Hello Again & Problem

[ThomasMcKean]

Hi guys...

I haven't been around for a while. I was the guy back a few years ago that teed everyone off by complaining no end that they were dragging their feet in getting a mask for me.

So here I am now with another problem about something else and hopefully this time one of yew will have an idea? I can't be the first one this has happened to.

I was going merrily along and sleeping well (and I even lost a bit over 25 pounds and was able to reduce my pressure by .8, bringing me to 11.2) and things were fine for a couple of years.

Then the CPAP broke.

It was a Resmed S8 Elite II. Now certainly I understand these things happen. I know they are supposed to last longer than 2 years but sometimes things go awry and break. I get that.

My problem, yew see, is the DME is taking their own sweet time (yet again a problem with time?) and I took it into them they told me they would send it in for repairs and when I checked on them a week later, they still had not sent it in yet! ARGH!!! It was just sitting there on the floor against the wall and forgotten.

What gives with THAT?

Meanwhile, they gave me a REMStar Plus as a loaner, but it has no humidifier and that makes it even worse than not using one at all. And, to top that off, it is an old model and it makes a LOT of noise! Kind of a loud ringing sound that makes it impossible to get to sleep.

But there is more. No one can (or is willing to) give me a clear answer on insurance. I don't know if this break in the CPAP is covered or not, because whenever I try to ask, I keep getting different answers.

At this point I am thinking I may need to do what I know a lot of you have done, and that is to take things into my own hands and just buy another model on my own because no one who is supposed to be dealing with this situation is doing their job.

So now I have a few questions if someone will please to answer?

1) How can I move things along with the DME?

2) How can I get a clear answer on insurance? If I had my way, I would want to get a new machine out of this because I know they have advanced. I know that is wishful thinking but one person I talked to at the insurance company told me they would replace it with a new model. Others have said I am completely on my own. Still others have me somewhere in between. How can I get an accurate answer to what my insurance covers? Or maybe some of yew know? I have Medicare with a United Health Care supplement. But if one of yew answers this, I do expect it to be very different from all I have heard so far. Yet I would likely believe it more, I think. So no fooling Thomas. That would not be nice.

3) What is that site that I saw a lot of yew mention? That one that sells used supplies? That may be an option for me.

4) Is there a way to get the DME to give me a humidifier? It seems strange they would have a loaner that didn't have one?

5) This is a big one for me. I think a lot of problem with the REMStar loaner is in the settings. I have looked over them though and I can't find a way to change what I am looking for. As yew know, the ResMed has an INHALE setting. It can be MED or FAST. I have played with both and preferred one over the other at various times. The REMStar would have a very FAST inhale, and that is when the annoying bell sound comes. Almost like the motor could use a bit of WD40. Being as it is not my own machine, I am hesitant to open it up and give it a spray, though I I am very mechanically inclined. So I am wondering if there is a setting like on the ResMed to lower the inhale down to more of a MED setting? I have gone through the settings and the manuals and I have not found it. But maybe I missed it or it is called something else that I didn't see when I was looking it over.

Thanks in advance for any help yew can provide.

[Artcarved]

Insurance: I have Av-Med Medicare and as of the first of the year they will pay for 80% of the Cpap. I was going to use the company they contracted with to get a Cpap. The machine they supply was one I have never heard of before. I can't recall the name now. I went on line to order my Cpap, and will be filling out the claim form to get reinbursed my 80%. The manual does not say I have to get the machine through their supplier. I had called them before I ordered to verify that I could get a reimbursement. I had an appointment with my Pulmonary doctor, brought the SD card for a report on progress. I will have to send in a copy of report with my claim. It's 10 weeks now that I am using the Cpap.

To get the mask right (have a nose mask), I hold the mask in position and then hook the strap. I find by doing it this way I don't have to fuse with the mask.

[wolewyck]

I don't know how to get a definitive answer from the insurance people, but I would ask your doctor to talk to your DME. Your doctor will want to know if the DME is not being responsive... if they're not doing their job, your doc may stop referring them patients, right? They have an incentive to be responsive to the doc, you see. Also, check your prescription. Mine specified a heated humidifier. If yours does-- or if your doctor can update yours to specify that--you might get some traction that way. Good luck!

[kteague]

Hi, and welcome back. Sorry that means you have a problem. You might try telling the DME that any replacement should duplicate the existing treatment, so a machine with no humidifier is not acceptable, especially in view of THEIR delay in sending it for repairs.

Congrats on the weight loss!

Kathy

[ThomasMcKean]

I don't know how to get a definitive answer from the insurance people, but I would ask your doctor to talk to your DME. Your doctor will want to know if the DME is not being responsive... if they're not doing their job, your doc may stop referring them patients, right? They have an incentive to be responsive to the doc, you see. Also, check your prescription. Mine specified a heated humidifier. If yours does-- or if your doctor can update yours to specify that--you might get some traction that way. Good luck!

I did not make a copy of the prescription (which I have since regretted multiple times) but I do recall clearly that it called for a heated humidifier.

I like your idea.

[archangle]

No immediate help for you, but this is another example of how people should get a spare machine. Watching Craigslist for good deals has done it for me. I watched for 3 months before I got a really good deal on my current machine.

[ThomasMcKean]

No immediate help for you, but this is another example of how people should get a spare machine. Watching Craigslist for good deals has done it for me. I watched for 3 months before I got a really good deal on my current machine.

Yes. This experience has totally convinced me about THAT! It is on my list to do deal with for sure!

[nanwilson]

Barring getting any help from the DME.....cpapauction.com or secondwind.com or craigslist.

[SleepingUgly]

Did you get your machine back, Thomas?

[ThomasMcKean]

Did you get your machine back, Thomas?

Not yet. I have a M series loaner that I really really HATE. Even with the humidifier. I am looking at the auction site for something else.

[rubymom]

Is your insurance through an employer? You should be able to contact your benefits department, explain your dilemma and ask them to get a definitive answer for you (preferably in writing).

Good luck!