Questions -- again

onecent · Post by **onecent** » Sat Apr 28, 2007 8:25 pm

I have seen where many of you have equipment where you can observe and analyze data.

I, unfortunately, have a new machine - thru Apria...

I have read in this forum that they are not well liked...

So

I called these people and asked if I could get a machine with a data card software or whatever, and they said insurance won't pay for it.

I said, what if the insurance pays for the machine and I pay the difference.

NO CAN do.

Are there other companies in Kansas City North Area that will oblige, or is this ALWAYS out of pocket?

I had my sleep apnea test several weeks ago, and have gotten the equipment, but I don't see my doctor until May 8th.

I don't have to order from Apria, that is just what was suggested to me, and since I don't know any names of anyone who provides this equipment, I took it. Insurance does cover it.

Any help will be appreciated

WearyOne · Post by **WearyOne** » Sat Apr 28, 2007 8:36 pm

Call your insurance company and ask them what DME providers you can use. That's what I did and they gave me a list of them that I could choose from.

I have a fairly good DME provider (NOT Apria), so there are good ones out there!

Pam

SleepySandy · Post by **SleepySandy** » Sat Apr 28, 2007 8:39 pm

Insurance will cover any CPAP. A CPAP is a CPAP is a CPAP to insurance. There are data-capable CPAPs and non-data-capable CPAPs. To insurance they are the same. You wouldn't need to pay the difference.

Call your insurance and ask them if they work with any DME other than Apria. It sounds like you're still in the rental period with Apria, which is good because your insurance hasn't bought the machine for you yet.

If I were you I would do everything possible to get with another DME and get a fully data-capable machine and dump Apria.

One thing - I know my insurance wouldn't cover me changing machines "just because I wanted to" even though it was still in the rental period. I know others here have succeeded in changing machines but you might want to make sure your insurance won't have an issue - you don't want to get stuck with the bill.

Wulfman · Post by **Wulfman** » Sat Apr 28, 2007 9:18 pm

(If this is feasible)
Check with your insurance provider and see if they will reimburse YOU for an out-of-pocket purchase. (tell them you can save them a lot of money)
If they will, purchase your equipment from CPAP.COM and then submit an invoice from yourself to your insurance provider. This has worked for many of us. They should reimburse you at their standard "in-network" Durable Medical Equipment (DME) rate......which may be 80% or thereabouts. What happens is the DMEs inflate their prices so much that by the time you pay your co-pay (probably 20%), you'll be close to what the equipment would cost from CPAP.COM. AND, you'll be able to get the machine YOU want.

Look into it.....do the math and see what you can do. There ARE other alternatives.

Den