Buying CPAP Online and Supplies from DME?

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

Buying CPAP Online and Supplies from DME?

Post by Jilt » Sat Feb 06, 2016 11:25 pm

Will be a first time CPAP user in a few weeks. Just waiting on my appointment for the 2nd sleep study (cpap titration).

Just trying to get myself prepared before it happens. Aetna told me that they only RENT the machines so I will be paying a service fee for as long as I own the machine. I don't really like that, so I will be purchasing my CPAP machine online. Will DME's be turned off by me having bought a CPAP elsewhere? I really just want to go through a DME for supplies and so I can find a mask that can fit. Would they offer Mask Fittings for me even if I didn't rent a CPAP from them? Would my insurance even allow this? Please if you have any experience with buying just supplies from a DME, I would like to know how it went!

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Julie
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Re: Buying CPAP Online and Supplies from DME?

Post by Julie » Sun Feb 07, 2016 4:45 am

It's not the DME's business where you buy your machine - they want whatever business you do give them. You don't answer to them however intimidating they might try to be. Most people here get their things in various places and only your insurance co. has any say in it, but you need to ask them re what's allowable on your policy - everyone's set-up is different.

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andycole
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Re: Buying CPAP Online and Supplies from DME?

Post by andycole » Sun Feb 07, 2016 6:31 am

My insurance also used the term 'rent'. However, it is only for a period of time (10 months) and then the machine is mine. They want to be sure machine will be used.

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Michelle-OH
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Re: Buying CPAP Online and Supplies from DME?

Post by Michelle-OH » Sun Feb 07, 2016 7:32 am

My machine would have cost me more to 'rent' for the 9 months before I owned it than the machine I just purchased online. In fact, my 'upgrade' cost for the mask I have and the pillows is as much as they are online...and I supposedly have good insurance.

Sleeprider
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Re: Buying CPAP Online and Supplies from DME?

Post by Sleeprider » Sun Feb 07, 2016 8:24 am

Michelle, you can sometimes buy online (out-of-network), and still submit claims to your insurance. CPAP.com provides forms to help you submit claims for any purchases that include all the required insurance codes. http://www.Easybreathe.com has recently indicated they will submit your insurance claims for you, and they report they work with Aetna. I think it might be worth contacting them and seeing what they can do for you. It seems like the best of both worlds; online prices and insurance billing and assistance.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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Additional Comments: Sleepyhead software. Just changed from PRS1 BiPAP Auto DS760TS

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bwexler
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Re: Buying CPAP Online and Supplies from DME?

Post by bwexler » Sun Feb 07, 2016 10:10 am

I just purchased an oxygen concentrator out of network.
My Medicare Advantage plan didn't care if I rent or buy.
The medical group has only one in network DME for O2 and they will not sell ever. They only rent for ever.
I expressed my frustration directly to the insurance company and they initiated a grievance procedure. Monday morning I will be calling the grievance lady to move the process along and see if I can get reimbursed for all or part of the insurance companies 80% share of the purchase.

Never believe what the first or second person tells you if you don't like the answer. Weigh the time and effort against the dollar return and decide how hard you want to fight. For $500 I can afford to put in 5 or 6 hours of debate. YMMV

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Michelle-OH
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Location: Columbus OH

Re: Buying CPAP Online and Supplies from DME?

Post by Michelle-OH » Sun Feb 07, 2016 10:32 am

Sleeprider wrote:Michelle, you can sometimes buy online (out-of-network), and still submit claims to your insurance. CPAP.com provides forms to help you submit claims for any purchases that include all the required insurance codes. http://www.Easybreathe.com has recently indicated they will submit your insurance claims for you, and they report they work with Aetna. I think it might be worth contacting them and seeing what they can do for you. It seems like the best of both worlds; online prices and insurance billing and assistance.
Will definitely look into this! Thanks for the info.

Janknitz
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Re: Buying CPAP Online and Supplies from DME?

Post by Janknitz » Mon Feb 08, 2016 3:23 pm

There's a lot of paperwork for the DME whenever they sell you anything covered by insurance. Some DME's don't think it's worth it to sell you just a mask (or parts of a mask) when you don't also buy your machine with them. So you'll have to play it by ear with each DME.

Things are so fouled up, that they really don't care if they have your business or not. The paperwork often eats the profit on small ticket items. So if they agree to work with you on a mask, that's great, but don't be surprised if they refuse.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
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