Suggestions for bilevel machines to replace PR System 1?

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ellen1159
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Suggestions for bilevel machines to replace PR System 1?

Post by ellen1159 » Mon Dec 15, 2014 4:37 pm

Hi everyone, haven't posted here in a very long time b/c I've been doing well I rent my PR System 1 Remstar Bipap 60 series machine from Lincare. Long story short, I've had my machine since May, 2013. My new insurance policy with Anthem BC/BS has a high deductible so Lincare is now deducting $110 per month from my checking account for a machine that is 18 months old. By my reckoning, that machine has been paid for at least once already. I might as well just buy a new machine outright.

I'd like to do a little online research on prices for different machines to take to my sleep doc so he can write me a scrip. My understanding of my rental agreement with Lincare is that I already own the System 1 Heated Humidifier (I paid $867. directly to Lincare when I took possession of the machine, my understanding was that it paid for the humidifier outright and the balance would be applied to any amount due Lincare that my insurance carriers didn't cover). I had thought just to ask for an Rx to replace the same machine, but it occurred to me that you folks might know of newer, better, or cheaper models that would accomplish the same things. My employment situation is sporadic so money is a consideration.

Just reading the codes on my Explanation of Benefits forms from Anthem, I can see that Lincare deserves its nasty reputation. They billed (or attempted to bill) Anthem $632.43 for one month's rental on this machine - $400 more than they were billing Health Markets for the same machine one year ago. Anthem knocked it down to $110.99 but as I mentioned above, it doesn't matter because my deductible is $2,400 per year. Their customer service is the worst. My doc ordered a mask from them and after four months we gave up, and they gave me another Wisp for free.

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Pugsy
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Pugsy » Mon Dec 15, 2014 4:43 pm

The only 2 bilevel machine brands that I would consider are the Respironics BiPap and the ResMed machines.
Respironics is going to be your least expensive alternative.
ResMed costs more...the new AirCurve 10 machines (bilevel) were just released last week but they are going to be more pricey plus you have to get a new humidifier. You might find a S9 VPAP Auto which is what the AirCurve 10 VPAP Auto replaced and is like your current machine but it's going to cost more.

You least expensive option is to get just a PR S1 60 Series BiPap Auto and use your existing humidifier with it.
If you check cpap.com prices...be sure to call for price because there is a substantial reduction that they can't advertise.
You might also check out secondwindcpap.com for a gently used machine.

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grayghost4
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by grayghost4 » Mon Dec 15, 2014 5:07 pm

This one is in your area .... just talked to him ... confirms it is a Bipap.

http://hudsonvalley.craigslist.org/hab/4753395718.html

If you don't want it I will buy it
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

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Pugsy
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Pugsy » Mon Dec 15, 2014 5:11 pm

And if grayghost doesn't...I will.
I know someone who needs a bipap and doesn't have insurance.
Move quickly...it won't last long at that price.

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I may have to RISE but I refuse to SHINE.

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Krelvin
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Krelvin » Mon Dec 15, 2014 5:31 pm

Don't you have a cap on the rental? Most have 10 - 13 months.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) - Resmed S9 VPAP Auto w/h5i Humidifier - Quattro Air FFM
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grayghost4
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by grayghost4 » Mon Dec 15, 2014 5:34 pm

problem is he won't ship .... cash in hand only ....
and it is too long a drive for me

someone in Poughkeepsie should snap it up
Last edited by grayghost4 on Mon Dec 15, 2014 5:37 pm, edited 1 time in total.
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

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Pugsy
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Pugsy » Mon Dec 15, 2014 5:37 pm

grayghost4 wrote:problem is he won't ship .... cash in hand only ....
and it is too long a drive for me
Well crap...too long of a drive for me too. Bummer.
Krelvin wrote:Don't you have a cap on the rental? Most have 10 - 13 months.
Yes...but she changed insurance midway in the rental and LinIdon'tcare has started the rental all over again (and yes, it sucks but they can do that) and this time the monthly rental is all going towards the deductible which is now $2400 and she can buy a brand new BiPap Auto for half that out of pocket.
So she is paying new prices at double online retail for her old machine...double screwed.

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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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Krelvin
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Krelvin » Mon Dec 15, 2014 6:03 pm

That is strange. I got my machine 3 months ago and we are also switching to Anthem BC/BS, however when I talked with them, they said they would convert it to a purchase and there would no longer be any rentals needed.

I do know Anthem BC/BS doesn't mean everyone has the same deductibles etc... as that has a lot to do with your company's insurance and how the contracted for it. Where I work self-insures, just uses Anthem BC/BS as the agent to do the billing etc..

So perhaps, they just don't have a similar like plan with them.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) - Resmed S9 VPAP Auto w/h5i Humidifier - Quattro Air FFM
TNET Sleep Resource Pages - CPAP Machine Database
Put your equip in your Signature - SleepyHead v1.0.0-beta-1
Kevin... alias Krelvin

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Pugsy
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Pugsy » Mon Dec 15, 2014 6:14 pm

Krelvin wrote:So perhaps, they just don't have a similar like plan with them.
Are you also using LinCare?
Even if you are using LinCare it could be the local office doing the screwing...and it is also very likely that her plan is different from yours. She's got a $2400 deductible now anyway.
There are probably thousands of different BCBS plans with just as many different deductibles and the fact that your company self insures plays a huge factor. It's all in how things were initially set up. You got the the cream of the crop plan...she's got the skimmed milk plan.

_________________
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.

ellen1159
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by ellen1159 » Mon Dec 15, 2014 7:25 pm

Pugsy et al, thanks so much for your advice. Will check with sleepdoc but it sounds like my original plan, to just replace the bi-pap, is what I will end up doing. I will shop around for a new machine; if that fails, thanks for your suggestion about gently used.

I've changed insurance carriers several times since getting my machine: originally I had MEGA (Health Markets), which covered everything; then I found I qualified for state medicaid (Husky A) in Conn., when the ACA went into effect. Unfortunately, I got kicked off when I sold my house, which was in foreclosure, for below market value: the sale ratcheted up my income but the proceeds went to cover the outstanding mortgage. I qualified for a subsidized Anthem BC/BC so I chose the one with a lower premium, higher deductible, since I'm not covered by an employer.

Yeah, I'm basically screwed. But at least I have health insurance and the premium is still way less than I was paying before.

_________________
Mask: Eson™ Nasal CPAP Mask with Headgear
Additional Comments: Software is Sleepyhead
Machine: Respironics Bi-level 760 pressures 9.5/13.5
Humidifier: Respironics heated humidifier
Mask: F&P Eson Nasal mask
(previous tries with ResMed Swift FX Nano nasal and Mirage Quattro Full Face...still looking for my holy grail mask)

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palerider
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by palerider » Mon Dec 15, 2014 7:40 pm

ellen1159 wrote:Pugsy et al, thanks so much for your advice. Will check with sleepdoc but it sounds like my original plan, to just replace the bi-pap, is what I will end up doing. I will shop around for a new machine; if that fails, thanks for your suggestion about gently used.

I've changed insurance carriers several times since getting my machine: originally I had MEGA (Health Markets), which covered everything; then I found I qualified for state medicaid (Husky A) in Conn., when the ACA went into effect. Unfortunately, I got kicked off when I sold my house, which was in foreclosure, for below market value: the sale ratcheted up my income but the proceeds went to cover the outstanding mortgage. I qualified for a subsidized Anthem BC/BC so I chose the one with a lower premium, higher deductible, since I'm not covered by an employer.

Yeah, I'm basically screwed. But at least I have health insurance and the premium is still way less than I was paying before.
I'd recommend going and buying the one that grayghost4 found, it's a killer deal.

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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Sleeprider » Mon Dec 15, 2014 8:07 pm

Pugsy wrote:Yes...but she changed insurance midway in the rental and LinIdon'tcare has started the rental all over again (and yes, it sucks but they can do that) and this time the monthly rental is all going towards the deductible which is now $2400 and she can buy a brand new BiPap Auto for half that out of pocket.
So she is paying new prices at double online retail for her old machine...double screwed.
More like triple screwed...she will spend $1320 per year at $110 per month. The deductible resets in the next year. It is never paid off under insurance unless she has significant other costs in the year. The guarantee is she will spend $2400 before she gets a dime of coverage.

Last year my insurance policy had a $1500 deductible for me, and another $1500 for family (wife). Everything came out of pocket since the insurance doesn't pay a dime until the full $3000 is met. If the insurance ever kicked in it would be a good policy, but you have to have a major injury or hospitalization to get out of self-insurance. On the other hand, the policy rates should reflect this.

The answer is, talk to your doc. If he understands your insurance situation, he can help you avoid a rental situation by writing a script for a device, and you can then decide whether to use the insurance or not. O.P. seemed to have this down.

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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Guest » Tue Dec 16, 2014 6:12 am

grayghost4 wrote:This one is in your area .... just talked to him ... confirms it is a Bipap.
I once drove an hour for what the seller on phone said was a bipap. It turns out he was looking at the box it came in which also said bipap.

I would ask to see a picture of the model writing on top or bottom of the machine before saying it is a bipap since they ALL look the same from that distance. Many failed users just have no idea what they were issued.

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bwexler
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Re: Suggestions for bilevel machines to replace PR System 1?

Post by bwexler » Tue Dec 16, 2014 1:02 pm

I had a similar arrangement with Crapria for my ASV machine. I kept calling everyone I could think of and complaining about a perpetual rental. I finally talked to someone in the billing department at Crapria who agreed to convert to a purchase and informed me there had already been enough payments to be paid in full as a purchase. But she made sure to warn me numerous times that I would no longer get any support from Crapria. Since I could not remember getting any support for the first year, I figured I could take the risk.
I now own my machine. Concern over starting the rental period again was the main stumbling block, when considering a change in insurance for the new year.

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Re: Suggestions for bilevel machines to replace PR System 1?

Post by Pesser » Tue Dec 16, 2014 3:05 pm

If all else fails I'd go with secondwindcpap.com; see my post: viewtopic/t102679/viewtopic.php?f=1&t=1 ... 72#p957272

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