New CPAP Cost Questions

[sleepnewbie1]

So...

I went to the sleep doctor because my wife was complaining about snoring and I had many sleep disorder symptoms. He had me do a sleep study and they called back and said I had Obstructive Sleep Apnea and scheduled me to have another sleep study to set the CPAP settings. With all this being done they want me to come in Wed and pickup the machine. They are telling me it will cost 1200 without insurance or 1400 with insurance because I will have to rent the machine. With that being said do these prices sound reasonable or is it something I could put together myself from the internet for alot cheaper? I have a 2000 deductible so the cost will all be out of pocket anyways. The only thing I like about them putting it together is they know everything I need and whatnot. This is alot of money and im just scared they are trying to take advantage of me.

[cflame1]

yes you can do better on the internet, but you'll need a prescription in order to do it.

check cpapauction.com or cpap.com

[Muse-Inc]

They are trying to take advantage of you. Now that said they might have a contractual thing with your insurance...this whole area is murky & stinks of greed. But, you can buy your equipment online from our host https://www.cpap.com for probably less than your insurance co-pay. When I started, my co-pay was $890 for a machine that did not record sleep efficiency data that I could have bought for about $350, my mask was just over $100 -- I was clueless at the time and paid thru the nose. Typically, insurance makes you rent the machine for several months at lease if not an outright 10-month lease purchase -- it's expensive to go this route; they want to know that you are using the machine at least 4 hrs every night, that's called compliance. Last Oct, I bought a much more sophicticated machine that sells for $550. Our host also price matches other internet sites. You are legally entitled to a copy of your sleep study and a copy of your presciption which should identify the type of machine and the pressure needed -- this will be needed in order to buy equipment. We strongly recommend that you only get a machine that records sleep efficacy data (not just compliance data that only records how long the machine was on). If you have trouble getting these things, come back and tell us -- someone will give you some suggestions.

[snoregirl]

Get your prescription and shop at CPAP.com. $1200 is way too much. Get a copy of your sleep study too.

[sleepnewbie1]

Is it complicated or something thats pretty easy for someone that knows nothing about whats needed can figure out? Like a said ill I know is that I need a machine anything after that is greek. Do they sale full packages with everything you will need, or do I have to figure out everything that is needed and buy individually?

[el_zorro]

The main advantage of a medical equipment provider through your doctor (DME) is that you can try different machines and masks on for comfort and fit and many of them have a liberal return policy (30 exchange and get a different mask or machhone). However with the money that you save on the machine online you can afford to buy a couple of masks or pillows to find one that works for you.

However, if you cant afford the $1200-$1400, you have a lot of options for purchasing a CPAP. The good news is that there is a fairly active market for these machines because many people can't get used to them so they buy them online and end up selling them right away. For example, I bought a brand new (near top of the line machine made by a market leader in the industry, with humidifier and mask for $200 shipped).

The doctors should concentrate on educating you and giving you advice on your condition instead of peddling equipment and they should also let you know that there are many very good options out there that will give you the same or better equipment for way less than the $1200. Follow this forum and you will get good education before you get the results of your second sleep study. You can learn a lot fast and you have a little time to investigate before you make your buying decisions.

There are also many good web merchants that provide excellent service (cpap.com) being one of them. You can get a near top of the line system with mask for $600 or less.They do most of the work for you (set the pressure from your second study) and all you need is your prescription from the doctor. You can fax them the prescription. Think of them as a virtual medical equipment provider but one that you can email and talk to to help you get started.

This condition seems foreign at first but it isn't too bad. My advise would be to concentrate on getting therapy from a good machines and have a positive attitude about it. Once you get used to the therapy you start sleeping and feeling a lot better. The cost will seem small to you once you start recovering from the condition.

[sleepnewbie1]

Why do i need the sleep study and prescription. I thought all that was needed was a prescription to buy the equipment what is the sleep study used for?

[KatieW]

You will definitely get better prices on the internet. But you must be willing to do your homework, so you can order exactly what you need. Get a copy of the results of both your sleep study, titration, and your prescription.

It wouldn't hurt to talk to the Equipment Supplier, and find out the exact make and model they are offering you for $1200, and whether it's new or re-conditioned. Be careful here, many models have similar sounding names. Then go on-line, and and compare costs.

The one advantage of buying in person is that you can try on a variety of masks. But if you buy a mask on-line, you can buy mask insurance, which gives your 30 days to return for a refund of the purchase price.

Read as much as you can at this forum, plus here is an excellent blog:

http://smart-sleep-apnea.blogspot.com/

Here is a list of machines that are data capable. I would recommend printing this list for future reference:

viewtopic.php?p=307168#p307168

[Muse-Inc]

A machine will come with a long hose that connects to the mask. If you get a ResMed machine it also comes with a travel case. We recommmend you get a heated humidifier, they can cost from $150 and up. The mask I currently wear is selling for $98. There is a lot of info under Where A Newwbie Should Start . The top 2 mfgs are ResMed and Respironics but there are other good machines. First find out what kind of machine you need, CPAP or autotitrating CPAP (APAP), Bi-level CPAP, or a servo ventilator...most likely one of the first 2. CPAP (continuous positive air pressure) delivers one pressure while an APAP delivers pressure based on your preceding several breaths. There are multiple types of masks: the main ones are:
Nasal that covers the nose
Pillow (weird name) that has these sorta fat very short straw-like things that sit at the end of your nose...sounds weird but very comfortable
Full Face that covers the nose and mouth, touchs the forehead to stablize the mask on the face
Hybrid that covers the mouth and has pillows so it does not cover the nose or toruch the forehead
There are other styles of masks. The most popular is the pillow mask tho if you are a mouth breather or have chronic congestion issues, it's a challenge as you will likely lose therapy air (that's supposed to stent open your airway) via your mouth.

The Sleep Sudy provides valuable info for optimizing your therapy and determining the right course for recovery. At a minimum it determines the right pressure to eliminate apneas and hypopneas.

[el_zorro]

Why do i need the sleep study and prescription. I thought all that was needed was a prescription to buy the equipment what is the sleep study used for?

The sleep labs usually do the diagnosis on the 1st sleep study then they start you on a machine and mask on the second sleep study. They look for compatibility issues (some people have major issues with straight CPAP) and then they vary the titration pressure and turn it up until it controls your snoring and apneas. They also usually let you try on different masks until you find the one you are comfortable with. The combination of these (machine type, pressure setting and mask) are what goes on your prescription. So it is very difficult (or impossible) to get a prescription without the second study. This is usually called a titration study.

Many people ask the same question that you did, "why the 2nd study". It is a very good question. Technology exists that may make the second study unnecessary for most people (APAP) but because of some rare conditions, the medical community has deemed the second study necessary.

[DBoone]

Do a search here on the forum and find out what your prescription should preferably say. If you can get a script for an auto machine that's data capable and the software to go with it that would be best.

You can do a lot better than $1200 by shopping cpap.com. I spent a little over $800 last year to get the machine, software and card reader that I wanted.

[Doze]

I imagine your first sleep study was not free. How potentially unfortunate that they're asking you to do a second one across the calendar-year break btw 2009 and 2010. I pushed hard late last year to ensure my CPAP study and equipment purchase were done by December so all the costs were put in the same year and against the same deductible. It's a shame to have split some major costs already, but depending on what else you reasonably expect for 2010, and what your post-deductible contribution is, you may still be lower out-of-pocket going the in-network route with insurance.

You're very *very* likely to do much better online as most have already said; I'm not trying to disagree with those sentiments, but don't just assume that's the case for all situations. Consider well if you might hit your $2000 deductible for other reasons anyway in the next 11 months and 29 days. Any known future medical expenses should absolutely be factored in directly. But beyond that, how large your family is, your age, any [covered] dependents ages and how prone they are to risky behavior (got a teenage son that's into skateboarding, perhaps?) are all potential factors. In my case last year, my toddler had significant expenses mid-year, and everything related to CPAP for me was covered at 90% so I went in-network and it was all a bargain. If I'd had my CPAP expenses early in the year though, I wouldn't have known about my son's upcoming unexpected expenses and might have opted for an online purchase. By the end of the year that would have eventually proved to have been the more costly route, but with imperfect information at decision time, sometimes that happens.

Another factor might be if you have HSA or FSA funds to pay with, and if online purchases can be made with those funds - or how likely you are to independently submit forms/receipts against those accounts otherwise. That's something I've been wondering actually. Anyone know for sure or have experience with using HSA/FSA credit/debit accounts upon checkout at our host site?

[thewetlizard]

Sorry, I can't help much on this subject because the V.A. lent me my equipment to me for free.

[riveredge1]

I got my stuff at cpapusa.com--the owner Mark is a cpap user and very nice to talk to and order from--got a good deal as they retired the machine i wanted for a new model--be sure and get one with software you can use to keep track of what goes on at night--mine has not let the public have software yet which has me looking for another machine until then--but i need a back up so it is all good--this board is fantastic and lots of comforting folks here--

[sleepnewbie1]

Do i still need the prescription if I buy the machine from the Sleep Center?