Alternative to Apria?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Hosehead4ever
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Alternative to Apria?

Post by Hosehead4ever » Thu Jan 29, 2015 8:17 am

I live in Maryland and have used Apria as my DME since starting pap therapy in 2011. The last time I got replacement nasal pillows from them, they refused to supply one twice a month as Medicare covers, rather they would only send a new one every two months. At least a monthly change would be nice as that seems to be about the length of time before the silicone starts breaking down and having seal issues. At this point, I'm ready to change DME if there is a better one so I'm hoping for recommendations for a different one.

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chunkyfrog
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Re: Alternative to Apria?

Post by chunkyfrog » Thu Jan 29, 2015 10:09 am

Check my link below, and enter your zip code.
The green "M" shows the contracted providers, who have agreed to accept Medicare allowable as full payment.
As for Apria's refusal to send you scheduled supplies, complain to Medicare, please!

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Hosehead4ever
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Re: Alternative to Apria?

Post by Hosehead4ever » Thu Jan 29, 2015 10:41 am

Thank you. Very helpful. (Also, not my only complaint about Apria, they suck balls - they have sent the wrong supplies twice. I've been buying from our host out of pocket for two years now rather than deal with them) Have already complained to Medicare about it..

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Pugsy
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Re: Alternative to Apria?

Post by Pugsy » Thu Jan 29, 2015 11:17 am

Are you wanting local or mail order?
If local you might simply call the ones close to you to see how they handle Medicare covered cpap supplies. You also may or may not be in a competitive bidding area.
If mail order I have heard of good things from forum members using American Home patient I think it is.

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drubin007
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Re: Alternative to Apria?

Post by drubin007 » Thu Jan 29, 2015 11:33 am

I can vouch for American Home. Never had an issue with them... they call me about every 3 months and tell me what I am eligible for... I tell them yes or not... just got my replacement machine from them about 2 months ago (S9). This last go around I wanted to try a new mask (one with a bite plate in it). They sent me one (not the papcap but something similar). It was a night from hell... I called the next business day and asked to return it and go back to my Opus 360. no questions asked and they said the replacement would ship faster then I could send the bad one back (on their dime of course). Last 5 years never had a bad experience with American Home.

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Uncle_Bob
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Re: Alternative to Apria?

Post by Uncle_Bob » Thu Jan 29, 2015 12:11 pm

I've used cpap.com for years. Very happy with them.
I bill the insurance myself, once you do it and get used to it it is no big deal, at least so far.

Good Luck
~UB

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chunkyfrog
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Re: Alternative to Apria?

Post by chunkyfrog » Thu Jan 29, 2015 12:16 pm

Great suggestion UB!
If anyone can figure out how to do this with Medicare, please share.
Their rules state they cannot accept claims from the patient--not sure of the exact language, though.

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squid13
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Re: Alternative to Apria?

Post by squid13 » Thu Jan 29, 2015 12:21 pm

I also use American Home Patient and have never had a problem with them. I just call there 800 number and place my order with them, if I haven't called in awhile they'll call me. They tell me what I'm eligible for but are never pushy about it.

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Hosehead4ever
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Re: Alternative to Apria?

Post by Hosehead4ever » Thu Jan 29, 2015 12:28 pm

Chunky Frog, I was going to say the same thing. Plus, Medicare apparently has different billing rules if you have secondary insurance (regardless of whether the secondary payer covers the item)

Pugsy, it does look like I am in a Competitive Bidding Area, but that link did give me a bunch of alternative providers. Thanks.

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Pugsy
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Re: Alternative to Apria?

Post by Pugsy » Thu Jan 29, 2015 12:42 pm

Medicare patients who want Medicare to pay for stuff cannot use cpap.com as far as I understand to even get reimbursed for out of pocket expenses or have the dollars applied to the part B deductible.
I doubt that patient filing of a universal insurance form to Medicare (cpap.com will supply you with that form if you want it).
I don't have straight Medicare (I have a Medicare Advantage plan) or I would attempt to self file the universal insurance form to Medicare to see what would happen. I know how to file (used to do that filing at a doctors office for Medicare patients) but that was a long time ago. Rules may have changed and it is very possible that self filing with the universal claim form supplied by cpap.com may not be accepted by Medicare due to cpap.com provider status.

It's just simpler to tell Medicare patients who want to buy equipment and have the provider bill Medicare so that Medicare does their share up front, to simply use a Medicare approved provider to start with....like American Home or Apria or LinCare or anyone locally who already has an established provider relationship with Medicare.
Using cpap.com to be saved for the times when we know Medicare won't pay anyway unless someone wants to try self filing to see what happens. I do that when I want a mask (usually brand new model) and I am not eligible yet for a new mask according to Medicare replacement schedules.

Now other private insurance companies might be willing to accept a claim from cpap.com and that is just something that is up to the individual's policy. Some might allow those claims but most won't unless it might be covered under out of network expenses.

I pay for Medicare with my monthly premiums so I want Medicare to do their share up front and save myself out of pocket expenses whenever I can. I don't want to go through the hassle of self filing....Medicare is notorious for disallowing a charge for the tiniest of errors and unless someone really knows their universal insurance forms (if Medicare even would accept one) and coding...not worth the hassle to try to self file.

Perhaps the next time I buy a mask from cpap.com I will at least give it a try and see what happens. Will only cost me a bit of time and a stamp.

But in general...if a person has Medicare and wants Medicare to pay so they don't have to....I wouldn't advise using cpap.com as much as I love them.

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dreamzone
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Re: Alternative to Apria?

Post by dreamzone » Thu Jan 29, 2015 1:35 pm

I have Kaiser, and ALL my supplies - including the machine and humidifier - are covered benefits at no cost to me.

Unfortunately, their only vendor is Apria.

So now I am in the position of going elsewhere and paying full price out of pocket, or getting free stuff from incompetent idiots at Apria.

Sorry if anyone here works for Apria... Didn't mean to insult you. Even Kaiser DME hates Apria, but they tell me despite all the complaints, the corporate office has no plans to switch.

Thanks for suggestions on alternative suppliers!

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Sir NoddinOff
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Re: Alternative to Apria?

Post by Sir NoddinOff » Thu Jan 29, 2015 1:43 pm

A bit off topic... I hope your avatar picture is not of your cat sitting amid the carcass of your clawed and drained waterbed Cats haven't been getting very good press on CPAPtalk lately. Ask Pugsy about that.

BTW, I hate Crapria too. Good luck finding a replacement.

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chunkyfrog
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Re: Alternative to Apria?

Post by chunkyfrog » Thu Jan 29, 2015 2:26 pm

FYI: my Medicare link can determine if you are in a CB area by your zip code, and will list those suppliers where applicable.
Since the government does not work too swiftly in updating the site, and there may be additional (or fewer) providers
than listed, you may need to call Medicare directly. {{{plug in your phone, there may be a hang time}}}.

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Hosehead4ever
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Re: Alternative to Apria?

Post by Hosehead4ever » Thu Jan 29, 2015 3:25 pm

Yes, I am in a Medicare Competitive Bidding Area according to my zip code.

Just back from doctor and apparently his treatment notes from my last visit two years ago say he wanted me to try an autopap at that time. He also said not to bother trying to get Medicare to pay for a new machine at this point because of the five year thing, but he does want me on an auto. I was expecting him to lecture me about not changing my pressures, but he loved it.

Am still looking for a new provider for masks and supplies though. He recommended Bay State if anyone has any experience with them.

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Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Auto 5-7 cmpw, EPR 3; Climateline heated hose; Snugglehose cover; Airsense 10 Autoset apap backup machine; off grid
Full-time off-grid hosehead living in a converted school bus with on-board solar power system consisting of 480 watts solar panels combined with 340 Ah LifePo4 batteries.

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Pugsy
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Re: Alternative to Apria?

Post by Pugsy » Thu Jan 29, 2015 3:56 pm

Is your machine for sure what you show in your profile...the model 250 or maybe 150? If so it is a non data brick and too bad someone didn't give you an apap back when you first started because all the APAPs are full data.
If you do have the brick...there might be hope to get Medicare to go for a new machine based on need for data that your current machine doesn't offer.

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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.