How/When Can I Get A New Xpap

[John Galt]

I started on cpap treatment ~August, 2005. Initially, I was provided with a very basic cpap unit with no recording capabilities. After one year and poor response, I convinced my Sleep Doc to give me a prescription for a machine with recording capabilities, so I bought an APAP, got the software, and I took control of my treatment. The results strongly revealed the need to increase my pressure. With that and adjustments to my mask, I have done dramatically better.

I still have the machine that was provided by the DME. I have been waiting for enough time to pass to try to convince them to provide me with a better machine. (Even though I have purchased my own machine, I believe that my insurance should provide me with one that I can use as a backup or for traveling.) But, I have realized that my initial machine will reveal tremendous non-compliance since I haven't used it for over a year.

Do any of you have advice on how and when I will be able to return the obsolete/antiquated machine for one that will meet my current sleep needs and my need to track/control my sleep?

Thanks.

[Goofproof]

It depends on your INS or the size of your billfold. Your old machine is your backup. It's generally 5 years to replace a machine under medi=don't-care.

You will have to ask the people you use, as even in the same company, plans differ. Jim

[John Galt]

Yes, my plan requires five years to replace a cpap. However, my original machine will not show use. Will they replace it if they know that I'm using a different machine that I purchased myself? Or, will they just say ... "Hey, we don't need to spend our money, 'cause you have a newer machine on your dime."

[Goofproof]

I have a Pro 2, the ins is paying for, but I am using two Remstar APAPs, I bought. I figure what happens in Vegas, stays in Vegas. If I'm still playing in this world in five years, I'll deal with it then. Chances are by then they won't make anything as good as my Pro 2 "Classic Tank" anyway. Jim

[Bearded_One]

They don't take the old machine back after five years, they just get you a new one. The old one is yours; keep it a as a backup, use it as a doorstop, sell it, give it to Goodwill, or play hockey with it.

Five years is five years. There is no reason for your insurance company to know how much or how little you used your old machine, or why -- it is none of their business.

I have heard that some insurance companies want to check usage for the first few months to make sure that patients are compliant, but that isn't a factor here and I am not sure that this even actually occurs.

[Slinky]

If you were going to exchange that first, basic, machine you should have done so during the first 1-2 months. At one year of age it has been paid for. The DME has no more responsibility for it. Its yours and yours alone.

[DreamStalker]

As has been said, it is now yours. There is no exchange ... the Guest, I mean DME has already cashed the insurance check.

Just keep it as your back-up machine. Backup machines do not have to have the data capabilities.

[Wulfman]

Post subject: How/When Can I Get A New Xpap

Anytime you want......as long as you have a prescription (for a new one) and the $$$.

My insurance bought 80% of my first one (Pro 2), but I purchased 2 Autos for myself a year later and just recently purchased another Auto for my son who got screwed by his DME (in another state) and got stuck with a Plus model that didn't even have C-Flex (and a el cheap-o mask).
(In case you ever wonder if I personally have a bone to pick with DMEs.....THIS is it)

Now I'm going to be reading his cards to see how he's doing.


Den

[johnnygoodman]

Howdy,

As others have mentioned, a prescription and cash gets you what you want shipped out same day from CPAP.com.

However, Medicare and most private insurance companies have tightened down on providing replacement units. You may be able to get a replacement if your current machine is 5 years or older and the machine has been assessed and there is documentation stating it is broken and the cost of replacement exceeds buying a new one or if there is a physician signed Letter of Medical Necessity noting the reason for the need for a replacement. Medicare considers a CPAP machine that was received through any source (self purchase, receiving through private insurance) as having a life expectancy of 5 years. Therefore, as an existing CPAP/BiPAP user, Medicare will consider a replacement machine after 5 years.

With these rules in place, BillMyInsurance.com faces an increasingly uphill battle. However, we are still helping a good number of people a month get high end equipment and we will continue to do so!

Johnny

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[johnnygoodman]

They don't take the old machine back after five years, they just get you a new one. The old one is yours; keep it a as a backup, use it as a doorstop, sell it, give it to Goodwill, or play hockey with it.

Or sell it on CPAPAuction and put the profits toward a shiny new CPAP.

Johnny

[lvwildcat]

johnny's right. List it on cpapauction or keep it as a back-up. I just bought a basic machine(for travel/back-up) complete with a heated humidifier at cpapauction for $105!! It only had 200 hours on it. The humidifier alone was worth it for me-I broke one of hinges on mine(no leaks;still use it) and Resmed charges $260 for a replacement.