Hi,
I am soon to be a "hosehead". I am just waiting on the call from the supplier to bring my equipment over. I think anyway.....
My question is.....it seems really expensive, I am going to end up paying 95 dollars a month through the place my doc sent my prescription to....I have read that alot of you just buy your equipment on the web and it's much cheaper.....do I HAVE to get it through the doctor first and then the second time I can buy online? It just seems really expensive to me for something that is medically necessary. Do the online distributors accept insurance also? I am not in the best position financially and 100 more dollars a month is not going to be easy.
As soon as I know WHAT equipment I have I will update my profile but right now I know NOTHING except that I should be getting it next week. It's being shipped to a local rep who will come over and show me how to set it up, work it, adjust it????? I don't know....it's all new to me! I kjnow it's automatic, and that's alllllll I know. But I am really looking forward to not waking up a million times a night, that's for sure!
I just know all those single men will be LINING UP at my door when they see me in my mask.....and to think I was having a hard time before! hahahahaha
Have a great day!
Jodie
HELP!
13 posts
• Page 1 of 1
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drummergirl410
- Posts: 315
- Joined: Thu Jul 12, 2007 2:55 pm
- Location: SC
- Contact:
Welcome to the "future" members of the hosehead club! I'm also waiting for a call from the doc. about getting the equipment. It is a bit complicated at first, but hang in there. I don't know much about buying online... a lot of the other members do though. I do know that you will need the perscription even when buying online. Most wil tell you to get a copy of the original scrrip and hold on to it. I'm sure some of the other guys and gals can help with your other questions!
Joined the Hosehead Club on 7/26/2007 100% Compliant for four months... and counting!
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Guest
There is a site called billmyinsurance.com. I haven't used them so I don't have a link to give you. They will work with your insurance company to see what they will cover. You will need a prescription to get the cpap machine (or one of the better models) even on line. You never have to go thru a MD or DME for the equipment, just the prescription.
Julie
Julie
_________________
| Mask | |
 |
"Do what you know in your heart is right. You will be criticized either way" Eleanor Roosevelt
FIGURE OUT WHAT YOU TRULY WANT TO DO BEFORE YOU TAKE STUFF AND SIGN ANYTHING.
First off. You need to know what your copay is and what your deductable is and if you have satisfied it already this insurance year.
Then you find out from the local DME that is "coming to bring your stuff" how much you are going to owe (and for what brand and model and features). Not just monthly, but in total by the time the rental is up and you own the stuff.
Also don't forget to get numbers on the HEATED humidifier (will most likely be a purchase upfront even if the machine is a rental) and Mask (same deal).
Make them tell you brand, model etc. Look up the price on CPAP.com
Make sure this is the machine that you really want. The DME gets paid the same for "a cpap". Billing code E0601 (machine only)
Call Bill My Insurance and get a quote. They may not be much different in price than a local supplier but you get what YOU want. They may or may not work with your insurance, but if you sign on with a local DME they WILL NOT WORK with you most likely at that point.
Get copies of your sleep studies and most of all a prescription from your doc, even if you buy local it is good forever. Make sure the machine you think you want is appropriate. If you pressure is high 16 or more you might need a bipap. Check for central apneas.
Make sure you aren't paying in total more (out of your own pocket) than about $700 for the total setup or you could ignore your insurance and buy online for cash a top of the line machine, or less for one with less features, financing it however you want.
Make sure the machine they are giving you if you decide to go local DME collects useful data not just compliance data. If you have a higher pressure make sure you get exhale relief.
Machines are easy to set up. Easier than your phone answering machine or VCR. You don't need them if you don't want them (DME). Even if you are not technologically savy you have a relative or friend who is. Consider the software so you can tweak your treatment.
It is your money and your treatment.
Do this research before you commit to a DME and ask more specific questions.
And above all watch out. Don't believe "this is what the insurance will pay for" Call them yourself. And "this is the mask we start everyone on ......"
You get the idea.
First off. You need to know what your copay is and what your deductable is and if you have satisfied it already this insurance year.
Then you find out from the local DME that is "coming to bring your stuff" how much you are going to owe (and for what brand and model and features). Not just monthly, but in total by the time the rental is up and you own the stuff.
Also don't forget to get numbers on the HEATED humidifier (will most likely be a purchase upfront even if the machine is a rental) and Mask (same deal).
Make them tell you brand, model etc. Look up the price on CPAP.com
Make sure this is the machine that you really want. The DME gets paid the same for "a cpap". Billing code E0601 (machine only)
Call Bill My Insurance and get a quote. They may not be much different in price than a local supplier but you get what YOU want. They may or may not work with your insurance, but if you sign on with a local DME they WILL NOT WORK with you most likely at that point.
Get copies of your sleep studies and most of all a prescription from your doc, even if you buy local it is good forever. Make sure the machine you think you want is appropriate. If you pressure is high 16 or more you might need a bipap. Check for central apneas.
Make sure you aren't paying in total more (out of your own pocket) than about $700 for the total setup or you could ignore your insurance and buy online for cash a top of the line machine, or less for one with less features, financing it however you want.
Make sure the machine they are giving you if you decide to go local DME collects useful data not just compliance data. If you have a higher pressure make sure you get exhale relief.
Machines are easy to set up. Easier than your phone answering machine or VCR. You don't need them if you don't want them (DME). Even if you are not technologically savy you have a relative or friend who is. Consider the software so you can tweak your treatment.
It is your money and your treatment.
Do this research before you commit to a DME and ask more specific questions.
And above all watch out. Don't believe "this is what the insurance will pay for" Call them yourself. And "this is the mask we start everyone on ......"
You get the idea.
I was a bit suprised. I contacted billmy insurance (the seniors part because I had to go with medicare, had BC/BS, now secondary), I wanted to get my supplies from them (so much trouble with my local DME, but that another post), because my machine is still rented and has been to long to change, they could not bill my insurance as long as I had charges with a local DME. Told me once I owned the machine (13 months) and I did not have any charges for supplies from the local DME for 6 months they could take me and bill my insurances. I did not know doing business with one locked you out of going to another. Must be a medicare rule.
_________________
| Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand |
| Additional Comments: 11cm/H2O, Encore Pro 1.8i, Pro Analyzer, Encore Viewer1.0 - 3 Remstar Pro2's, 1 Remstar Auto |
Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting: "Wow what a ride!"
I still play Cowboys and Bad Guys but now I use real bullets. CAS
I still play Cowboys and Bad Guys but now I use real bullets. CAS
Well, Tigmonster. I wish I had read your post earlier than this! Your local DME didn't waste any time bringing your equipment out! They gave you a VERY good machine. I also have a Resmed S8 AutoSet Vantage (and a Resmed S8 Elite) and Humidaire 3i integrated humidifier. I love both of them.
Was the person who brought out your equipment a Respiratory Therapist? Did he/she explain the setup and operation to you clearly? Did he/she have a good mixture and supply of masks for you to try out? Did he/she give you a good, thorough fitting of the mask? Did he/she explain if they had a mask exchange policy and what that exchange policy was? Did he/she make it clear to you when you were eligible for a new mask, hose, filter for your Vantage, etc.? Do you know if he/she programmed in a Reminder notice for replacments, filter changes, etc.? Will they deliver new masks, hoses, etc. when you are due or mail them or will you have to go in to pick them up? Were you given a data card w/your machine or were you told they would come out or you would have to take your machine in to have the data read? Did you really read over the paperwork before you signed it?
Have you called your insurance company to ask what local DME suppliers they are contracted with? Is this local DME supplier one of those your insurance is contracted with? Have you asked your insurance company what your co-pay and/or deductables are for DME equipment? Have you asked your insurance company how often they will pay for a new CPAP interface and headgear?
During this first 30 days you have the option of returning/refusing this equipment if you find your insurance is contracted w/other local DME suppliers and one of them will give you a better "price" for the same equipment. Some local DME suppliers might give you a break on the co-pays/deductables.
On the other hand, this DME was quick to provide your equipment rather than keep you waiting so a lot would depend on how thorough the person who delivered your equipment was and how comfortable you were w/him or her. If you are "stuck" w/a local DME supplier you sure want one who is willing to work with you if at all possible!!!!
So now you have your equipment and you've had the opportunity to sleep w/it at least two nights. How are you doing w/it? Any problems? Any questions?
Was the person who brought out your equipment a Respiratory Therapist? Did he/she explain the setup and operation to you clearly? Did he/she have a good mixture and supply of masks for you to try out? Did he/she give you a good, thorough fitting of the mask? Did he/she explain if they had a mask exchange policy and what that exchange policy was? Did he/she make it clear to you when you were eligible for a new mask, hose, filter for your Vantage, etc.? Do you know if he/she programmed in a Reminder notice for replacments, filter changes, etc.? Will they deliver new masks, hoses, etc. when you are due or mail them or will you have to go in to pick them up? Were you given a data card w/your machine or were you told they would come out or you would have to take your machine in to have the data read? Did you really read over the paperwork before you signed it?
Have you called your insurance company to ask what local DME suppliers they are contracted with? Is this local DME supplier one of those your insurance is contracted with? Have you asked your insurance company what your co-pay and/or deductables are for DME equipment? Have you asked your insurance company how often they will pay for a new CPAP interface and headgear?
During this first 30 days you have the option of returning/refusing this equipment if you find your insurance is contracted w/other local DME suppliers and one of them will give you a better "price" for the same equipment. Some local DME suppliers might give you a break on the co-pays/deductables.
On the other hand, this DME was quick to provide your equipment rather than keep you waiting so a lot would depend on how thorough the person who delivered your equipment was and how comfortable you were w/him or her. If you are "stuck" w/a local DME supplier you sure want one who is willing to work with you if at all possible!!!!
So now you have your equipment and you've had the opportunity to sleep w/it at least two nights. How are you doing w/it? Any problems? Any questions?
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
Yo, 6PtStar, I also have Medicare primary and BC/BS secondary. Altho our BC/BS contracts might not provide the same benefits. I, too, called billmyinsurance too late. And I sure wasn't getting good service from my CPAP DME supplier either! Are you counting the months until your 13 months w/those jokers are completed? I know I sure am! I got my CPAP in Oct 06 so come Nov 07 I am DONE w/those jokers.6PtStar wrote:I was a bit suprised. I contacted billmy insurance (the seniors part because I had to go with medicare, had BC/BS, now secondary), I wanted to get my supplies from them (so much trouble with my local DME, but that another post), because my machine is still rented and has been to long to change, they could not bill my insurance as long as I had charges with a local DME. Told me once I owned the machine (13 months) and I did not have any charges for supplies from the local DME for 6 months they could take me and bill my insurances. I did not know doing business with one locked you out of going to another. Must be a medicare rule.
Actually, that is more a cpapforseniors/billmyinsurance rule than Medicare's or BC/BS's. I got so frustrated w/my CPAP DME supplier that I get my 02 supplies, CPAP masks, etc. from another local DME that I like MUCH better. Of course, as far as my CPAP itself I'm stuck w/the lousy service DME supplier. Just get a script for a mask and use it elsewhere. How does the new DME supplier know how long you've had your CPAP or where you got it? For all they know you originally got a CPAP when you lived out of state. I think it is understandable that one local DME supplier might not want to step on the toes of another local DME supplier that you've already started doing business with and they certainly aren't going to want to take over w/providing you w/a new CPAP for just the remaining months' rental. Ah, if only we had known more when we first got started w/this CPAP bit, huh?
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
Yes Slinky I am counting the months. January 08 will be 13 months. Script is no problem, my doc is real generious with that, besides it don't cost him anything. Will just have to go Out-of Pocket to CPAP.com on the stuff I need and they won't supply.
And did you ever hit the nail on the head, if I had known more before I started this it sure would have made it a lot easier. Just so frustrating that I can't get to my insurance without going through the DME. Same story with the CPAP companies, won't take anything for repair unless it comes from the DME and DME does not want to send stuff back for repairs unless you bought it from them.
And did you ever hit the nail on the head, if I had known more before I started this it sure would have made it a lot easier. Just so frustrating that I can't get to my insurance without going through the DME. Same story with the CPAP companies, won't take anything for repair unless it comes from the DME and DME does not want to send stuff back for repairs unless you bought it from them.
_________________
| Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand |
| Additional Comments: 11cm/H2O, Encore Pro 1.8i, Pro Analyzer, Encore Viewer1.0 - 3 Remstar Pro2's, 1 Remstar Auto |
Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting: "Wow what a ride!"
I still play Cowboys and Bad Guys but now I use real bullets. CAS
I still play Cowboys and Bad Guys but now I use real bullets. CAS
I ran into that w/the Recall on my Resmed S8 AutoSet Vantage. I had purchased it used w/505 hours on it. When I called Resmed they gave me the option of Resmed replacing it thru SteriCycle or my taking it in to ANY local DME to have them place it on their Recall replacement list.
My sheister DME supplier that I got my Resmed S8 Elite from told me
'too bad, so sad, go thru Resmed".
My 02 DME supplier said "no problem, what's the serial number?". As it turned out Resmed had given my serial number to SteriCycle, evidently when I told them my Elite DME supplier wouldn't handle it, and SteriCycle came thru before my 02 DME supplier got a Vantage in.
I have NOTHING good to say about Wright & Filippis in Saginaw, Michigan.
My sheister DME supplier that I got my Resmed S8 Elite from told me
'too bad, so sad, go thru Resmed".
My 02 DME supplier said "no problem, what's the serial number?". As it turned out Resmed had given my serial number to SteriCycle, evidently when I told them my Elite DME supplier wouldn't handle it, and SteriCycle came thru before my 02 DME supplier got a Vantage in.
I have NOTHING good to say about Wright & Filippis in Saginaw, Michigan.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
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TIGMONSTER68
- Posts: 27
- Joined: Wed Jul 18, 2007 10:46 am
- Location: Enfield, CT
My first night ......
Hi all,
Thank you for all your advice about DME's and insurance and what to ask....it was all very helpful although by the time I read everyone's reply the DME had already delivered my equipment~ and she was awesome. She answered all my questions, showed me how to use the equipment, take it apart, put it back together, how to adjust it, etc etc etc....she said my insurance covered a new mask every 6 months, new filters every 3, etc....so I was pretty comfortable with her so I think I'll stick with my DME. I did find out that my boss put me on the WRONG insurance and THAT is why I'm paying instead of it being covered. So as soon as that is taken care of with HR I won't have to pay a penny for my equipment. Exactly how I would like it to be!
So on to my first night....I guess it went okay, I had a pretty hard time falling asleep, took me 2 hours, which I usually have a hard time anyway so that wasn't totally out of the ordinary. I finally fell asleep around 1ish, I slept pretty well, woke up a few times to turn over to my side or back, and woke up at 7:30 for the first time to go to the bathroom, went back to bed and slept til 9:30 and COULDN'T sleep any more. Which is UNUSUAL for me on a weekend. I can sleep the day away normally, but I think it was a hoax, I'll have to see what happens next weekend....kept the mask on all night which surprised me because I felt a little claustrophobic when I was trying to fall asleep and I was pretty sure I'd be tossing it aside in the middle of the night, but NOPE kept it on. And when I open my mouth, WEIRDEST thing I ever felt in my life.... that will definitely make me want to keep my mouth CLOSED! My eyes were a little goopy in the morning, so does that mean leak?
I have no idea about my settings, or any of that techno stuff you people talk about because I don't have the software or a cardreader, just the card so I CAN get the software and a reader in the future...but I really don't know what all of it means anyway. I can't honestly say I notice a difference, it's only been one night, and maybe tonight won't go so well, or it will be better.......I'll have to update you.
So how'd I do?
Waiting to hear back,
Jodie
Thank you for all your advice about DME's and insurance and what to ask....it was all very helpful although by the time I read everyone's reply the DME had already delivered my equipment~ and she was awesome. She answered all my questions, showed me how to use the equipment, take it apart, put it back together, how to adjust it, etc etc etc....she said my insurance covered a new mask every 6 months, new filters every 3, etc....so I was pretty comfortable with her so I think I'll stick with my DME. I did find out that my boss put me on the WRONG insurance and THAT is why I'm paying instead of it being covered. So as soon as that is taken care of with HR I won't have to pay a penny for my equipment. Exactly how I would like it to be!
So on to my first night....I guess it went okay, I had a pretty hard time falling asleep, took me 2 hours, which I usually have a hard time anyway so that wasn't totally out of the ordinary. I finally fell asleep around 1ish, I slept pretty well, woke up a few times to turn over to my side or back, and woke up at 7:30 for the first time to go to the bathroom, went back to bed and slept til 9:30 and COULDN'T sleep any more. Which is UNUSUAL for me on a weekend. I can sleep the day away normally, but I think it was a hoax, I'll have to see what happens next weekend....kept the mask on all night which surprised me because I felt a little claustrophobic when I was trying to fall asleep and I was pretty sure I'd be tossing it aside in the middle of the night, but NOPE kept it on. And when I open my mouth, WEIRDEST thing I ever felt in my life.... that will definitely make me want to keep my mouth CLOSED! My eyes were a little goopy in the morning, so does that mean leak?
I have no idea about my settings, or any of that techno stuff you people talk about because I don't have the software or a cardreader, just the card so I CAN get the software and a reader in the future...but I really don't know what all of it means anyway. I can't honestly say I notice a difference, it's only been one night, and maybe tonight won't go so well, or it will be better.......I'll have to update you.
So how'd I do?
Waiting to hear back,
Jodie
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drummergirl410
- Posts: 315
- Joined: Thu Jul 12, 2007 2:55 pm
- Location: SC
- Contact:
Sounds like you did pretty well, at least from my limited experience. I've read about others that had a harder time on their first try. Keep thinking positive... that'll keep you going in the right direction. Glad the insurance got fixed up for you too. Not having to pay is nice! Oh, BTW I love your avatar!
Joined the Hosehead Club on 7/26/2007 100% Compliant for four months... and counting!
13 posts
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