Apria or American Homepatient?

I may be the only one, but I have never had issues with Apria in the 2 years of having them as my DME

When I need to order supplies, I call and they arrive within 3-5 business days.

Wait until they mess up. They pay people to do that--IMO.

The way insurance works today, you usually have a high deductible and possibly a 20% co-pay. It may cost you more to replace your CPAP through one of the major DME providers, than it would cost you to simply buy it outright using your prescription from an online or forum vendor. If your health care costs normally exceed your deductible liability anyway, then the math may be different, but I have seen Apria quote prices of $3200 on a Respironics or Resmed machine I can obtain for $650. Now if I do the math correctly, at 20%, not to mention the co-pay, the Apria system might save me $10 if I use my insurance. How much is tolerating their B.S. attempts to supply a lesser machine, delays in receiving equipment, and crappy customer service worth to you?

Thanks for all the answers. It really is so crooked and weird how DME's work, isn't it? Why is it legal for them to work this way?

I called Apria yesterday and could not get a straight answer about anything - routed to person after person, from the 800-number to my local office and back, etc. and nobody could provide me with prices for equipment and supplies, nobody knew Aetna's allowances and frequency of replacements, etc. Complete shit show. I eventually hung up. I'll be talking to American Home Patient next.

I just don't understand why I need a DME in the mix at all - they seem to exist purely as middlemen to drive prices up and essentially get paid twice. Why would I ever need to rent a machine when I've been compliant for years and own two machines outright? So stupid.

My phone shows the caller ID when the local Crapria returns my call. But when I dial that number I get the call center.

I have also been compliment for years but when I got my new ASV machine a year ago, it was a rental. No one would tell me anything about the cost other than they needed my credit card in case the insurance didn't pay. Well I keep forgetting to give them my CC number. I finally found out the cost. It is $393/mo for 13 months than 393 every 6 months for service and support. Never an option to own it. I haven't been able to get anyone to tell me what service or support I should expect for only $393 every 6 months. Until December my insurance has paid 100%. January is my 13th month and I will have a 20% copay with next years changes.
I think the folks that negotiated this contract must have been related, or just plain committed Medicare fraud by grossly over charging.

Black Shampoo wrote:nobody could provide me with prices for equipment and supplies, nobody knew Aetna's allowances and frequency of replacements, etc.

I'll bet Aetna knows... tho you will need the codes Apria will send them, get the codes then call Aetna. obtw -They will still serve you w/o a credit card.

bwexler wrote: I finally found out the cost. It is $393/mo for 13 months than 393 every 6 months for service and support. Never an option to own it. I haven't been able to get anyone to tell me what service or support I should expect for only $393 every 6 months.

Two and a quarter months of that monthly payment is what I paid in cash for my first ResMed ASV about a year ago. It was from a trusted member of this forum and had maybe a month and a half of use on it. BTW, Crapria is great, UNTIL they screw you over... if they get away with it and you give them your CC# they will make your life a living hell. Rumor has it there are several civil lawsuits in the works. If anyone can confirm this I'd like to hear about it. PM me.

Sleeprider wrote:The way insurance works today, you usually have a high deductible and possibly a 20% co-pay. It may cost you more to replace your CPAP through one of the major DME providers, than it would cost you to simply buy it outright using your prescription from an online or forum vendor. If your health care costs normally exceed your deductible liability anyway, then the math may be different, but I have seen Apria quote prices of $3200 on a Respironics or Resmed machine I can obtain for $650. Now if I do the math correctly, at 20%, not to mention the co-pay, the Apria system might save me $10 if I use my insurance. How much is tolerating their B.S. attempts to supply a lesser machine, delays in receiving equipment, and crappy customer service worth to you?

In order to figure what your actual cost will be, you need to know what your insurance's allowable is for that item. It does not matter what the DME charges the insurance. It could be a million dollars. Your insurance will only pay 80% of your insurances allowable. Then you pay the 20% of your insurance's allowable. You do not pay the difference between the allowable and the charged amount by the DME. That is written off by the DME and they should never charge you for it unless you have signed a paper before you received the service from the DME that lets them charge you. Don't ever sign that paper for xpap's or supplies. Your cost will be your deductible if not already met and your 20% copay. To find out the allowable, call your insurance company and give them the HCPCS code or look on your Explanation of Benefits you get in the mail.

I agree with Ogeo. Unless you are paying cash (in which case you would be better off online 100% of the time), the list price at the DME doesn't matter. You can try to get your insurance to tell you their negotiated amount for each item (machine, humidifier, hose, mask, filters, cushions, etc) ahead of time so you can calculate what you expect to pay. However, even though that is a published amount, it is very tough to get that info out of them before the claim is paid & you receive the EOB. I couldn't get that info out of my insurance, let alone out of the DME...they wouldn't even tell me what patients with my insurance paid on average. Thankfully I was pleasantly surprised how inexpensive my out of pocket costs on my CPAP setup were. It sounds like you are only talking about replacement supplies, so that is even less of a potential for price difference. The negotiated amount will be in between an online price and the DME list price. Mine seems to be only slightly above the online price for each item.

It usually comes down to if you have a deductible and how much remains as to if buying out of pocket is a better deal. The DME agrees to write off the amount between the negotiated & list prices when they are am insurance contracted supplier. You also need to talk to your insurance (Aetna) to find out their replacement schedule. In some cases it can be "as medically necessary", meaning they don't have a set schedule. They should have a written policy specific to xPAP and/or DME. It can vary from policy to policy, so I'm not surprised the DME couldn't tell you. Too bad most insurance company's won't reimburse online purchases (as they consider it out of network); it would save both parties time & money. Best wishes.

Just to throw my 2 cents in the hat... I use American Home.. a little over 5 years ago I went to the closest office (Ft. Lauderdale) and picked up my new machine at the time (F & P HC254). they were real nice and responsive to al my questions\needs. I have not been back there since, but they do call me every (3) months and ask what I need, letting me know what I am elgibile for based on my insurance...
they called me maybe 2 months back and said I am due for a new machine, and even made the appt. for me with my ENT so he could write the prescription. Went and saw him, did a home sleep study, told AHome what kind of machine I wanted and it was all taken care of for me...
I probably talk to a different person every time but does not bother me.. they are nice, professional and have never had an issue with them.