One month check in - feeling awful about life.

[guttersnipe]

Went to my one month check in. I'm under control!
But now they want to find my "ideal pressure" so they want two more nights of home sleep test - which will be another 300 dollars after discounts for insurance. And a $150 deposit to do it.
When does it end? I already had a study. I already did this. I can't afford to keep paying like this. Why is it so expensive to not want to die?

[Gasper62]

Something about that sounds a little 'fishy" to me. Do you currently have a machine that you sleep with ?

[guttersnipe]

I do.

I did two nights of home sleep study initially and they said - You have sleep apnea. Take this Auto-CPAP. It is set to 6-12 pressure. See you in a month!

Now they are like - Great it's under control! Looks like you're usually set at 8-11. We need to find your optimal pressure! You need two more nights of sleep test that cost $$$$$$. Also there is a $150 deposit before we can even schedule it.


But....I thought I already had a machine, am 90% compliant and under control....

I'm about to change jobs, and my insurance will be all topsy turvy for a while so I wanted to get this under control. I don't know what to do.

[Wulfman...]

Sounds to me like they're stringing you along for the ride........$$$$$$
They probably know how long they can stretch it with the insurance payouts and your finances and will take it to the limit.
But, what they're doing, you could have done by yourself (with the help of a few on this forum) and saved lots of greenbacks.


Den

.

[Janknitz]

The sad thing is that with a fully data capable machine, you could easily determine the ideal pressure or range of pressures yourself, you don't have to pay them to do it.

Do you still have the loaner machine? If you do, tell us the make and model and we can help you download free software so you can see the data and determine the best pressures yourself.

If not, you can ask you doctor to simply prescribe for you an auto-machine as your permanent machine and you can take it from there.

Switching insurers on CPAP is always challenging. Does your current insurer require rent to own or purchase? What will the new insurer require? Do they contract with the same DME companies? It's going to be a bit of work to sort all these details out, or you can skip all that by buying your own machine out of pocket, new or used, online. In the end, if you have deductibles and co-payments for both the old and new insurers, you may come out ahead by doing this, and it will certainly be less frustrating.

[guttersnipe]

Sadly I don't have the funds to buy one out of pocket.

Such is life in America.

[Michelle-OH]

I would call your insurance directly and ask if this is how the process really works. Is the machine you have just a loaner? Or is it a rental thru the insurance? I've not heard of someone having to have a sleep study after they've already been using the apap for a month. I swear I don't trust any dme providers, mine just tried to bill me Jan and Feb, for a cpap that I returned to them in Dec!

[robysue]

I do.

I did two nights of home sleep study initially and they said - You have sleep apnea. Take this Auto-CPAP. It is set to 6-12 pressure. See you in a month!

Now they are like - Great it's under control! Looks like you're usually set at 8-11. We need to find your optimal pressure! You need two more nights of sleep test that cost $$$$$$. Also there is a $150 deposit before we can even schedule it.

That Auto CPAP is perfectly capable of figuring out what pressure you need. And if you are usually between 8&11cm of pressure, "they" already know what a near optimal pressure is and tweaking it to find the optimal pressure does not require more home sleep tests.

By the way: What kind of an Auto CPAP are you using?

I don't know what to do.

Tell us the following and we can help you figure out what to do next:

1) Is the APAP you are using a loaner, or have you or your insurance purchased the machine (or are in the process of purchasing the machine)?

2) What country are you in? Most of us are in the US and so we sometimes assume everybody is in the US. (BIG mistake---there are lot of people on the forum who are not from the US.) But if we knew where you are, we might not make some bad assumptions on how the system works where you live.

[Janknitz]

Sadly I don't have the funds to buy one out of pocket.

Such is life in America.

I feel for you, we are in the same boat.

BUT, you have to figure this out so you don't end up paying more than you have to. You need to know:
1. What deductibles and co-pays you will have if you get the machine through your current insurance.
2. Will your current insurer buy the machine outright or require you to rent it for a period of time (what period of time)?
3. What DME providers are covered by your current insurer?
4. If you can possibly find out anything about the new insurer, you need the same information.

You may be able to buy a great machine on Craigslist for $200 to $400. It could cost you much more than that for the deductibles, co-pays, from one or both insurers. You also need to know if it would be worth waiting until you get to the new insurer--maybe the new insurance coverage is really good, and waiting until that starts will get you a brand new machine for very little money. I know it will probably be difficult to get information about your new insurer. The HR department at your new employer may be able to help you get the info, but you have to decide if you are ready to disclose to your new employer that you have this medical condition (if you are fully hired, they cannot rescind the offer of employment if you disclose this).

[guttersnipe]

I just drove back over there and got this sorted out.

I can opt out of this second test for a while. So i'm cleared on cash.

Current plan is to get the new job (contract) buy my own insurance (yay obamacare) that includes my provider in network. Then save up the money and just buy a machine myself out of pocket with the big raise.

[Goofproof]

Sadly I don't have the funds to buy one out of pocket.

Such is life in America.

It doesn't sound like you have enough money for their scams either. If it were me, I'd buy a good used one from someone, instead of feeding the piggy. Jim

[LSAT]

I just drove back over there and got this sorted out.

I can opt out of this second test for a while. So i'm cleared on cash.

Current plan is to get the new job (contract) buy my own insurance (yay obamacare) that includes my provider in network. Then save up the money and just buy a machine myself out of pocket with the big raise.

If you purchase a good used Autoset machine on Craigslist or from someone on this board you won't have to worry about insurance or your provider. Good machines can be purchased for under $300.

[Janknitz]

I'm looking at ACA plans now. They all have HUGE deductibles. We can't possibly use up those deductibles barring a catastrophic illness or accident (G-d willing we won't!). I'm feeling pretty frustrated that this is going to cost us a LOT of money for insurance we won't even use.

If you plan to go on ACA, unless you will qualify for a big subsidy with no deductible you might as well buy yourself a good used machine. You certainly aren't going to get much from ACA.

[tazmania]

Sadly I don't have the funds to buy one out of pocket.

Such is life in America.

guttersnipe. I just bought a Respironics System One on Amazon without a prescription for $465. When I bought my first machine through the insurance company over 8 years ago I paid over $550 AFTER insurance.

It is far cheaper to buy a machine outright then try to buy one through insurance. Unless you have some amazing insurance plan. Maybe your new plan is that ... but I doubt it. Too many greedy people with their hands in the pot.

Do not rent equipment. You'd be better off getting a loan to buy one than to pay rent on a device.