prescription for CPAP supplies - Is an office visit needed?

It a patient has been using a CPAP machine for several years and needs a new prescription for CPAP supplies, do they need to be seen by their doctor first?

It may depend on the doctor. I don't see mine very often but I am an established patient with her, and my initial referral for and results from my sleep study are in her file. I have called and requested prescriptions for other maintenance medications without an office visit. I received a hard copy of my Cpap prescription at my last office visit but I am confident that if I'd misplaced it I could call and request another.

I would suggest you call the doctor's office and ask, you may not need a visit if it's simply an updated script for the DME.

haheater wrote:It a patient has been using a CPAP machine for several years and needs a new prescription for CPAP supplies, do they need to be seen by their doctor first?

Generally, but it depends on the honesty of your Doctor, and your INS requirements. Jim

My DME has been using my existing prescription. The prescription was issued when I got my last machine in June 2014. If I needed a new prescription, I'm sure my Primary would mail one to me.

I lost my sleep doctor when I changed insurance, but I monitor my results and everything has been going so well that I haven't felt the need to find another yet. My primary care physicians are always happy to renew my prescription when I need to buy a new mask, and I recently found out that a physician assistant can write one as well (at least here in Illinois). I saw her for a case of swimmer's ear and mentioned that my prescription was out of date. She was happy to provide a prescription for supplies and it worked fine. There was no insurance involved.

It depends on the DME. CPAP dot com will keep your prescription on file for at least as long as you are still breathing, I believe.
It depends on weather you expect insurance to pay. If you want the insurance to pay, you must follow their rules, whatever they are.

haheater wrote:It a patient has been using a CPAP machine for several years and needs a new prescription for CPAP supplies, do they need to be seen by their doctor first?

WHAT "supplies"? The only things you need a prescription for is a machine or a complete mask. Mask parts, hoses, filters, etc. can be purchased from any number of sources. Go to CPAP (dot) COM and look at their masks. They also have many mask "kits" which don't require a prescription.

For what you'd probably pay for a visit to the doctor's office, you could buy many items out-of-pocket.

+100

It's hard to say - how often do you see your doctor? Scripts in this state are valid only one year. I didn't have to make a special appointment for the DME to get a new script (changed DMEs) from my primary, but I see my primary twice a year. If you never see your primary, chances are that you will be asked to make an office visit if it's been more than a year. I'd give it a whirl. Medicare doesn't have any special requirements for supplies other than a valid script once the paperwork is in.

That said, if you get your supplies from online retailer instead of through a local DME, they don't seem to ever ask for an updated script and you can just order whenever you want. It's insurance that requires the script for supplies.

It doesn't really matter to me. Medicare covers the yearly visit with my sleep doc.
I might not seriously need him now; but creating a relationship may be essential
to getting more help later--when my life could depend on it.