CPAP was my introduction to some of the more bizarre aspects of medical billing. There are actually three contracts: between you (well your employer) and Aetna, between you (as an individual) and your DME, and between your DME and Aetna. And they won't tell you the terms of that last agreement, even though it has a financial impact on you.drduke49 wrote:I don't know if I "own" my machine or it is rented by my carrier (Aetna).
Also, with Aetna, the humidifier is purchased outright. The blower you make monthly payments on for 13 months (I believe is is parallel to Medicare), and then you make a payment every six months in perpetuity. As a "service contract." For which they do NOTHING. It is infuriating.
However, comma, if you look at Aetna's CPBs (Clinical Policy Bulletins), they consider the effective useful life of a CPAP to be five years. So what I did in February, when I hit my five-year CPAP-aversary, was to call up my DME and try to get them to take their machine back. Of course, because it was a five-year-old machine that Aetna now says is useless, that was the last thing in the world they wanted. Not much resale value in a 550P (although it is a perfectly good machine).
The net upshot of my rather hilarious conversations with the DME was that they terminated the stupid service contract and I got to keep the machine. Because of course I did. They didn't want it. It's actually my second backup machine now, behind my two Craigslist finds, because it has more hours of usage (it took me a couple of years to get smart about shaking out CPAP CL deals--helps to be in a major metropolitan area). I'm not sure I will use my insurance coverage to purchase another CPAP before I become eligible for Medicare (another 7 years) because I find this "service contract" nonsense so irksome and I have plenty of CPAP capacity right now (3 machines in total).