Medicare & Machine Replacement?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sat Mar 11, 2017 8:38 am

CowFish wrote:How do you know these things if you don't have a Medicare Advantage Plan?
Talking with people who had to wait months for reviews from their plan before surgery was approved.

Simply put my co-pay picks up anything that Medicare pays. I do not need pre-approvals and I can see any doc who takes Medicare w/o a referral.
SewTired wrote:Even us regulars don't quite know how DMEs are going to respond to the new Medicare rules.
What qualifies one to be a regular? And exactly when is it that a regular is infused with the wisdom to know-it-all?

Now I would like to point out the regulars here are derailing this OP's thread and have not offered anything useful to help with the questions posted, just snarky comments.

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LSAT
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Re: Medicare & Machine Replacement?

Post by LSAT » Sat Mar 11, 2017 9:25 am

Guest wrote:
CowFish wrote:How do you know these things if you don't have a Medicare Advantage Plan?
Talking with people who had to wait months for reviews from their plan before surgery was approved.

Simply put my co-pay picks up anything that Medicare pays. I do not need pre-approvals and I can see any doc who takes Medicare w/o a referral.
SewTired wrote:Even us regulars don't quite know how DMEs are going to respond to the new Medicare rules.
What qualifies one to be a regular? And exactly when is it that a regular is infused with the wisdom to know-it-all?

Now I would like to point out the regulars here are derailing this OP's thread and have not offered anything useful to help with the questions posted, just snarky comments.
A regular is someone that has the guts to register and remain on the site to offer advise to newer users. A regular has been around to read and learn from the advise given by others. By registering the person can become known by the community. People can go back and look at the posts by regulars to see if they want to take the advise given.We have about 6 "guests" that pop up occasionally and spout off advise that is weak at best. You can't tell one "guest" from another and you don't know which "guest" you are reading or replying to. Personally, I have always believed that unregistered "guests" should be able to read, but not post.

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chunkyfrog
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Re: Medicare & Machine Replacement?

Post by chunkyfrog » Sat Mar 11, 2017 9:34 am

I agree, 1000%.

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Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sat Mar 11, 2017 9:47 am

If you insist on further derailing with contributing to the OPs questions let's get right to it...
LAST wrote:Personally, I have always believed that unregistered "guests" should be able to read, but not post.
If you are a regular here you would know the policy here and if you disagree you can either take it up with Johnny or go elsewhere but other boards will not likely tolerate your total lack of wisdom. Those are your choices but you choose to just derail.

So while we are at it others can search your previous comments to see that you are not just here to derail but also entertain and point out when someone has replied to an old post. Pretty handy, NOT. You seem to think that every newbie should have had the same experience you have.

Now take the time to contribute something helpful, if you can.

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LSAT
Posts: 13229
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Location: SE Wisconsin

Re: Medicare & Machine Replacement?

Post by LSAT » Sat Mar 11, 2017 10:05 am

Guest wrote:If you insist on further derailing with contributing to the OPs questions let's get right to it...
LAST wrote:Personally, I have always believed that unregistered "guests" should be able to read, but not post.
If you are a regular here you would know the policy here and if you disagree you can either take it up with Johnny or go elsewhere but other boards will not likely tolerate your total lack of wisdom. Those are your choices but you choose to just derail.

So while we are at it others can search your previous comments to see that you are not just here to derail but also entertain and point out when someone has replied to an old post. Pretty handy, NOT. You seem to think that every newbie should have had the same experience you have.

Now take the time to contribute something helpful, if you can.
Still Hiding...coward

_________________
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

Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sat Mar 11, 2017 10:30 am

LSAT wrote:
Guest wrote:If you insist on further derailing with contributing to the OPs questions let's get right to it...
LAST wrote:Personally, I have always believed that unregistered "guests" should be able to read, but not post.
If you are a regular here you would know the policy here and if you disagree you can either take it up with Johnny or go elsewhere but other boards will not likely tolerate your total lack of wisdom. Those are your choices but you choose to just derail.

So while we are at it others can search your previous comments to see that you are not just here to derail but also entertain and point out when someone has replied to an old post. Pretty handy, NOT. You seem to think that every newbie should have had the same experience you have.

Now take the time to contribute something helpful, if you can.
Still Hiding...coward
Still not contributing?
How does not being able to spell LAST make you superior?
Or make you any more knowledgeable than a Guest?
Is this how mother taught you to treat a Guest?

Why do you insist on whining about things you have absolutely no control over? Do you know?
Are you not getting even the least bit of attention at home? Have NO Hobbies?

I encourage the readers to search your fabulous username to count just how many of your posts are more than 1 sentence never mind a complete sentence or a thought or were relevant to the topic.
I like to read his posts purely for entertainment. You can't make his comments up.

SewTired
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Location: Minneapolis area

Re: Medicare & Machine Replacement?

Post by SewTired » Sat Mar 11, 2017 11:35 am

Guest wrote: Now I would like to point out the regulars here are derailing this OP's thread and have not offered anything useful to help with the questions posted, just snarky comments.
By complaining about the snarky persons, you just end up derailing the thread yourself. Several good comments have been made regarding Medicare considering we don't have enough info from the OP. As to the mention of the VA, there is a big difference between going to the VA and having VA 'coverage'. Even if going to the VA, what VA you go to can net you different results on vastly different time scales. You go to the VA in Pensacola, you literally have equipment thrown at you the same day. You go to a small VA in the middle of the country, you may be lucky to get a danged blood glucose meter within a month. (I'm quoting my BIL's son here).

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Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sat Mar 11, 2017 12:07 pm

SewTired wrote:By complaining about the snarky persons, you just end up derailing the thread yourself.
Wasn't complaining just pointing out how totally wrong hang fire is... I suspect he wears the devil is his other ID.
Hang Fire wrote:
kalatraza wrote:Hoping you can help me figure out what I can do to help my dad out in Iowa.
You can get some good help here, but not from those two unregistered guests - their posts each contain some bad advice. Wait to act until some of the registered regulars reply. It may be Monday because sometimes they don't post on the weekend. Sorry, but I have to leave and can't help you now.
And while I am at it I would also like to point out that most of those "regulars" that posted early on are alter egos of those who were caught deleting posts only because they didn't agree with what was posted (like lsat has done). So had their "SPAM Delete" buttons removed then created another ID only to have that "SPAM Delete" button removed. It's called censorship. Now they use their alter egos to troll this forum, detracting from the purpose of the forum while calling others names (at times spouting vulgarities).

Take a look back to see what they offered on topic to this OP while I was trying to quell their nonsense.

kalatraza
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Re: Medicare & Machine Replacement?

Post by kalatraza » Sat Mar 11, 2017 11:11 pm

Thanks so much everyone.

To those concerned, please know that the DME did provide a "loaner" CPAP machine for dad.

Looked into it and dad does have a Medicare Advantage plan. It sounds like that makes a big difference on the replacement policy? Dad's current machine is an older RESMED. I don't know the model but it has a humidifier, isn't autoset, has data collection for both compliance and AHI-type stuff. It was a newish model when he got it. That may help a little.

And:
You have one of the strongest, most supportive online communities I've ever encountered here. I found you when I started and struggled with CPAP. There's no way I could have made it work without your help. And here I am again. Keep in mind that everyone is trying to help. Disagree with an opinion? Explain why rather than finding fault with the person who posted. Every boost you write can add value to this forum...make it more welcoming...encourage others to start posting. Think about whether you're using your voice to its fullest potential before you hit submit. xoxo

Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sun Mar 12, 2017 6:03 am

kalatraza wrote:Looked into it and dad does have a Medicare Advantage plan. It sounds like that makes a big difference on the replacement policy?
Advantage mean they are the "GateKeepers" so contact them to ask how they work then talk to the DME but all that will take time and more time.

For those who like Advantage its fine as in the examples above she is happy to pay $700 - mine with co-pay I would pay Zero$ that makes me happy. So I guess it all depends on what makes you happy eh?

Dad is lucky to have you.

DHKaplan
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Re: Medicare & Machine Replacement?

Post by DHKaplan » Sun Mar 12, 2017 7:41 am

I have Medicare Advantage and my doctor told me that he changes out machines after 5 years even if they are working fine. Just had my first change over and never had any problems with insurance or the DME provider.
Resmed Elite S9 with Humidifier & Heated Tube

Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sun Mar 12, 2017 7:47 am

DHKaplan wrote:I have Medicare Advantage and my doctor told me that he changes out machines after 5 years even if they are working fine. Just had my first change over and never had any problems with insurance or the DME provider.
What people don't understand that just like insurance each Advantage plan can be run differently, unlike Medicare which is Medicare they go buy the same rules for everyone on Medicare.

DHKaplan
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Re: Medicare & Machine Replacement?

Post by DHKaplan » Sun Mar 12, 2017 7:50 am

@Guest:
What you say is of course true, but one should not make assumptions that it WON'T be covered. That was why I posted that it is at least possible.
Resmed Elite S9 with Humidifier & Heated Tube

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ChicagoGranny
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Re: Medicare & Machine Replacement?

Post by ChicagoGranny » Sun Mar 12, 2017 7:53 am

DHKaplan wrote:I have Medicare Advantage and my doctor told me that he changes out machines after 5 years even if they are working fine. Just had my first change over and never had any problems with insurance or the DME provider.
+1

Guest

Re: Medicare & Machine Replacement?

Post by Guest » Sun Mar 12, 2017 7:55 am

DHKaplan wrote:@Guest:
What you say is of course true, but one should not make assumptions that it WON'T be covered. That was why I posted that it is at least possible.
This is what was said...
Guest wrote:Advantage mean they are the "GateKeepers" so contact them to ask how they work then talk to the DME but all that will take time and more time.
No assumptions made.