that fall under that name.

The current ones:
https://sleep.tnet.com/cmd.class?class=series60

Note some of them are NOT data capable and should be avoided. Which one you need, depends on what your Study shows etc.. .most common would be the PR System One REMStar 60 Series Auto CPAP Machine.
Thanks!

I will see what the specific model they are recommending is and follow up here.

Guest

Re: Getting a CPAP for the first time

Post by Guest » Wed Jul 29, 2015 8:22 am

Talked to the DME again today, the 2 models they have (nomenclature his so it may not be exact):

"Philips Respironics similar to 560p REMstar auto" He says it is actually a newer model that will not be available until September but he has some on hand (sounds strange I know). He did say it had user accessible data.

or

"Resmed Airsense 10". He says this model also has user accessible data

He seems to really like the Phillips Respironics unit and sells the most of those.

Any preference between the two? Are these machines good to go?