New to CPAP, need help with a machine

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Jdugan4859
Posts: 1
Joined: Sat Feb 06, 2016 7:26 pm

New to CPAP, need help with a machine

Post by Jdugan4859 » Sat Feb 06, 2016 7:39 pm

I figure I've had sleep apnea for years, but the last month it had gotten really bad. I would stop breathing as I would fall asleep, and wake up gasping for air, and once I did get to sleep I would be jolted out of bed 3-4 times a night gasping. My Dad has been on CPAP for the last year, so I scheduled an appointment with his doctor, and did an at home sleep study this week. The obvious was confirm erred, I have severe sleep apnea. My insurance isn't the greatest, I have a $1,500 deductible with a $3,500 max out of pocket. We switched to an HSA insurance this year with BCBS, and I have it setup to have the entire $3,500 in it, but it won't be fully funded till the end of the year. I am pretty much on my own right now to pay for my machine, and I'm willing to spend whatever I need to spend to spend to get a good machine, as long as it will be within the bounds of my insurance and will count toward my deductible and co-pay, since once the money is in my HSA I can reimburse myself. The doctors office is setting me up with a DME company, but I'm wondering what the best route to go is, use the DME or buy a machine online. What questions should I ask the insurance company, and what questions should I ask the DME to make sure I get a good deal, and don't get screwed. My dad has an old machine he is letting me use till I can get setup, so it's not like I'm in a rush to do anything.

Thanks for any advise

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OkyDoky
Posts: 2870
Joined: Mon Aug 25, 2014 5:18 pm

Re: New to CPAP, need help with a machine

Post by OkyDoky » Sat Feb 06, 2016 8:18 pm

Since you want to go through your insurance company you need to ask your insurance company what DME's are in network. You can also ask about using an online company and if they will reimburse but most do not. Our forum sponsor is https://www.cpap.com/
When you are getting a machine it needs to be full data capable. As long as your apnea is obstructive and pressures are not high enough to require a bilevel, an auto APAP would be best since it can also be set in CPAP mode but a CPAP machine is only CPAP. The insurance company pays by code and a fixed pressure CPAP machine and APAP are the same code and allowed price so go for the APAP. Look at the machines in this data base and do not get one that has a red NO on data. https://sleep.tnet.com/cmd
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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RogerSC
Posts: 1892
Joined: Sat Jul 21, 2012 1:11 pm

Re: New to CPAP, need help with a machine

Post by RogerSC » Sat Feb 06, 2016 8:31 pm

Kind of wondering about the results of your sleep study...did they find just OSA's? Or CA's and OSA's? If you have a copy of your study results, look for the interesting parts, like positional aspects (sleeping on your back versus sleeping on your side), what kind of apneas were found, etc.? Did your doctor write you a prescription for a cpap of some sort? What kind? Straight cpap, apap, bilevel, asv? You should get a copy of your prescription as well as your sleep study so that you can shop around a little.

Second what the other poster said about sleep data, you need to get a cpap that provides that so that you can see how you're doing, and tune your therapy if it's not working or if things change over time (they do).

Just a few thoughts, mostly questions, not answers, sorry.