What to do?

[Oldern]

I started therapy in 2010 with the VPAP Adapt SV machine-some may remember this 9-10 pounder.

In order to get ahead of any potential problems with patients being treated with this machine and who have or had certain heart problems, ResMed replaced the earlier machine with the AirCurve 10 ST, at no cost.

It is now June of 2018 and the humidifier in the AirCurve has gone bonkers. Don't know if the machine can be repaired and if so how much it will cost. (I paid $98 per month for 13 months when I got the VPAP Adapt SV machine-has no bearing on current problem.) My gut reaction is that the repair to the AirCurve unit will be pricey and with no real assurance of how long it will last. (Somewhere I saw a reference to $5,800 for the AirCurve in June 2015-again not pertinent.) Current costs $1,700 w/o warranty? Not sure about this.

If I repair, I will surely be faced with replacement in the future, maybe the near future-20% copay?

I'm guessing the cost of a new machine will be shared by Medicare-haven't had time to check yet. And, that my part will be 20%. Again, I haven't looked into cost sharing arrangements.

Oh, one other thing. The replacement machine I got from ResMed apparently came without any warranty. Imagine that!

Anyway, any thoughts on how to proceed and what I should consider?
Thanks.
Ernest

[Julie]

Define 'bonkers'. Someone might have an idea of what to do. Also, how long have you had it - don't want to presume it's been since 2010)?

[Pugsy]

With Medicare paying part that means you pay 20% of what Medicare allows and not the pie in sky amount that the DME might want to bill out or what you see as retail pricing and it's spread out of 13 months.
If you have straight Medicare and a supplement then the supplement will pick up the 20% of what medicare allows.
Make sure of course that you use a medicare participating provider.
If you have one of those Medicare Advantage plans....you need to check with them directly. Some are a little different in terms of how long they pay. Mine is a perpetual rental....never ends...so I wouldn't want to use it for a machine. Only pertains to some of those medicare advantage plans.

Medicare might pay to fix a broken one. It all depends on how much to repair it.

You might contact acbio.com and see if they can give you an idea about costs.
They repair ResMed machines too.
https://acbio.com/

Alternately I might know of someone with a slightly use AirCurve 10 S/T they want to sale (if he hasn't sold it yet). Would you be interested if the price was in the $600 range?

[Oldern]

I may have to RISE but I refuse to SHINE.
I like it. Absolutely applicable to this octogenarian.

I'm not sure when the 'controversy' with the VPAP Adapt SV first arose but ResMed's issue of the AirCurve 10 to me occurred in 2015. One study about the ". . . ASV Therapy In Central Sleep Apnea and Chronic Heart Failure" is dated May 13, 2015. I followed the issue for awhile but don't know the current status. I had a lot of faith and trust in the Neurologist treating me at the time and who has since retired-darn it!

The humidifier quit heating-I don't know enough to say more.

My trusted DME implied that the repair would likely be pricey, or in the range of my co-pay on a new machine. I don't have an independent confirmation from ResMed that the AirCurve 10 is without warranty. However, and needless to say, I was disappointed but not greatly surprised when my DME shared the news about the warranty.

No question about the M/C payment methodology-in my past life I started dealing with M/C cost reports for hospitals in 1965. That's why the payments were only $98/month-my share of about $6,400. Kind of pricey for 2010 but I was glad to get the treatment.

At the least, it will be informative to check with Advantage (M/C Provider) about payment for repairs. I can do that first thing tomorrow AM. I'm almost on a first name basis with several people at Vantage Health Plan. They are very helpful.

Good suggestion to check with https://acbio.com/

Thanks. I started reading the posts on this site a long time ago.
Ernest

[Pugsy]

I don't know if there has been any reversal of the recommendation about "no ASV to heart failure patients with ejection rates of 45 or less" since that study was released. I think there was initial panic and no one with heart failure was supposed to use ASV and then they decided 45 or less ejection rate was a cut off point. I haven't kept up with that side of things.
When all else fails...ask your doctor and review what your last heart test showed in terms of ejection rates.

Warranty on ResMed machines is 2 years at the best. If it's been over 2 years probably out of lucky anyway.

Unfortunately one of the drawbacks to having that humidifier built in...if it craps out you can't just go replace the humidifier like you can with the other brands.

Do give acbio.com a call because if you are getting some sort of error message they might be able to troubleshoot a bit with you over the phone.

[Oldern]

Sir! You do a great service!

I'm very tight with a cardiologist-heart cath 2005, 2010, various monitors (or thereabouts) and pacemaker 2017. No problems that I know of. Ejection fraction anomaly (if it is one) has been around for a number of years.

I just saw a reference to the clinical manual downloadable-not sure if my particular machine is listed. But I will check it out.

Ernest

[Pugsy]

Don't know where you were looking at the manuals but you can find them here.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
You have to request it via email but it's set up for automatic email if you follow the directions.
If not I think I have AirCurve 10 S/T clinical manual somewhere hidden in my downloads as I used to have that machine.

If your ejection rate isn't bad I think that they have lessened the warning about ASV and heart failure patients.

As always run all this by your cardiologist.

[chunkyfrog]

Could the HC150 by Fisher-Paykel be used with the end cap on the Aircurve?
Of course, the heated hose is out of the question unless one uses the Aussie hose instead.

[Pugsy]

Could the HC150 by Fisher-Paykel be used with the end cap on the Aircurve?
Of course, the heated hose is out of the question unless one uses the Aussie hose instead.

You know I think it could but the problem might be that with the humidifier being integrated the damn blower won't work if their is a fault with the humidifier somewhere.

If it will blow air...yeah a person could maybe use the end plate thing and stick a stand alone humidifier like the HC150 beside it.

I just don't know if it will still blow air or not....if it will, yeah worth trying.

[chunkyfrog]

I guess the sidekick HH might interfere with user feedback--probably not a great idea.

[Pugsy]

I guess the sidekick HH might interfere with user feedback--probably not a great idea.

Might work with the end plate being used instead of the water chamber.
I just don't know but I bet acbio.com would know.

[Oldern]

I'll talk with DME person tomorrow and see what he says. Also, I think I need to contact ResMed direct to see what they have to say.

Doesn't look to good-either cost to repair or 20% of new machine! Warranty of sorts will come with a new machine. Stuff happens.

Does anyone have any experience with the fail rate of the AirCurve 10, anecdotal or real life?

btw, I must be doing something wrong when trying to download Clinician Manual for AirCurve 10ST. Can't get access on the Apnea Board. Not sure of exact name, but have tried several times.
Ernest

[Pugsy]

Use this link for the apneaboard. I know it works.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

[OkyDoky]

Use this link that Pugsy gave above. Scroll down to section three and follow their directions to receive by email.

[Oldern]

I have submitted my request for Clinician Manual. Thanks for the clarification.

Should get a reply tomorrow.

Many thanks.

Ernest