Time for new machine

bmanley wrote:Now how does it work if I happen to get the new machine with the humidifier built in? Don't see how they can bill you for two items if they are together but I'm sure if there is a way they will do it.

Medicare (and other insurance companies) have long since allowed a DME to break down the cpap bill so that the humidifier is a separate purchase...until recently they were separate items and for some brands they still are separate.
The ResMed AirSense models have the humidifier "built in" but there's no provision in the HCPCS billing codes (which is what Medicare uses to pay for anything cpap related be it masks or whatever)...the DME will bill for the humidifier separately because it is not only allowed but expected by Medicare.

Here's how it usually works for Medicare cpap machine and humidifier.
The blower part of the unit is usually a 13 month rent to own situation where you have to prove compliance at sometime during a 30 day consecutive during the first 90 days after you get your machine. Compliance is defined as using it for more than 4 hours a night for 70% of the nights during a 30 day period. At some time after the 31 day and before the 91st day you have to have a face to face meeting with the doctor where it is also determined that you are using the machine and it is helping.
Medicare requires this for them to pay the monthly rent to own fee for the 13 months.
The humidifier is usually considered an up front purchase because it isn't "returnable"...so the bill for the humidifier will usually be in the first months bill.
No one has figured out what will happen to someone who fails compliance and has to return the blower on those machines where the humidifier is built in and they have paid in full for the humidifier with that first month bill.
Other items are also typically billed out separately like the hose or water chamber despite the machine coming with those items in the box.
Same thing goes for the mask...despite all the items being included in one package...they are all billed out separately.
Medicare allows it and actually expects it since it is allowed.

I am pretty sure that even though you are already an established cpap user that you will have to abide by the same regulations as someone brand new to therapy.
When in doubt...call Medicare up and ask them.

I want to thank everyone for the input. This is the kind of stuff I need. The first time it was my regular doctor that wrote the order so I don't think he knew too much and I really didn't. They gave me the basic machine and I didn't know until later about the different ones out there. Several doctor had asked for more info from the machine but I had none. Like I said I've never felt rested even after I started this and I do use it every night so until I started seeing this pulmonary doctor I don't think the others knew what else to do. He is the one saying we need something to tell if I'm having an issue with leaks or what. And also because of the pressure he wanted it to be able to change pressures to see if this will help. As for the full mask I'm not a fan and hope the one I have is working okay, just maybe being able to change pressure like the auto ones do will fix any issue. I know it may not but hold out hope it will provide some help.

With this info I can make some phone calls tomorrow and maybe learn some more. I think O2 would help but we did the night with a pulse ox and it fell off for a part of the night but they said the lowest I got was 93%