Twight np headgear question?

[sleepyhead63]

I went to my doctor today and he wrote a prescription for the twilight np mask, I hope this mask works for me because I have been struggling for a long time to find one.My question is the insurance will pay for the mask but not the headgear, do I have to buy the headgear or I read somewhere that you can make your own headgear with panyhose or something. Can anyone confirm this and direct me to where I can find this information?

[tangents]

Hi Sleepyhead63,

Unless I'm mistaken, you have to buy the headgear, and then you can modify it if you want. The Headgear does more than just strap the mask in place - it contains the exhaust port and routes the air through a smaller "interface hose" to the CPAP hose. The insurance should really buy the mask and headgear, at least once. Then they could replace the pillows, but without the headgear it's worthless.

Good luck,
Cathy

[blarg]

Just let them get the whole thing, as long as you pay less than 100 bucks. You can buy it out of pocket for that price with both M and L pillows.

https://www.cpap.com/productpage.php?PNum=1717

The DME will probably strip a pair of pillows out of the package.

[rested gal]

the insurance will pay for the mask but not the headgear

Sounds like the insurance is using the replacements schedule Medicare uses:

New mask every 3 months.
New headgear every 6 months.

I guess Medicare expects people will be sticking with the same mask forever, and figure the headgear lasts twice as long as the "mask" itself.

I ran into this when I went to Lincare last year to ask for a different mask for a friend in town that I've been helping with her cpap. She's on Medicare. It had been 4 or 5 months since she started treatment, so she could have a new "mask." But it was not yet time for new "headgear."

The guy at the local Lincare kindly let me have the entire mask/headgear for the lady anyway. I guess he just made a note of it and billed for the mask that month and planned to bill for the headgear when that time came. Or maybe he held off billing for either until he could submit both at the same time.

As tangents said, you do need the whole thing, headgear and all, if you get the Twilight NP....even if you plan to chop it to pieces and make your own headgear. Tangents is right:

The Headgear does more than just strap the mask in place - it contains the exhaust port and routes the air through a smaller "interface hose" to the CPAP hose.