How often does Medicare allow a new machine and humidifier?

jomac30 · Post by **jomac30** » Mon Jan 28, 2008 6:26 pm

My DME set me up with a Respironics M with c flex and the humidifier that goes with it. Being new to cpap I didn't know I had a choice. Next time I probably will get the A flex and the separate humidifier that is recommended on this forum.
I don't know if my humidifier is the one that has been recalled or not.
I don't know how to tell if it is.

I've had this machine for a year. Will I be eligible for a new one in two years?

Thank you

jimbassett · Post by **jimbassett** » Mon Jan 28, 2008 6:36 pm

It is my understanding that we are only eligible for a new machine ever 5 years. I think I read that on this forum somewhere. Anyway its not very often. Hang in there.....jim

jomac30 · Post by **jomac30** » Mon Jan 28, 2008 6:49 pm

Thanks Jim. I wasn't sure if it was 3 years or 5 years. What happens if your sleep doctor writes a prescription for a different machine before the 5 years is up? Does Medicare then allow it?
Anyone know?

Slinky · Post by **Slinky** » Mon Jan 28, 2008 7:28 pm

To the best of my knowledge, not unless the order is for an entirely different class of CPAP, for example a bi-level (Bi-PAP). AutoPAPs are considered as the same class of xPAP as a straight CPAP.

Bearded_One · Post by **Bearded_One** » Mon Jan 28, 2008 7:32 pm

It depends upon why a different type of machine was ordered. If you have a CPAP or autoPAP and you need a BiPAP because of a change in your condition, there shouldn't be a problem getting a BiPAP. But if you have a CPAP and the Dr orders an autoPAP, it ain't gonna work.

6PtStar · Post by **6PtStar** » Mon Jan 28, 2008 11:09 pm

Medicare told me 5 years unless it is upgraded to a different class (Bipap, eetc.) or if it is broke and goes back to the factory and they send a letter that it would cost more to repair than to replace. Then it would be considered on a individual basis.

Jerry

jomac30 · Post by **jomac30** » Tue Jan 29, 2008 6:05 pm

Thanks everyone.

Can you tell me why a person would need to change from cpap to bipap?

cflame1 · Post by **cflame1** » Tue Jan 29, 2008 10:23 pm

High pressures
Aerophagia
Can't handle regular CPAP/APAP for whatever reason
Heart problems (would need an Bipap ST or something more)

Ok... I'm sure that I haven't covered all of the reasons.

Barks1 · Post by **Barks1** » Tue Jan 29, 2008 10:32 pm

You guys are so lucky as we have to buy our own in Aussie land.

JeffH · Post by **JeffH** » Tue Jan 29, 2008 10:35 pm

Barks1 wrote:You guys are so lucky as we have to buy our own in Aussie land.

There are millions of us here in the US that don't have insurance, are treated like second or third class citizens, and damn sure have to buy our own EVERYTHING.

JeffH

Mask	Humidifier

Additional Comments: Equipment isn't correct, S9 ASV w/H5i