Buying from a DME vs cpap.com

[Chilehead]

On cpap.com it's nice ... you can see the masks and supplies, and a novel thing like price. I've only bought my supplies from cpap.com because it's easy and relatively affordable.

Since I started therapy about a year ago, I get monthly calls from American Home Patient, which is where my insurance (Cigna) sent me for my initial set up (machine, mask, etc ...) though Carecentrix. I still don't understand why cigna/carecentrix/americanHome are all involved, it makes it so much harder to figure out what's going on.

I always ignore the calls from American Home Patient. I answered once and asked how much the supplies were going to cost. They couldn't tell me. We had to go through several phone calls before I could get a price, which is a bit annoying. Turns out the price was nearly twice that of cpap.com. Since I'm on a high deductible plan, that's all out of pocket for me as I typically don't hit my deductible, so I just stay with cpap.com

Does it ever make sense to go through the insurance path if you're on a high deductible plan, other than if you have already met the deductible?

[LSAT]

Do your homework...COMPARE PRICES !!!!

[Chilehead]

Do your homework...COMPARE PRICES !!!!

Easier said than done! When calling the insurance, the provider, the DME and trying to get price, they would only give me an estimate. Well screw that. This isn't rocket scientist ... forgetting about my deductible, what would it cost me if I hadn't met my deductible? I can figure out the rest. Since they never could give me a price, and their estimate is much higher than cpap.com, it's just a hell of a lot easier and less time to buy from them. If I was close to my deductible, I'd probably spend more time navigating the confusion, but honestly it's just not worth my time.

[LSAT]

Do your homework...COMPARE PRICES !!!!

Easier said than done! When calling the insurance, the provider, the DME and trying to get price, they would only give me an estimate. Well screw that. This isn't rocket scientist ... forgetting about my deductible, what would it cost me if I hadn't met my deductible? I can figure out the rest. Since they never could give me a price, and their estimate is much higher than cpap.com, it's just a hell of a lot easier and less time to buy from them. If I was close to my deductible, I'd probably spend more time navigating the confusion, but honestly it's just not worth my time.

You said that you don't meet your deductible so really you are paying out of pocket...cpap.com should be cheaper than DME

[Goofproof]

Buying from the DME is easier than buying online, your statement does not compute. You say your DME can't give you a firm price, I never buy anything without knowing what it will cost, that's for fools....

I use a DME because of the cost thru my INS is low, for most people that's not the case, but I also bought a new machine from Cpap. com, a fine honest company with fair pricing. Jim

[SewTired]

The only thing I can think of is that if you lack a relationship with a local DME and need additional services, you won't get them. I think this is mostly an issue if you are physically handicapped in some way, but also if you have a lack of transport. For instance, many DMEs will not do repairs on a machine you did not buy from them unless you are somehow their client in another capacity.

Now, I know someone else will jump on here and say you can ship it yourself to a repair person, but in most cases, that person hasn't had to deal with complications of being handicapped, living in a rural area or lacking transportation. To have your machine repaired at a DME, you just bring it in (or have them pick it up) and tell them what's wrong. They package it and send it to the repair place. If you do-it-yourself, you have to provide the packaging, which you might have to buy, package it and then take it to a shipper or have them pick it up (usually for a charge). I could manage this - my brother could not. MANY people don't have the advantage of having family living close by to help them.

Anyway, this is really the only thing I can think of. I certainly would buy from an online retailer until my deductible was met. But, I can still do so.

edited to add: I wanted to add that you can at least apply this item to your insurance deductible! Just ask the online retailer to send you the codes. Send it in to your insurance carrier and it will be added to your deductible - you never know when you are going to end up hospitalized - always happens to me in November, so it IS NOT a waste.

[Goofproof]

As far as buying online and not getting service, the price almost allows you to buy two units for the cost of one at a DME. Jim

It pays to keep one for Murphy, and his Law Buddies

[Uncle_Bob]

I have only ever used the DME at my sleep doctors office for my initial supplies because I wanted to get up and running ASAP. The doctor was very honest in saying that he had an interest in the DME business but advised my that I could purchase on line if I wanted.

I have been using CPAP.com ever since. Shipping can take a week but I always keep backup equipment so I never really need anything urgent.
If you are an Amazon prime member you can get mask parts on Amazon and get prime two day or same day shipping. If you need to purchase a certain amount to quality for any shipping upgrade then you can always add something like a movie or computer game that is not yet released and then once you place the order go back and cancel the movie/game purchase. You will get the shipping upgrade on your cpap purchase

I advise checking with your insurance to see if they allow you to purchase on line. My new insurance is a bit funny about buying on line in that my coverage is 70/30 whereas if I go through a DME I get 80/20

Also neither of the two insurance companies I have had have been able to tell me what the allowable amount is for each billable item. sometimes they cover the cpap.com cost, sometimes I will end up paying myself as their allowable amount falls short of the cpap.com price.
You will need to get the allowable replacement schedule for each billable item, the schedule varied drastically between insurance companies with me. And the schedule can change at any time, for example BCBS of Alabama went from allowing two pillows a month to two pillows every 6 months, they had a medical policy on line for sleep apnea with the schedule and rules in. With my new insurance the customer care rep just said to order what I wanted when I wanted I called back a week later and got told the schedule is probably the same as the medicare schedule

Claim processing also took longer for me. Because the claim came from me and not a doctor/DME they had to send it to an internal doctor and have the claim come back for processing before they would issue me the check.

You can also visit a DME with your machine and try on masks, mine had a bed so you could try sleep positions and check for leaks. Then just leave without a new mask and then purchase the mask you preferred on cpap.com.

The only major advantage with a DME is that you can return the mask within 30 days if you don't get on with it. With cpap.com you have to purchase return insurance which can be almost as much as 50% of the purchase price. I can understand the need for shipping to be paid by the buyer but the DME told me they just return my Quattro to Resmed so they are not out of pocket.

[D.H.]

Unless insurance is paying for it, there' almost never a reason to buy from a DME. Also, don't limit yourself to CPAP.COM, shop around at other on-line vendors including (but not limited to) Amazon & Ebay.

A little anecdote here. I needed to replace my (then) six-year old CPAP machine in 2005. After getting an estimate from a DME, the cost would be approx. $1500, and they'd decide which machine I would get. At that time, it was possible that I would be send a machine with a "stand-alone" humidifier that was not compatible with intentional voltage. My insurance would cover 90% of the cost. An on-line vendor would me the machine I wanted for $500; of which the insurance would pay a 70% out-of-network benefit. Thus, it was, in effect, the same price. I got the machine I wanted and I didn't have to deal with that annoying DME. OF course, it came UPS rather than being delivered by the DME, but I wasn't interested in that anyhow.

[Guest]

I always ignore the calls from American Home Patient. I answered once and asked how much the supplies were going to cost. They couldn't tell me. We had to go through several phone calls before I could get a price, which is a bit annoying.

American Home Patient (AHP) has such a nice friendly sound to it but is far from friendly. I called to ask them if they could provide the cpap I wanted, they said they could. I said I want you to put in my record right now that I will not accept anything else.

After the doc sent over the order things apparently changed and AHP said the order doesn't say the make/model machine I wanted (I said) but it doesn't say the one you want to give me either. AHP said it's a very good cpap - it may very well be but I don't want it, period. I have supplies and accessories to fit the one I want, including a DC power cord.

So after 5 weeks AHP called to say my cpap was in (can you believe they waited 3 weeks before even ordering it?) but lost that sale. Can you believe it took 2 weeks to come in, I couldn't but already had what I wanted. She asked where I got mine at to which I said it doesn't really matter.

Then I asked if I could get supplies from them since they had all the required paperwork. AHP agreed I could and would call once a month until I asked to try the P10 nasal pillows - the girl told me they didn't carry that mask. I asked to order it for me she said no without an apology, a hesitation, or anything. So we both hung up.

I read on here about getting supplies from Verus and they accept Medicare so I called them and have been getting what I need from them ever since.

Now AHP calls a couple times each month but I don't bother to answer. When will they figure it out? Will they ever figure it out?

BTW - AHP wanted me to drive to them to pick it up and they are 30 miles away, one-way.

American Home Patient has such a nice friendly ring to it.

[SewTired]

I always ignore the calls from American Home Patient. I answered once and asked how much the supplies were going to cost. They couldn't tell me. We had to go through several phone calls before I could get a price, which is a bit annoying.

American Home Patient (AHP) has such a nice friendly sound to it but is far from friendly. I called to ask them if they could provide the cpap I wanted, they said they could. I said I want you to put in my record right now that I will not accept anything else.

After the doc sent over the order things apparently changed and AHP said the order doesn't say the make/model machine I wanted (I said) but it doesn't say the one you want to give me either. AHP said it's a very good cpap - it may very well be but I don't want it, period. I have supplies and accessories to fit the one I want, including a DC power cord.

So after 5 weeks AHP called to say my cpap was in (can you believe they waited 3 weeks before even ordering it?) but lost that sale. Can you believe it took 2 weeks to come in, I couldn't but already had what I wanted. She asked where I got mine at to which I said it doesn't really matter.

Then I asked if I could get supplies from them since they had all the required paperwork. AHP agreed I could and would call once a month until I asked to try the P10 nasal pillows - the girl told me they didn't carry that mask. I asked to order it for me she said no without an apology, a hesitation, or anything. So we both hung up.

I read on here about getting supplies from Verus and they accept Medicare so I called them and have been getting what I need from them ever since.

Now AHP calls a couple times each month but I don't bother to answer. When will they figure it out? Will they ever figure it out?

BTW - AHP wanted me to drive to them to pick it up and they are 30 miles away, one-way.

American Home Patient has such a nice friendly ring to it.

If you are going to diss a company, at least register and make yourself known. Or do you just go from place to place to lambast ? Next time they call, simply ask them to take you off their call list because you are no longer a client. Simple.

[bwexler]

My new DME is Lifecare Solutions. Having been assigned to them in January I finally completed my first order.
I ordered 5 items, a SleepWeaver Élan mask fit kit, a PRS 1 series 60 humidifier chamber, heated tube, black foam filters and white fine filters.
I received the mask and Resmed H5i chamber and Resmed heated Tubing, NO filters. It only took a month of dancing with Lifecare, the insurance company, the medical group and the doctor. I called to complain and they suggested I drive 35 miles each way to return the wrong items and pick up the correct items, to be sure they didn't screw it up again. I suggested it was a shorter trip if they drove to me. Got the package Friday. Every thing was there including ONE foam filter and ONE fine filter. At lest the price was reasonable, ~$35 instead of ~~$140 through CPAP.com, if you don't count the dozen hours on the phone to make it happen.

I did pay by check after advising them they would never see my credit card.

I just really needed to test them to verify they could actually be as bad as Crapria.

Thankfully I was not in urgent need for any of the supplies.

[lanco]

When I got my first Respironics Solo LX cpap 16 years ago for $1500 I asked Lincare how much the cpap cost and they said they were negotiating the price with the insurance company. Not much I could do but, what the heck kind of BS is that anyway?

Not only that, but recently while shopping around for a new one they told me they don't sell to anyone without insurance. Basically, I guess somebody is making a lot of money.

[chunkyfrog]

. . . they said they were negotiating the price with the insurance company.
. . . they don't sell to anyone without insurance . . .

---Two issues that should make you put on your running shoes.
I had a DME who "couldn't" tell me what the insurance allowable was;
so I initiated a conference call with insurance right there in their office.
The frog does not eat baloney.

[SewTired2]

If you are going to diss a company, at least register and make yourself known.

are you really in charge here or do you just want people to think you are impotent?