Rule/LAW that says DMEs can't deliver supplies automatically

[Hang Fire]

My internist insists that she can only write a "dispense one" prescription for masks and supplies.

She's had a problem with mask addiction with some of her patients.

[Michelle-OH]

I'm in the group being hounded by my dme, they leave messages every week or so. They also tried to bill me for 3 mos. rental for a machine I already returned to them. I apparently have good insurance and they are seeing $$$. I have no intention of getting stuff just because I can.

[Mr Nifty]

My local DME only lets me buy a month of supplies at a time. Plus I have to call them and remind them. I feel like I inconvenience them with my phone calls. So I contacted a different DME who will provide 3 months of supplies and free shipping. They will call me every 3 months to confirm the order before shipment. ResMed recently bought a company called brighttree. I think the company has software for making robo call orders and supply management.

My prescription calls for a new cushion and 2 filters each month. Every 3 months a new mask assembly and tubing. And new head gear, chin strap and humidifier water chamber every 6 months.

I suspect some people with good insurance get supplies regularly at little or not cost. Than sell some of them on ebay. Ebay allows for the sale of cpap parts. Parts do not require a prescription.

[Gryphon]

For me I have to pay a deductible - but once I pay that then every single thing I'm "allowed to have" I'd like to get. Other members of my family have had issues were the DME will wait till the last second then put in the supply order near the end of the year and you wind up not getting it because the Insurance denies it. I'll be calling a week in advance each time I'm allowed to order supplies to make sure they get them to me before insurance cut offs.

We'll see how things go this time.

[Wulfman...]

For me I have to pay a deductible - but once I pay that then every single thing I'm "allowed to have" I'd like to get. Other members of my family have had issues were the DME will wait till the last second then put in the supply order near the end of the year and you wind up not getting it because the Insurance denies it. I'll be calling a week in advance each time I'm allowed to order supplies to make sure they get them to me before insurance cut offs.

We'll see how things go this time.

Does that deductible apply only to CPAP supplies or other medical "stuff"? (medications, doctors' visits, etc.)

I used to have a $750 annual medical deductible which for years I never touched (except for 2005 when I had my sleep study, etc. and met it.). So, in the following years, I was able to apply that much to machines, masks, cushions, headgear and other accessories out-of-pocket. I wasn't about to pay overpriced amounts just to "fill in that hole" to meet the deductible.


Den

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[Gryphon]

Just my DME stuff. Since I got a new machine today I hit the deductible right off - now everything else for the rest of the year is free. Not to annoy others but I'd rather get as many supplies as I can wail the get'n is good. I'm not trying to get more then what I'm allowed but I want the supplies I'm allowed to have. Just have to make sure my DME delivers them on time so things get billed right.

[Wulfman...]

Just my DME stuff. Since I got a new machine today I hit the deductible right off - now everything else for the rest of the year is free. Not to annoy others but I'd rather get as many supplies as I can wail the get'n is good. I'm not trying to get more then what I'm allowed but I want the supplies I'm allowed to have. Just have to make sure my DME delivers them on time so things get billed right.

Good idea!


Den

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[RogerSC]

I'm very firm with my DME on sending me things only when I request them. As it is, I still have a backlog from when they were just sending me stuff on the max Medicare schedule without asking, before I took them in hand. Told them in no uncertain terms not to send anything without asking me first. I've sent a pile of stuff back a few times. Latest was just a few days ago, when I told them I only needed a new mask. They sent me a heated hose, 6 nasal pillows, a load of filters, a humdifier tank, and the mask that I needed. So I ended up sending back everything except the mask and heated hose.

It's kind of annoying to have to send things back. They do pay return postage, though, and I do end up getting what I need. So we kind of tolerate each other, me and my DME *smile*.

[LinkC]

Thanks for helping to increase insurance premiums for everyone Link.

You are most welcome!
Tossing mask cushions in the trash is so much easier than washing them. And healthier, too.

[palerider]

Tossing mask cushions in the trash ... And healthier, too.

that's really not correct. most of the germs on the mask are coming from you... and since you can't make yourself sick...

[LinkC]

most of the germs on the mask are coming from you...

And the rest are the ones to watch out for...

[palerider]

most of the germs on the mask are coming from you...

And the rest are the ones to watch out for...

well, unless you've got sick neighborhood kids coming in and spitting in your mask while you're not looking, where are these new germs coming from, if not the room that you're in, anyway?

[Debjax]

It would be nice if hubby's and my masks and headgear will last for a year or more....but they do not. I can get maybe 90 days out of one nasal pillow. Hubby becomes leak central if he does not replace his mask at least once every 2 months and he cleans his mask regularly. Headgear we get when it is allowed, and it is sorely needed by that time. We do use the "old" mask and gear in the camper as the new ones come in. We are not trying to raise premiums, we pay a hefty cost share for the supplies we get. I don't let the DME autoship, as they tend to send stuff we don't need. Hoses? Those do last a year or more. Always keep 2 spares handy--have had some rather painful blowouts. (on the road and no hose?) Recently we had a problem after hubby took his mask in from the camper to clean it--and forgot to put it back. Found out the first night at campground on a Friday night 12 hours from home. 4 nights no CPAP for him...it was brutal for both of us.

[Okie bipap]

With my insurance (Medicare and Tricare for life), my CPAP supplies cost me nothing. If I got all of the supplies I am allowed under Medicare, I would soon run out of space to store them. I can get at least three months from a mask cushion and even longer for the headgear. Hoses and water chambers don't wear out if they are taken care of properly. I only get those items I actually need. I keep a spare hose, water chamber, mask cushion and headgear on hand in case something happens to one. I don't have room to store a lot of extra stuff I don't need.

[Julie]

"Tossing mask cushions in the trash is so much easier than washing them. And healthier, too."

Healthier for your vivid imagination maybe, a whole lot sicker for the planet! Do you have any idea what landfills might look like without all that plastic junk in there, the junk that is likely just fine to re-use for months more, if not years? Just because you can't be bothered washing it? Talk about irresponsible, lazy, with no thought for the next generation.