Blue Cross FEDERAL

[OkyDoky]

I believe she got it in 2015. They probably won't take it back. It is so irritating that we even have these bricks being sold because even the doctor can't get information from them, other than a clumped AHI, leaks and time used. Well how does that help with therapy and needed changes? Sorry about the rant.

Fwesley, if you can get your doctor to justify to the insurance company the need for a full data machine due to your increasing uncontrolled AHI, maybe they will allow you to get another. Otherwise I would be looking for one on my own.
But if the increase is in centrals a regular auto might not be the answer. The only way to know is to try a full data machine and see, or have a Sleep study. I think I would buy a used machine and get the data then if it looks like centrals, go the sleep study route where the insurance pays for the more expensive machine.

[Pugsy]

I own the machine. My insurance let me but it. I really hope they can get approval for me to buy a new one through my insurance. What they have now is a Respironics Auto CPAP Dream Station. Is it a good machine? Do you buy your machine online through your insurance? I'm getting frustrated with the high numberes. I feel so tired all the time.

It's a good machine. I personally prefer the equivalent in the ResMed but Respironics makes a darn good machine. I have owned several over the years. Both brands have minor pros and cons.

It's hard to use online sources and insurance together. There are some online cpap sources that will work with insurance but you would first need to check with your insurance company directly and find out which online cpap supplier they will work with and secondly...get them to agree to buy you a new and different machine.
Places like cpap.com...don't work with insurance companies and won't file insurance in lieu of payment.
Now sometimes insurance companies will reimburse an online purchase like from cpap.com as an "out of network" purchase but sometimes they just won't pay anything.
Medicare won't at all..no discussion. This again is something you would have to find out from your insurance company...it all depends on the company and even the plan.

And to top it all off...even if your insurance says yeah we will pay...you may have a deductible to meet and depending on what that might be you might be money ahead to pay the lower online prices and not mess with insurance.

[linuxman]

Does anyone have Blue Cross Federal? My DME does not believe that I don't have a minimum number of years before I can replace my machine. They are investigating. In 2015 I got a Resmed CPAP machine and my AHI was 1 or 2 for almost a year. Then it went up to 4 - 6 the last 6 months. I have experimented with the pressure from 9 to all the way to 12. I do believe I need an APAP machine. I have gone to a full face mask with no improvement. The DME lady told my an AHI of 6 was okay because it's only mild. I have heart problems and don't agree.

Great advice already given by others. I just wanted to respond to "I do believe I need an APAP machine". What evidence do you have for needing auto mode specifically? I know you've got a semi-brick, but do you see any response in your AHI at all as you've raised your pressure? There's nothing wrong with an auto machine..and in fact you should get one if you can, because it gives you options, and I think for all auto machines today, data. But saying "I need an auto" is sort of an odd claim, and one they're not likely to take seriously. Without more evidence, it's hard to say what you might need. Heck, your AHI may be all central events and you need an ASV, but there's just not much to go on. Need more data, even rudimentary data.

My own personal experience with auto mode was that's it's not terribly useful for ongoing therapy. It's nice to have, and good for initial use getting dialed in (especially if you did not have a titration study), but in practical day to day use, my Dream Station auto mode is just not responsive enough to make any difference in AHI. Even with a known good base pressure, by the time it's ramped to higher pressures, I've already had several events and probably turned a different way such that I don't even need the extra pressure anymore. The only thing that helps lower overall obstructive events for me is to raise the base pressure. I know the consensus is that the Resmed machines are more responsive, and that may make auto a lot more useful on those machines for day to day therapy. I switched my machine to cpap mode after a couple of weeks of therapy, and I don't see going back to auto. I have experimented with it a couple of times since, and it just doesn't make any difference for me. If I try to lower base pressure even a little bit, and use auto, AHI goes way up..so it's not useful to even give some minor pressure relief. Honestly, I don't need it. I'm at 16.5cmH20, and I'm completely used to it now. In fact, it feels weird to me to even be at a lower pressure. I don't even use the comfort features like ramp and exhalation relief.

So, get an auto machine if you can. Get a machine that's data capable, but there's no guarantee that auto is going to solve whatever you need solved ( and again, not sure what you are trying to solve).

[fwesley]

I am trying to lower my AHI, in hopes that I would feel better. My apnea may have nothing to do with my extreme fatigue. I feel trapped in my fatigue. It's a horrible life to lead. I guess I was just hoping and praying that if I got my AHI lower it would make some difference. A higher pressure does make some difference but the highest I have gone is 12. Sorry to have taken up your time, but I am desperate at this point. I don't feel any more rested when I wake up than when I go to bed. The only morning I felt like I had slept was in the sleep study where they adjusted my pressure throughout the night. That is why I have a small feeling an auto machine may help. Thanks for the information.

[palerider]

I am trying to lower my AHI, in hopes that I would feel better. My apnea may have nothing to do with my extreme fatigue. I feel trapped in my fatigue. It's a horrible life to lead. I guess I was just hoping and praying that if I got my AHI lower it would make some difference. A higher pressure does make some difference but the highest I have gone is 12. Sorry to have taken up your time, but I am desperate at this point. I don't feel any more rested when I wake up than when I go to bed. The only morning I felt like I had slept was in the sleep study where they adjusted my pressure throughout the night. That is why I have a small feeling an auto machine may help. Thanks for the information.

more pressure may help, all you can do with your machine is try, and hope.

an auto machine makes the process *easier* but what is essential is data.

one of these days, someone like yourself is going to hire a lawyer and sue whoever sold 'em the piece of junk that offers no help whatsoever to improve their treatment...

[OkyDoky]

One thing you can do is get a copy of your Sleep Study. It is your medical record and will give you information on your events, limb movement and oxygen decreases. Also get a copy of the original prescription that you can use to buy outside of insurance if needed.

[fwesley]

I have my sleep study and got an RX if I need to buy equipment elsewhere. FYI: I'm a female.

[Pugsy]

FYI: I'm a female.

We don't have any way to know unless you change the gender in your profile from N/A to F.
And while I might remember it in this thread I guarantee I won't remember it if you start a new thread 2 days from now.
Change it to F or be prepared to get referred to as "he" more often than not.

You might ask your DME for a loaner apap...just so you can try it and get the full data it offers.
They may or may not oblige but if you hint around about being willing to buy a machine out of your own pocket even if insurance won't pay they might be willing to "find" a loaner because they will want to sell you another machine and make more money off you.
Of course you wouldn't likely want to pay their inflated prices but they don't have to know that.

[fwesley]

I changed it to female. They will let me rent an auto CPAP machine for 5 days for $100.00 Cash! I thought that was too steep a price for 5 days!

[OkyDoky]

FYI: I'm a female.

Corrected. Please do put it in your profile. I still might make a mistake but mean no offense by it.

[Pugsy]

I changed it to female.

It's still showing N/A...did you hit "submit" after the change? It won't stick without hitting the submit button.

They will let me rent an auto CPAP machine for 5 days for $100.00 Cash! I thought that was too steep a price for 5 days!

Wow...that is a bit steep for just 5 nights. Don't blame you there.
That $100 would pay a good size chunk of the price for an apap you would have that was totally yours.

Where are you located? State is close enough for right now.

[fwesley]

Louisiana

[Pugsy]

Check your private message box please.

[glarnold]

Just for some information. You were asking about BCBS Federal. It is what I have. Five years between is normal. But I can find no reason to buy thru them or the DME. Your share is 30% (for now). And that's about $600. Depending on DME, it may be monthly for a few months. But you'll still pay about $600. Or, you can buy a machine (almost any machine) from our sponsor here, for about $600. You already have the script. And you can get the machine you determine you need.
Hope this helps.

[fwesley]

Do you have Standard or Basic BCBS Federal? I am paying 15% after my deductible.