New To Cpap's...Need Advice

[Hawthorne]

Adding the card slot attachment and card will only let the card tell you how often and for how long you used the machine because that's all the data a Plus will give. You will know that without having a card.

You need a Pro machine to get anything detailed data beyond compliance (how often and how long you used it).

Don't waste your money buying the card slot attachment. Save you money and get a Pro or an Auto sometime in the future. It will come with the card slot attachment and the card.

Your Plus will be a good backup machine for an emergency. You certainly can use it as your regular machine as well but you will not get any detailed data from it.

[fedupwithit]

Thanks for the input. I was hoping the difference between the Plus and the Pro was only the addition of the card slot similar to the way you can add accessories to your car-just mount it and plug it in. Oh well.

[DisneyFan]

I was given the Breeze SleepGear CPAP Mask with Headgear on Thursday, the new dme said my insurance won't cover the one requested on my prescription which is the mirage swift lt.

I slept with it for the first time last night and I woke up with MAJOR neck pains/headacke! I sleep on my side and at times on my back, obviously with this mask, I cannot sleep on my back because of the metal piece on top.

My husband says I did very well on the new rental(plus, but still going to push for the pro)...I slept like a baby.

Which mask is mostly recommended for side and back sleepers?

[Hawthorne]

DisneyFan - Just a comment about what your husband said about you doing well on the Plus - you will do just as well on the Pro.

They are the same machine except that with the Pro you can get some detailed data on the LCD screen or on your computer. To get the even more detailed data on your computer you also have to buy the software and card reader.

Push for the Pro!

Masks are just so individual that it is really hard to say what would be the best one for you. Trial and error is really the only way. Hopefully your DME will let you try some. There are some trials on this forum where you can get a mask to try and then mail it on to the next person on the list. I'm not sure which masks are being trialed that way. Ask Babette. She can lead you to the list, if you want to do that.

[rested gal]

I was given the Breeze SleepGear CPAP Mask with Headgear on Thursday, the new dme said my insurance won't cover the one requested on my prescription which is the mirage swift lt.

DisneyFan, I really think the DME is...to put it politely...misinforming you about what mask your insurance will or won't cover. I think they are "blaming" it on "insurance", simply in order to give you the mask the DME wants to give out -- a less expensive nasal pillows mask.

As far as I know, insurance companies do not dictate which brand/model mask is covered. What insurance does do is enter into a contract with a DME to pay the DME one fixed set amount for "a mask" of a certain type (perhaps reimbursing more for a Full Face type vs nasal or nasal pillows.) Then it's up to the DME and you to decide exactly what mask the DME will give you. I don't think an insurance company would say to the DME, "You can use our mask reimbursement money to give Ms DisneyFan a Breeze nasal pillows mask, but not a Swift LT nasal pillows mask."

If, for example, the insurance company's contract with the DME is that insurance will pay the DME $40 on a nasal pillows mask, and the Breeze costs the DME $20, but the Swift LT costs the DME $45, which one do you think the DME is going to want to stock and give out? I have no idea what the masks actually cost the DME or what they get back from insurance... I'm just making up those amounts as an example.

[DisneyFan]

Well, I called today and now they told me they don't carry the resmed mirage swift lt and I'm stuck with the breeze because it's not returnable, I will have to wait 3 months before the insurance can cover another mask(bummer)...

I also pushed for the "pro" machine, they will contact me tomorrow to let me know.

[Guest]

DisneyFan - for the love of God, find yourself a new, reputable DME. To tell you that you're stuck with a mask you can't use is ridiculous. Also, you are entitled to ANY nasal mask regardless of whether the DME "orders it" or not.

You are also fully-eligible for a M Series Pro or Auto under code E0601.

You have a bad DME who is giving you less than what you need. Change it.

[fortomorrow]

Well, I called today and now they told me they don't carry the resmed mirage swift lt and I'm stuck with the breeze because it's not returnable, I will have to wait 3 months before the insurance can cover another mask(bummer)...

I also pushed for the "pro" machine, they will contact me tomorrow to let me know.

DME's can special order masks they don't "carry". Mine didn't carry the Hyrbid but because my MD prescribed that specific mask they were obliged to get it somehow.

Beyond that, mask manufacturers have a 30 day return policy. Take that thing back and demand they get you a Swift ASAP.

Or better yet, return the mask and the machine, and tell them you're taking your business elsewhere.

[DisneyFan]

DisneyFan - for the love of God, find yourself a new, reputable DME. To tell you that you're stuck with a mask you can't use is ridiculous. Also, you are entitled to ANY nasal mask regardless of whether the DME "orders it" or not.

You are also fully-eligible for a M Series Pro or Auto under code E0601.

You have a bad DME who is giving you less than what you need. Change it.

This is my 2nd dme..I am just to tired of arguing back and forth with them. I did not know that the masks were returnable? I was under the impression they were not, though my 1st dme took it back(and it was the swift too)...this 2nd one refuses to.

[DisneyFan]

hey everyone!..hope everyone had a marvelous holiday!

Well, as you remember my insurance switched to Aetna now. I called the dme to update my insurance and to let them know I wanted the
M-series Cpap "pro" not the plus which I have now and that I wanted the resmed mirage swift lt(this mask is stated on my rx), I can't sleep with the breeze....The guy told me that they don't have the pro that this is a special order and that my dr. will have to give me a new rx for it...is this true?

I told them to come pick up the machine tomorrow if they can't offer what I requested.

Now that I have Aetna will I need a new rx or can I use the current one with another dme?

[hose head]

if you have the script you can take it anywhere. I hope you get everything settled. I use the Swift LT and sleep on my sides and back. You should push for a data machine, because with it you can see what your mask leak rate, what your AHI is everynight and take charge of your therapy. If you wear your mask every night and it is leaking too much, your therapy is going to work. Good luck.
M

[DisneyFan]

if you have the script you can take it anywhere. I hope you get everything settled. I use the Swift LT and sleep on my sides and back. You should push for a data machine, because with it you can see what your mask leak rate, what your AHI is everynight and take charge of your therapy. If you wear your mask every night and it is leaking too much, your therapy is going to work. Good luck.
M

That's exactly why I prefer the swift lt, I slept better than the breeze I have now...I hope I finally find a good dme, this will be my 3rd one in a month and none seem to want to work with me in getting me what I need.

[Guest]

You don't need a new Rx just to get the M Series Pro....God, what FOOLS are you dealing with down there? That's a shame.

[Wulfman]

You don't need a new Rx just to get the M Series Pro....God, what FOOLS are you dealing with down there? That's a shame.

Ummmmm......... "typical"?

Happy New Year! Glad to see you're still hangin' around.

Isn't there anything YOU can do about this type of situation in the DME industry?
Somehow, I doubt that it's going to get better, anytime soon.


Den

[DisneyFan]

I spoke to a very nice lady at Apria and she said I can get the Respironics m-series auto(she acutally recommended the auto instead of pro) and the mirage swift lt(like stated on my rx), my insurance covers 100%(aetna) and that I did not need a new rx...keeping fingers crossed.