Need to buy a CPAP. Any suggestion ?

[Gourou]

Hi,

I'm having severe sleep apnea and I'm using a "loaner" CPAP from my hospital. I finally got a medical insurance and now I want to buy my own !

The hospital landed me a CPAP which I can't tell the model... it has an humidifier with a heater and a 20 minutes ramp.

I know some criterias I want for my CPAP: the humidifier with the reservoir, as less noise as possible, smallest possible (mine is heavy to carry in my luggages)

I don't know much about other CPAP... What other gadgets or criterias should I look at ?? I think my insurance are gonna pay me 100% of any price so I don't have to sacrifice functionalities for the price...

Any suggestions please ?

Are there website where I can see a list of different CPAP from differents companies with all their specs, prices and everything ?

Thanks!

[dieselgal]

I like my ResMed Elite S8, but I don't think it is the least expensive.

[Gourou]

Thanks dieselgal, I followed the link in your signature and found out https://www.cpap.com

I think some CPAP have logging and monitor features? (like connect to a computer and upload data) What does it keep track of exactly ?

[TXKajun]

Hi, Gourou and welcome to our crazy forum.

You might try going through the info under "Our Collective Wisdom" at the yellow lightbulb here. It's got lots of stuff about the different kinds of CPAPs and masks that you'll probably find useful.

A short answer (and remember, all this is only my 2 cents worth...YMMV), I love my Puritan Bennet 420E APAP with heated humidifier and the Silverlining software. Our hosts at cpap.com has a nice little "bundle" where they sell the entire package in one swoop. The 420E is small, portable (yep, I travel about once a month via airplane), has complete data capability and the software is easily available, doesn't require anything else such as a card reader or card, and is extremely user friendly. It can be used either in APAP mode or CPAP mode.

As far as what it doesn't have, it doesn't have any type of CFLEX or AFLEX for exhale relief, but even at my highest pressure of 15 cm, it doesn't seem to matter, at least to me.

Others are gonna chime in with their favorites, so stick around and again, welcome to the board!

Kajun

[CRMW]

Something else to keep in mind are your power requirements, there are CPAP's that will operate not only on 120v, but also 240v for europe etc. and 12v DC for camping.

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[DreamStalker]

Many of the cheaper models that a typical DME will dump on you are the machines that only provide compliance data (ie. how many hours you used it for).

The most important criteria is that it be capable of providing efficacy data (ie. leak rate, apnea-hyponea index, and pressure).

The following 3 manufacturers have data capable models:
Respironics (3 or more models)
ResMed (2 models)
Puritan & Bennet (2 models)

... just make sure you get the right models as they too make some which do not provide efficacy data.

All other criteria such as size, noise, humidifier, and exhalation relief should be secondary.

[Gourou]

Pretty good point... I have read that long debate thread about self-adjusting my pressure and I really love the idea! as someone mentionned, our "needed pressure" has been determined by only one night in a cold little room in an hospital... things might have changed since, and also i'm sure every body agree that it was not one of our best night...

thanks for the list of cpap having precise data gathering, i won't have to go through the whole list of them

I know my insurance company would be better to answer that question but... if they happen to be paying 100% of my xPAP... do you know if they will try to have me buy the cheapest? aren't they gonna say stuff like "You don't need monitoring software, just follow your doctor advice", and so they're gonna deny my request for something like your very cool apap...

[quote="DreamStalker"]Many of the cheaper models that a typical DME will dump on you are the machines that only provide compliance data (ie. how many hours you used it for).

The most important criteria is that it be capable of providing efficacy data (ie. leak rate, apnea-hyponea index, and pressure).

The following 3 manufacturers have data capable models:
Respironics (3 or more models)
ResMed (2 models)
Puritan & Bennet (2 models)

... just make sure you get the right models as they too make some which do not provide efficacy data.

All other criteria such as size, noise, humidifier, and exhalation relief should be secondary.

[Gourou]

OMG! I thought "our collective wisdom" was just a figure of speech, meaning to read the whole forum... hahah just found what you were talking about, thanks i'm gonna take a look at it

your APAP sounds pretty cool, i'm going to have a look at it too... lots of reading !

Hi, Gourou and welcome to our crazy forum.

You might try going through the info under "Our Collective Wisdom" at the yellow lightbulb here. It's got lots of stuff about the different kinds of CPAPs and masks that you'll probably find useful.

[DreamStalker]

Insurance doesn't care ... they pay the same amount regardless of brand or if CPAP or if APAP or if data capable or not ... they use same code.

The problem is with the DME who will try and maximize their profit at the expense of your health treatment.

[Slinky]

For insurance purposes there are ONLY two types of xPAPs. All xPAPs are billed by insurance code (HCPCS code). All straight CPAPs from bare-bones, not even compliance data capable only thru fully data capable autoPAPs are billed by ONE HCPCS insurance code: E0601. Bi-levels, SVs, etc. are an entirely different HCPCS code. Thus autoPAPs, whether the DMEs like it or not are considered for insurance purposes and HCPCS coding as CPAPs.

The sticker w/the DMEs working w/insurances is that they contract w/the insurances for ONE price for ANY CPAP (HCPCS code). So the DMEs working w/insurances get paid the same ONE agreed upon price for a bare-bones CPAP as they do for a fully data capable autoPAP. Which means the fully data capable CPAPs and autoPAPs cut into their profit margin.

So many less than truthful local DME suppliers will tell you that your insurance won't pay for a fully data capable CPAP or autoPAP and that they will only pay for that little ole bare-bones CPAP they want to give you to protect their profit margin.

You are defeating your purpose and doing yourself no favor by telling or making your insurance aware that you want a fully data capable CPAP or autoPAP "and" software to monitor your own therapy. Nor will you be doing yourself any favor by making the local DMEs your insurance is contracted with WHY you want a fully data capable CPAP or autoPAP.

Your reason to doctor and DME supplier for wanting a fully data capable CPAP is because you would not feel comfortable with your doctor not having access to the data during your CPAP therapy. How else is he to monitor how you are doing? W/o that data how is he going to know what problems you are having and what adjustments may need to be made to your pressure? You won't feel comfortable if he has to go by guess and by gosh!!

Also, I know of no insurance company that will pay for the software and reader cable. That will be your cost to pay if you want it.

[Gourou]

I called them yesterday and they told me to send them a prescription with details of the xPAP i want, so they can tell me if it would be accepted or not ...

So you're saying I just need to have my doctor prescribe me a precise cpap, with brand and model, then the insurance company will accept it ?

or you saying they pay like (example) 750$ maximum for whatever xPAP ?

Insurance doesn't care ... they pay the same amount regardless of brand or if CPAP or if APAP or if data capable or not ... they use same code.

The problem is with the DME who will try and maximize their profit at the expense of your health treatment.

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[TXKajun]

Gourou, the more specific you can get your prescribing Dr. to be, the better chance you'll get exactly what you want/need.

Now, with that said, be prepared to fight for what you are prescribed, especially if you're going through a DME! One good option is to go with "billmyinsurance.com", a sister-site of our host. They'll try and work with your insurance company and get you the best deal out there on exactly what you want. Another option would be an outright purchase by you from our hosts (yep, you'll ned a prescription for it, but it can be less specific) and try for reimbursement either from your insurance company or from your flex-fund if you have one.

Good luck!

Kajun

[linuxgrl]

Ugh. Yes, do be prepared to fight. My DME called me this morning at 7:45 (probably trying to catch me when I'm not too alert) and told me that it would be an extra $550 for the data capable machine.

I don't even know what to say to that. My insurance, like yours, pays 100% after my deductible is met (which it has). So these lovely people are going to screw me over and I 'm not sure what to do about it.

I am considering taking their POS machine and selling it, and buying my own out of pocket. Because for $550, I can get a top of the line APAP with no insurance involvement.

So many less than truthful local DME suppliers will tell you that your insurance won't pay for a fully data capable CPAP or autoPAP and that they will only pay for that little ole bare-bones CPAP they want to give you to protect their profit margin.

You are defeating your purpose and doing yourself no favor by telling or making your insurance aware that you want a fully data capable CPAP or autoPAP "and" software to monitor your own therapy. Nor will you be doing yourself any favor by making the local DMEs your insurance is contracted with WHY you want a fully data capable CPAP or autoPAP.

Your reason to doctor and DME supplier for wanting a fully data capable CPAP is because you would not feel comfortable with your doctor not having access to the data during your CPAP therapy. How else is he to monitor how you are doing? W/o that data how is he going to know what problems you are having and what adjustments may need to be made to your pressure? You won't feel comfortable if he has to go by guess and by gosh!!

[/quote]

[Slinky]

First off, here is a suggested script (as I remember it) that I purloined from RestedGal who is one sharp lady!!

1] Respironics REMstar M Series Pro w/C-Flex (w/heated humidifer if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] C-flex setting 3
4] Ramp off (unless you prefer it on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifer. If so just add "w/heated humidifier to the REMstar Pro)
7] Nasal mask, Full Face mask, or nasal pillows mask of patient's choice.

or for an autoPAP

1] ResMed S8 AutoSet Vantage (w/heated humidifer if you prefer)
2a] IP ---- cms (whatever your inhalaltion pressure is)
2b] EX --- cms (whatever your exhalation pressure is
3] EPR setting 3
4] Ramp off (unless you prefer it on)
5] Efficacy & Usage Data access
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifer. If so just add "w/heated humidifier to the REMstar Auto w/A-Flex)
7] Nasal mask, Full Face mask, or nasal pillows mask of patient's choice.

You will notice the similarities to each suggestion.

1] Exact brand and model of machine
2] Scripted pressure (the autoPAPs have a pressure range rather than a set pressure)
3] Scripted amount for lower pressure at exhalation
4] Starts w/4 cms of pressure and ramps up to your set pressure after you get to sleep
5] Allows you to access your nightly data via the LCD screen
6] While the integrated humidifiers are most convenient for travel and take up less space on your nightstand, in really dry situations sometimes they can't provide as much humidity as you might need or want. For many the integrated humidifiers are more than satisfactory).
7] This ensures that you can try several masks, including a full face mask (sometimes they insist on a script specifiying full face if the script just says mask, or will only provide the exact mask mentioned in the equipment order).

One thing it "is" wise to do is to call your insurance company and ask them what local DME CPAP suppliers they are contracted with. Hopefully you have the option of more than one. That way you can "shop" those contracted w/your insurance and see which one you feel most comfortable w/or will offer you the best deal. Their mask exchange policy is often an important issue.

LinuxGirl, if you have the option, shop the other local DME's your insurance is contracted with. If you don't have the option, and you are willing and able to buy online, accept the machine they are willing to give you and use it as your backup machine. Use it enough the first month to establish compliance so your insurance will pay for it. But buy what you want out of your own pocket online.

[linuxgrl]

Great script Slinky, thanks for that! I'm not exactly sure what I say to these companies that I'm checking out. How do I know they're not just like the last one?
I would go with billmyinsurance.com except that I think I've already established service with this DME and according to them, most DME's won't take you after you've started because insurance only pays for 13 months.

This is all really frustrating. And now I can't even get hold of the lady at the DME. She's incredibly busy and never calls me back. GRRRRR.

Unrelated question... can ANY doctor write a prescription for a CPAP or does it have to be a sleep specialist? Cause I know a guy...

LinuxGirl, if you have the option, shop the other local DME's your insurance is contracted with. If you don't have the option, and you are willing and able to buy online, accept the machine they are willing to give you and use it as your backup machine. Use it enough the first month to establish compliance so your insurance will pay for it. But buy what you want out of your own pocket online.

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