NPR article about insurance not wanting to pay for CPAP

[MrGrumpy]

Same old sh*t, different decade. You suffer from an illness, you have health insurance and "think" youre covered and good to go. You go to a doctor, they tell you "yeah, you might have sleep apnea but its really expensive. Why not just lose some weight that usually gets rid of apnea. Or sleep on your side." Who is gonna go around sleeping on their side all the time, when they are unconscious?

Its the old health insurance tightway misers, narrow minded pissmires who are behind the strings, at your state legislatures lobbying for laws that allow them to get away with murder (no pun intended).

Read this article, its an NPR article about the American system of private health insurance and their being unhappy with having to pay for "all these sleep studies and CPAP machines." One quote is from some Blue Cross Blue Shield of North Carolina asswipe who claims to be a "specialist in fraud." LOL

http://www.npr.org/sections/health-shot ... rent-happy

[jonny515]

I wonder if this is even true, wouldn't CPAP, sleep tests and so on be a LOT cheaper than just a single cardiac hospitalization?

Same old sh*t, different decade. You suffer from an illness, you have health insurance and "think" youre covered and good to go. You go to a doctor, they tell you "yeah, you might have sleep apnea but its really expensive. Why not just lose some weight that usually gets rid of apnea. Or sleep on your side." Who is gonna go around sleeping on their side all the time, when they are unconscious?

Read this article, its an NPR article about the American system of private health insurance and their being unhappy with having to pay for "all these sleep studies and CPAP machines." One quote is from some Blue Cross Blue Shield of North Carolina asswipe who claims to be a "specialist in fraud." LOL

http://www.npr.org/sections/health-shot ... rent-happy

[chunkyfrog]

I think much of this insanity is a relic of employer-provided insurance;
where an insurance company offered a good deal to get the contract,
but gradually raised premiums while reducing coverage until time for renegotiation.
Insurance companies avoided wellness and preventive coverage
in hopes that the next company would get stuck with the inevitable big bills.
Appropriate treatment was delayed as long as they could get away with it.

[Drowsy Dancer]

I notice that this article is four years old. Fortunately, the trend doesn't seem to have continued.

The article is correct that a lot of people who are prescribed the machines aren't adherent. But that doesn't mean that the machines were misprescribed...

[Mudrock63]

I notice that this article is four years old. Fortunately, the trend doesn't seem to have continued.

The article is correct that a lot of people who are prescribed the machines aren't adherent. But that doesn't mean that the machines were misprescribed...

Perhaps this is where the compliance protocols came from? I can't blame them for not wanting to pay for an expensive piece of equipment that in many cases is not used.

[ChicagoGranny]

I notice that this article is four years old. Fortunately, the trend doesn't seem to have continued.

I can't blame them for not wanting to pay for an expensive piece of equipment that in many cases is not used.

+1

Thanks to both of you for bringing some sanity to the rant.

Let me add that we, as insurance consumers, should not want insurance companies "to pay for an expensive piece of equipment that in many cases is not used." It just drives up our rates.

[MrGrumpy]

Ive experienced only one insurance company that acted like it was "enthused" about treating my sleep apnea. My insurance changes every three to five years, so Ive had about all the PPOs and a few HMOs. HMOs...FORGET IT. They wont pay for CPAP. At least in my state. PPOs? You have to push hard and get a sleep doctor who will advocate for you.

My experiences have not been very good with the insurance part of it with regards to this CPAP stuff. I got lucky one time years ago and that got me out of the hole long enough to where I could figure out what the root cause of things were...SLEEP APNEA. But these insurance companies are so overfocused on obesity and "lifestyle changes," because it does not cost them much if any money. And insurance is mostly full of stupid people who believe anything they are told in insurance training, so WTF do they know?

[Sir NoddinOff]

I think much of this insanity is a relic of employer-provided insurance;
where an insurance company offered a good deal to get the contract,
but gradually raised premiums while reducing coverage until time for renegotiation.
Insurance companies avoided wellness and preventive coverage
in hopes that the next company would get stuck with the inevitable big bills.
Appropriate treatment was delayed as long as they could get away with it.

I think this is true... I saw a lot of it when I was in private industry and also my wife saw a lot of it as a librarian. Promise them the sun, moon and stars then let 'em bite the dust when they've had the contract awhile. Then on to the next suckers.

[Sir NoddinOff]

But these insurance companies are so overfocused on obesity and "lifestyle changes,

It doesn't necessarily follow that this is a bad thing. Prevention is a big part of overall health. Especially in the USA where obesity and non-exercise is rampant.

Also, I don't think my wife's and my free insurance paid spa memberships are all that cheap, tho, maybe in the big picture with reduced overall health problems I suppose they could be considered 'cheaper'.

[MrGrumpy]

Health insurance company executives are the absolute last people I listen to regarding healthcare stuff. So far as Im concerned, the only reason you exist is the three S's. Sit down, Shut up and SHELL OUT when ordered to. Its attitudes like yours that led to the Affordable Care Act and no I did not vote for obama. And will eventually probably lead us to a single payer, government run medical system like Canada has.

Private insurance just gets in the way of patient's healthcare, its an obstruction to getting care.

But these insurance companies are so overfocused on obesity and "lifestyle changes,

It doesn't necessarily follow that this is a bad thing. Prevention is a big part of overall health. Especially in the USA where obesity and non-exercise is rampant.

Also, I don't think my wife's and my free insurance paid spa memberships are all that cheap, tho, maybe in the big picture with reduced overall health problems I suppose they could be considered 'cheaper'.

[Hang Fire]

HMOs...FORGET IT. They wont pay for CPAP. At least in my state.

You are FOS old man. Do you think no one else on this forum lives in NC and can catch you in lies?

I live in NC and have BCBSNC HMO and it paid for my CPAP machine without any question or delay and continues to pay for my supplies on a regular basis. I have no problem with this insurance and signed on again for 2016.

And insurance is mostly full of stupid people who believe anything they are told in insurance training, so WTF do they know?

You are too stupid to be hired by any insurance company. You are too stupid to read your benefit book.

[Iamagolfer]

Interesting article even tho it is a few years old.

I know myself that compliance is a huge issue but in many cases for good reason. When I was diagnosed 20+ years ago, I never was given a choice of masks. Of course I was not compliant. The mask was horrible. I was not overweight either - BMI was 23.

After having the UPPP surgery (I was desperate to get some quality sleep) I am now worse off - don't recommend it to anyone.

Finally with all of the masks available today, compliance has improved greatly in my case. As most of you here know, that the mask is critical....as is the monitoring IMO. Accountability is important.

Still waiting to try the DreamWear mask which I believe will help me even more but the small size has been out of stock (even per the manufacturer) for a while. What's up with that?

[MrGrumpy]

You sound as if you are an "insurance lover." Sad...very sad.

HMOs...FORGET IT. They wont pay for CPAP. At least in my state.

You are FOS old man. Do you think no one else on this forum lives in NC and can catch you in lies?

I live in NC and have BCBSNC HMO and it paid for my CPAP machine without any question or delay and continues to pay for my supplies on a regular basis. I have no problem with this insurance and signed on again for 2016.

And insurance is mostly full of stupid people who believe anything they are told in insurance training, so WTF do they know?

You are too stupid to be hired by any insurance company. You are too stupid to read your benefit book.

[Mopheus]

All out of pocket for me. In home sleep study $400, machine etc $1000. Have had some good nights but still rocky.
I don't understand why insurance won't cover sleep stuies, so much cheaper than a heart attack.

[ChicagoGranny]

All out of pocket for me.

I don't understand why insurance won't cover sleep stuies

You do realize these two statements are contradictory?

Out-of-pocket costs are costs for covered items below your annual out-of-pocket maximums.