Covered California plans paying for CPAP supplies?

[footballgirl13]

I have a life qualifying event. Well, once I get more hours at work, My income will go up. I expect to be working 64 hours each and every pay period once the middle of May comes around. And I am looking for another position and I'm seeking a sector change from non-profit to for profit with a higher hourly rate. That way I will never be in this position again.

Right now I'm on Medi-cal and I'm almost at the top of their limit which is about $1,350 a month gross or something like that (for a family of one).
I do NOT have to pay for ANY of my CPAP supplies and I just got an approval from IEHP for 12 nasal masks per year and I DO NOT need to pay out of pocket for any of my CPAP supplies due to being under the $1,350 gross each month.

However, everyone was just asked at work if anyone can work more hours and I'd like to work more than 24 hours a week and now I'm more than likely be over the income threshold for Medi-cal once May comes. I need to report my earnings to Med-cal (the state Department of Social Public Services) 10 days after I earn over that threshold of $1,350 or whatever it is.

I see Enhanced Silver 94 plans and I see Bronze 60 plans (four each). Of course the Bronze 60 plans have a lower monthly cost (premium) that go from $1 a month to $26 a month. The Silver 94 plans start a$34 a month and go up to $81 a month. I'm assuming that the lower premium will mean that I may need to pay out of pocket for the CPAP supplies, no matter if I earn $1,400 a month gross or $1,600 a month gross.

I really don't want to have to pay out of pocket for ANY of my CPAP supplies. Having to pay each and every single month for one nasal cushion can get expensive and I'm not sure if any of these plans (all of them under Enhanced Silver and Bronze 60) will cover the cost of the CPAP supplies.

I'd much rather pay $50 a month for a premium if it means that I can get all of my CPAP supplies at no cost. It's not like getting $704 every two weeks gross is a lot of money and I already calculated all of my expenses going out and it is about $470 or more every two weeks. Once I start working 64 hours in each pay period, it will leave me enough for me to pay $50 a month for a premium on one of these plans, but I will not be able to afford my CPAP supplies each month. If I can't afford my CPAP supplies, how will I get them? is there a special thing in Covered California for people with Sleep Apnea?
Is anyone else in this predicament?

[Julie]

Can't talk about any of your insurance issues, but why do you need a new cushion every month? Because they offer one? Some of us use them for months, years, etc... til they wear out, not til some co. charges our insurance by handing them out.

[Janknitz]

We just started a Kaiser silver plan. It seems to cover crutches and blood glucose meters, but I don't see CPAP or supplies in the Evidence of coverage. BUT, I'm not positive--I don't see oxygen on the list either. I can't see how they could not pay for that if medically necessary.

[palerider]

I really don't want to have to pay out of pocket for ANY of my CPAP supplies. Having to pay each and every single month for one nasal cushion can get expensive

gee, what a thought, if people had to *pay* for stuff, they might stop being wasteful and throwing away perfectly good cpap supplies just because a DME wants to pad their profits by selling a new one every month...

use 'em till they *NEED* replacing, then buy 'em cheap online or from amazon or ebay