Online DME

My DME closed up and my account was transferred to Lincare. I have been jumping through hoops ever since. In May I requested a new mask and wanted to try a full face. I've been using dreamwear since I started cpap last year. My wife says I leak out my mouth. I've been to Lincare twice in person to discuss, I've talked to their 1-800 supply service twice. They say they didn't get the proper info from my previous DME and I need a new Rx. Meanwhile they send me a new heated hose, 2 filters and 2 pillows of the wrong size. None of which I asked for or ordered. I go back to my dr and get a new Rx. A week later they claim they never got it. I have them call the dr and get it directly. A couple more days later and now my dr is telling me that the local Lincare office doesn't have a technician and I will need a titration study prior to writing a new Rx. Somewhere things have gotten all screwed up dealing with this new DME. There isn't another choice locally. 3 months trying to get a new mask and it is still up in the air.

So, how are the online retailers? My main concern would be they would be considered "out of network" and I would have an additional $7000 deductible. So, I would essential have to cover all the cost myself. Is it possible to find an online DME that is "in network"?

CALL YOUR INSURANCE CO. They are the only ones that can tell you who is in network for them. You could look at Amazon, E bay or Craigslist...I see lots of masks out there for half the retail price.

If you have a 7,000 deductible that you are unlikely going to meet this year then just buy online and pay out of pocket and be done with it.
CPAP.com has return insurance available (sometimes free and sometimes for a small fee)...if you hate the mask you can return it and get your money back.
They don't file insurance though and they won't be in your "network".

To find out who might be in your network that has an online website you would need to check with your insurance company and get a list from them and the go to the website and verify that they are in network and then follow whatever procedure that is involved with them.

Or do like LSAT said...there are other alternatives to get a mask...heck even ask here on the forum...never know someone might have one they don't want or need.
This is how I have been able to try lots of different masks...I get a gently used one for cheap or donated and I try it to see if I want to actually put some of my own money towards one.
Now if it creeps you out to get a "used" mask...then obviously it won't work for you but if it doesn't used is a good way to try something new without investing a lot of money in something you might end up hating.

What mask is it that you are wanting to try?

I have purchased several masks on eBay. They cannot list a complete mask, so will often be listed as mask frame. If you look at the picture, it is the complete mask. They are usually quite a bit cheaper than any DME either brick and mortar or on line.

Sounds to me like your doctor's office is the one that is giving you the run around.

As to the supplies you received from Lincare, call them up and tell them that they sent someone else's supplies and that you are returning them and there had better not be a charge to your insurance company because you didn't order anything through the warehouse. The number is on the slip inside your box. Then, call the local Lincare office and ask them if they have a Respiratory Therapist employed in their office. If they do, then your doctor's office is LYING to you.

If you don't have Medicare, consider contacting your primary and asking him/her if they will provide a prescription for your cpap supplies. Just tell them to list "patient choice" and list what should be included: mask, headgear, tubing, filters, humidifier bin, chin strap, cushions, pillows (I think I have it all there).

All that said, if you have a huge deductible, just select an online retailer (our sponsor for instance) and print out their prescription page. Bring that to your primary to fill out and sign and fax (I just got the copy, scanned it and emailed it). Easy peasy. I agree that Ebay and Amazon may have less costly options, but online retailers will provide return insurance so that if the mask doesn't work for you, you can return it (be sure to read the instructions so you don't miss the deadline). Once you decide, then you can pick where you want to buy.

You should get a copy of your original prescription to keep for yourself. That way, you can send a copy of it to any DME you want. Lincare plus 2 online DME's have a copy of my prescription.

While you should certainly and always have copies of your own records IME the DME will still contact the doc or sleep lab to confirm any documents you provide.

Dr office called back and said the dr misunderstood the message and agrees that a titration study is not needed and that they will get a Rx to Lincare today for a mask. We will see. Not sure why so much confusion over such a simple thing, but this has been going in circles for too long.

When going through an " in network" provided, my deductible is much lower and they pay out a set rate and then cover 80%. I think I ended up paying $-40-50 for a dreamwear mask and heated hose last time. I'm fine with that. Looking at online stores, the masks are 130-150 and the hose are 40-60. So having insurance coverage helps a good bit.

A friend of mine also had Lincare, but said he no longer uses them due to difficulties. He buys from Amazon, but his company has private insurance and allows him to buy wherever he likes, then reimburses him.

I have a working mask and a couple spare pillows, so I'm ok for now and will give it another week. They are supposed to have it worked out today. I appreciate all the feedback and may end up contacting some of you directly for supplies if this continues to be such a hassle.

I am planning to try the air fit F20. Just reading reviews and such, it looks like a good choice for full face mask. I see there is an air touch out now, but I'm not sold on memory foam. That cushion will work with the air fit, so I can alway just pick up that later and give it a try if the standard one doesn't work. There is also the option of staying with the dreamwear and try options like tape or chin straps, but none of those appeal to me. But I haven't worn a full face before, who know I may hate it and decide a chin strap is more tolerable.

ThisGuy wrote:I haven't worn a full face before, who know I may hate it and decide a chin strap is more tolerable.

You just never know how you will do with a mask until you try it and then sometimes the options that you once thought "no way in hell" become a lot more attractive. I had a similar discussion with myself early on in my therapy when I was suspected of doing a bit of mouth breathing with my nasal pillow mask. Not a good combination of course but when I read my options for fixing it there were several "no way in hell" thoughts. I finally did end up just taping my mouth shut for a while after trying the other usual stuff (chin straps, etc) but my first response to taping was "no way in hell"
It ended up being not nearly as bad as I first thought and worked out better for me than chin straps did.
Got lucky and a couple of months of taping seem to break the habit of mouth breathing for the most part. My nose was always clear though. I think my mouth breathing was just habit from gasping for air with the apnea events. Once the events went away there was no longer any gasping or need to get extra air via the mouth.

Most of the full face masks out there are still on my "no way in hell" list but because I have some preferences about having something on the bridge of my nose...I don't like it. So there's only a few masks out there that don't touch the nose nasal bridge area. That's okay though. I do have the Amara View that I could use if I couldn't use my nasal pillow mask for some reason but in over 8 years I haven't ever had it be that I couldn't get my nose clear enough.

Do I still sometimes mouth breath??? Yeah probably. Been known to wake up doing it but when I review my leak data the evidence doesn't point to huge massive prolonged leaks. Just mainly some maybe 5 or 10 minute sort of big leaks and total time might be 15 to 30 minutes (if it happened at all) and I sleep through them so I just don't care whatever the cause of the big leak. Some of it could be mask movement and not mouth breathing.

Call the doctor and request a copy of your prescription. Ask them to leave it at the front desk, then go and pick it up. Once you have it, make copies and don't lose it. I have mine that was written in 2010, and I still use it.

Sheriff