Me again, new rig and major leakage

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
Posts: 64027
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Me again, new rig and major leakage

Post by Pugsy » Fri Jan 05, 2018 11:42 am

Too bad you don't live close to me and could use my DME.
Mine will let you swap out masks unlimited times during the first 60 days after you get a mask. Same policy for a new to therapy person or a cpap veteran like me.

Here's how the mask thing works. Your insurance pays for whatever it pays for during the replacement allowance period. They have nothing to do with masks that don't work or do work or if you like the mask or not. They pay for one mask period and won't pay for another until the replacement allowance period is up. The replacement period is determined by your insurance company....what is your insurance? Is it Medicare or if something else do they follow Medicare guidelines? If you don't know...call them up and ask them so you know.

Now what DMEs can do is have their own in house mask swapping policy and they are free to make up their own rules.
All the major mask manufacturers have a 30 day return policy on their masks and those mask manufacturers will reimburse the DME for masks they dispense above the one the insurance will pay for so that the DME doesn't have to lose money giving out "free" masks.
It involves a bit of paperwork getting reimbursed...and most DMEs don't want to do the paperwork and will tell you "only one swap" or "no more swaps" or whatever. They could let you swap out more if they would just do the paperwork and then they wouldn't "lose money".

Yours doesn't want to do the extra paperwork. They are lazy and don't have your best interests at heart. I would move "finding a new DME" to the top of my to do list if it were me. I do realize that is easier said than done and if you have Medicare and live in a competitive bidding area that will further limit your choices. If you change...call up prospective DMEs and ask them specifically what their mask swapping policy is. Get the specifics.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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Okie bipap
Posts: 3553
Joined: Thu Oct 15, 2015 4:14 pm
Location: Central Oklahoma

Re: Me again, new rig and major leakage

Post by Okie bipap » Fri Jan 05, 2018 12:43 pm

The DME does not have to exchange masks. Some allow one swap within 30 days and some do not allow any any swaps. There a few that allow more than one exchange, but they are very few and far between.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: Evora Full Face Mask - Fitpack
Additional Comments: IPAP 20-25, ps 4, OSCAR software
Growing old is mandatory, but growing up is optional.

angryquaker
Posts: 7
Joined: Thu Aug 17, 2017 8:10 pm

Re: Me again, new rig and major leakage

Post by angryquaker » Fri Jan 05, 2018 3:13 pm

Thanks. My DME is Lincare, which I chose because A.) they're all evil; and 2.) Lincare happens to be the only one with an office local to me. I'm in a fairly rural area, about 30 minutes outside of Dayton, and my commute is to the other side of Dayton, so it's a challenge for me to get in anywhere with regular business hours without being late or missing work altogether. I figured Lincare would be as good as any, and thought the local office would be good for picking things up (like masks) until I found something workable. Turns out, they're as evil as any of the rest, and they don't stock much in the office, so the couple times I have asked for things, they've had to order them. If I decide to pay out of pocket for anything in the future, it will likely be thru 1800CPAP, which has a pretty large retail showroom about 30 minutes from my workplace. Or this site.

My insurance is Anthem BCBS, for which I pay thru the nose, and then still get to enjoy a high deductible and all that sort of thing.

I try to look on the bright side of things, so I still say I could be in much worse shape. At least I have insurance (which I am compelled to have, or else), and there's a DME in town. And there's this board, too.

-Russ

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Okie bipap
Posts: 3553
Joined: Thu Oct 15, 2015 4:14 pm
Location: Central Oklahoma

Re: Me again, new rig and major leakage

Post by Okie bipap » Fri Jan 05, 2018 3:18 pm

I have found masks at a reduced price on eBay and Craig's list. Some times, I have found complete masks on eBay that are listed as mask frame or complete head gear. EBay will not allow people to list complete masks for sale, but if you look closely at the pictures you may see they are offering a complete mask instead of a frame or head gear.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: Evora Full Face Mask - Fitpack
Additional Comments: IPAP 20-25, ps 4, OSCAR software
Growing old is mandatory, but growing up is optional.