CPAP 6 month follow-up supplies?

[laurie2025]

I got a letter from my DME "provider", Apria. I have apparently been on CPAP for 6 months. They say I should replace my mask, headgear, tubing and filters every 6 months. Now, does this mean my insurance covers these "replacements" or are they just trying to sell them to me? Anybody know? Or would that depend on my insurance? I have a BCBS HMO.
Plus, if I want a new mask, but it's not one they carry, do they have to order it for me, or can they refuse?
Thank you if you can help me out here.

[DeltaSeeker]

Laurie,

Most insurances do cover the replacement of masks and filters every 6 months - some every 3 months. But I would check first with your HMO - they're such stinkers...

If they don't have the mask you want MAKE them order it! When I went in for my mask fitting they only had 2 different kinds of full face masks - as far as I'm concerned that's negligible.

Plus the "A" people wanted to give me an outdated old fashioned machine that was not what I had specifically stated SEVERAL times in both faxes and voicemails that I wanted. They didn't have a problem once they say my insurance covered 100% but I had to go back for a 2nd visit to get the equipment I wanted.

Unfortunately I hadn't been a member of CPAPTalk long enough to know about what mask I wanted other than the FFM. I was concentrating more on the machine and wanted one capable of auto and software capable. I'm going to find another provider for next time as I haven't heard a peep from them and it's been almost a month since I picked up my equipment

From what I understand they should be contacting you in 1-2 weeks after equipment pickup - especially a newbie - to find out if you have any questions/problems, checking on compliance, etc. HA. Not those guys!!!!!

Best of luck,

"the member formerly known as LPADY"

[snoregirl]

There are two issues here. One is what your insurance will pay for and two is when you "need" to replace stuff.

My take after a year is if the insurance pays and the price is right (less than cash purchase without insurance) then take it. If you don't feel you need a new mask yet store the new one or choose a different one to try.

You never know when you will be without insurance so a couple extra hoses in the closet for a rainy day can be great.

Some mask parts may degrade over time so you don't want stuff you are paying for that you will not use for years, but in general an extra mask or two is nice, expecially if you can get a variety.

Filters? Take them when you can get them if the price is right.

[Wulfman]

I got a letter from my DME "provider", Apria. I have apparently been on CPAP for 6 months. They say I should replace my mask, headgear, tubing and filters every 6 months. Now, does this mean my insurance covers these "replacements" or are they just trying to sell them to me? Anybody know? Or would that depend on my insurance? I have a BCBS HMO.
Plus, if I want a new mask, but it's not one they carry, do they have to order it for me, or can they refuse?
Thank you if you can help me out here.

Another thing you might consider (and check with your insurer) is that depending on if you haven't met your deductiible yet this year, you would probably be paying their full retail price for the "replacement" supplies. Even if you have, many insurance providers pay 80% of Durable Medical Equipment. If the prices of Apria's masks and supplies are HIGHLY INFLATED (like I've seen some quoted on the forum), you might be better off buying from CPAP.COM.

Check into it and do the math before you commit to Apria's money-grabbing attempts.

Den

[ddpelp]

not exactly sure if this fits but having discussion about insurance companies this one just came across my email seemed to fit

[Sleepy Dog Lover]

If insurance isn't paying, get just the mask seal or cushion instead of a whole new mask. It will be less that replacing the headgear too.