Costs with medicare

Pugsy · Post by **Pugsy** » Wed Mar 08, 2017 12:53 pm

It's about as clear as mud I know.

My suggestion...go get the machine...don't get a new type of mask at this time.
Get the data and see if the leaks indicate mouth breathing to the point that you need the new full face mask.
If you got headgear back in Dec then Medicare won't pay for headgear for 3 more months.
Now if this new DME is willing to forgive the headgear cost out of a new package.. but that's up to them.
There's nothing that says they have to.

bmanley · Post by **bmanley** » Wed Mar 08, 2017 1:35 pm

I'm going to call them and see for sure what they have for me and maybe setup a time to go pick it up. I drove the 62 miles round trip to the other place only to find out they were going to give me a dreamstation after I asked for the airsense

Guest · Post by **Guest** » Wed Mar 08, 2017 2:46 pm

bmanley wrote:I'm going to call them and see for sure what they have for me and maybe setup a time to go pick it up. I drove the 62 miles round trip to the other place only to find out they were going to give me a dreamstation after I asked for the airsense

That is exactly what happens they want to hand out what gives them the most profit. Not sure if they wouldn't tell you which cpap on the phone but to future readers if they won't that is a clue it won't be what you want. Then if they do lie about it you do NOT want to do business with them.

There is a way to get them to get what you8 want and that is to have the doc put the make & model in the Detailed Written Order (DWO). But if they are reluctant this can also drag things out longer. You can certainly contact their Corp. HQ to file a complaint which may or may not work. Keep in mind you can then get your supplies from another supplier.

As for whether a supplier can tell what you received last - well lets just say even if they don't what will happen is the payment will be declined by Medicare and then you know who gets that bill, right? So I think what happens is before they give out any thing at all they do check to see if it will clear billing and that is what adds time to delivery.

On another note afaik with Medicare orders the supplier is supposed to deliver the cpap to the patient and not make the patient come to them for pickup. You haven't said it but it sounds like one of these is Apria who know do repeatedly do things this way.

bmanley · Post by **bmanley** » Wed Mar 08, 2017 3:03 pm

Not Apria and they will deliver but only on Wednesdays. That is why I gave them until yesterday afternoon. That was 16 days after I went in to pickup the machine and found out it was not what I wanted. Figured if they hadn't called by then they were not planning on bringing it out the next day. And yes when I first called them I told them what I was looking for and they said yes they had them. But then when they said everything was set I decided to drive there to pick it up so I didn't have to wait until the middle of the week to get it. That is when they tried to give me the dream station and told me that was the only one they were allowed to stock.
The place I'm now working with never offered to bring it out and I didn't ask. I'm just ready to get this new machine and get to working on figuring out what is going on and maybe get some better rest. And not over pay for anything. Fixed income sucks

bmanley · Post by **bmanley** » Wed Mar 08, 2017 9:42 pm

Well they did tell me today that all cpap machine are rented for 13 months and that they bill $179 a month and that is what I need to pay 20% of. That means I'm paying around $420 for it. Just doesn't sound right

bmanley · Post by **bmanley** » Thu Mar 09, 2017 2:12 pm

Got the new machine today and looking at the bill is interesting. They charge $130 a month for the machine and $42 a month for the humidifier which is built in. Thought medicare made you pay for that all at once and not monthly for the humidifier. They bill $78 for the climate line tubing which I know you can go buy for around $23. Now they did say they didn't know what medicare allows which is sad because you think they would know.

Pugsy · Post by **Pugsy** » Thu Mar 09, 2017 2:25 pm

bmanley wrote:Now they did say they didn't know what medicare allows which is sad because you think they would know.

Oh...they know or could know...they just don't want to let on they can.

bmanley wrote:They bill $78 for the climate line tubing which I know you can go buy for around $23

Where can you find a ResMed heated hose for $23? Best I could find was $40.

bmanley · Post by **bmanley** » Thu Mar 09, 2017 2:28 pm

Not sure what I was looking at when I saw the $23 price, my bad.

MedicareFAQ · Post by **MedicareFAQ** » Fri Apr 28, 2017 1:01 pm

ClayL wrote:Do you have a supplemental medigap policy? We have one through United Health Care and our out of pocket costs for CPAP machines, supplies and masks has been zero - 12 years for me and 3 years for my wife. The supplemental policy picks up the 20% Medicare does not pay.
The humidifier has to be sold as separate item per Medicare rules but was still paid for by Medicare and the supplemental policy.

Correct, the supplemental policy will pay for the other 20% that original medicare does not cover.

Costs with medicare

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