Insurance coverage

Does anyone here have anthem insurance and can't get dme coverage?

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Contact your benefits manager at work.
Employers often negotiate for plans that allow them the lowest cost.
Screwing the work force is a very old, dirty trick.

kfowler wrote:Does anyone here have anthem insurance and can't get dme coverage?

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That would depend on the plan you're in.
Just saying "Anthem Insurance" doesn't mean anything.
What type of plan is it?
If it's a group plan, they tailor them to what the business/employer stipulates.
You also didn't say where you're located.


Den

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Could you please clarify: are you looking at buying Anthem insurance or do you already have it?

If you already have it, you need to request IN WRITING the evidence of coverage booklet. That's the actual contract between you and Anthem that you've never seen before because they don't provide it unless it is specifically requested. There will be a section on DME coverage (or exclusions for DME coverage) in that book and whatever that book says is what they have to follow. If it's an ACA plan it very likely may not have CPAP coverage, because that wasn't mandated in the ACA.

If you are thinking of getting Anthem coverage, then you have to specifically ask for written proof that it will be in your coverage. It's not always possible to see the Evidence of Coverage before you agree to the plan because they consider it "proprietary". (In what other industry do they make you sign the contract before you are allowed to read it and know what it entails????? ).

If this is employer provided insurance the same principals apply. Ask for the EOC and ask your HR person to help you if you have questions about your coverage. If CPAP is not covered, there's not much you can do.

Unfortunately, if you already have the Anthem plan and it doesn't cover CPAP, you are SOL until the next open enrollment period.

BUT!
You do not have to buy from the local clip joints, or pay their gold-plated prices.
Cpap.com (sponsors of this forum) sells new machines for prices that
often compete with the deductibles and co-pays of many insurance plans.
For even lower prices, Secondwindcpap.com has open box and lightly used
machines for sale.

Also, check Amazon. You don’t even need insurance and they usually have the newest ResMed and Respironics APAPs