Cost of CPAP

[Tschno]

My wife is recently dx'd with sleep apnea. Her Dr. is going to prescribe her a CPAP machine. They told me the cost is about $2800 for the machine. Is this reasonable? Do most people buy them from the DR's office? I have a $2000 decuctibe and a 70/30 policy so most of it will be out of pocket. Just want to be sure since I have little info at this point.

[FoxNewsFan]

Before doing anything, spend as much time as you can reading and asking questions. It will prevent you from making poor choices and save you a lot of money. Start by clicking on the light bulb above.

Ed

[jules]

You need to find out what her prescription will say. Once you have the prescription (YES get it), bring back that information and people here can suggest what machines she can use. It makes a difference as not all machines offer the same therapy.

Online prices are a lot cheaper. However, it means no local service. If the doctor will provide help with masks and all, buying online is probably the way to go.

Unless this is a fancy bilevel, that price sounds high.

[tdm5032c]

I depends on what type of machine she needs to get. I'm not sure about the cost of the BI-PAP machines but that seems a bit high even for them. If it's just a straight CPAP or autpap, it shouldn't cost anymore than $1500 even with the mask and needed accessories. My RemStar M series auto machine with A-flex, which I think is one of the best machines out there, cost only about $1200 including the Swift LT mask I got and the heated humidifier. And that was through Apria, which is usually pretty expensive. I just don't think my insurance let them charge anymore than that, lol. They had different prices for different insurance companies when I was initially asking them how much it was going to cost.

Do your research and find out what providers your insurance will let you use and pay for. Most seem to limit where you can buy CPAP equipment from like mine. Before I did my research, the place I had my sleep study done was trying to sell me a straight CPAP machine with no accessories for over $2000!! If a straight CPAP machine is all you end up getting, it shouldn't cost anymore than $500 at the most for a very good machine. I highly recommend an auto CPAP machine right away though as there are many benefits to it and can change the pressure at night as needed to control your events. If it is set right anyway.

Like I said. Do you research. This forum and its great members have been a HUGE help to me on getting educated about my CPAP treatment.

[HeirloomGardener]

Since you will be going through insurance, the price you'll actually pay will likely be less than the "sticker price", assuming you go with an "in-network" provider. Generally, insurance companies contract with the providers for services, and the providers can only charge the contract amount. For example, if the contract amount is $2000 but they bill $2800, the insurance company will "disallow" the extra $800, and you'll only pay the $2000 (or $600 if you've already satisfied your deductible ... is it the same deductible as for the sleep study?).

Also, all CPAPs are reimbursed at the same rate (including Auto CPAPs), and so some DMEs will try to sell you the cheapest CPAP they can to maximize their profits. If you have multiple DME providers in the area that are in-network, call around once you have decided on the machine you want. You may find one that is willing to sell you that one without hassle. The provider I use actually gave both my wife and myself the M-Series Auto, even though the prescription was for a fixed pressure. From what I've read, it is rare to find a DME provider that will do that, but they do exist, so shop around.

[6PtStar]

Check the prices at cpap.com then check and see if your insurance will reimburse you. Prices on-line are a LOT less.

Jerry

[JeffH]

I just bought a bare bones cpap w/humidifier from cpap.com for $290.....you can do the math and see what a money making business this is.


JeffH

[Slinky]

VERY FEW people Dx'd w/apnea get their CPAP from the sleep clinic/sleep doctor simply because the LAW allows VERY FEW such "business arrangements".

MOST people Dx'd w/apnea get their CPAP from an INDEPENDENT from the sleep lab/doctor DME supplier. And a few people Dx'd w/apnea get their CPAP from an online DME supplier such as cpap.com, our host.

Call your insurance company and ask what local DME CPAP suppliers they are contracted with. Hopefully you have the option of more than one. If so, that gives you some bargaining/negotiating room to get the equipment you want (w/in reason).

With a $2000 deductable alone you'd do better price-wise to buy from cpap.com or other online DME supplier. (Not many can meet or beat cpap.com's prices). When shopping online keep in mind that Resmed, Respironics and Fisher & Paykel recently instituted MAP (minimum advertised pricing) policies against the online DME suppliers. So once you've decided on which CPAP you want, call the online supplier's toll-free number and ask if they have an "unadvertised sale price" on the item you are interested in.

As a for instance you can get a:
Resmed S8 Elite w/EPR (fully data capable)
Humidaire 3i integrated heated humidifier
6 Foot Hose
Carrying Case
One Filter
ReScan Data Card
and free shipping
for $439.95 from cpap.com
https://www.cpap.com/cpap-machine/resme ... -cpap.html

or a fully data capable autoPAP (APAP) such as the:
Resmed S8 AutoSet Vantage
Humidaire 3i integrated heated humidifier
6 foot hose
Carrying case
Filter
ResScan data card
and free shipping
for $679.95 from cpap.com
https://www.cpap.com/productpage-bundle ... ifier.html

Your only additional cost would be the mask of her choice. As a for instance:
Resmed Swift LT (new and quite popular, comes w/3 sizes of nasal pillows)
headgear included
for $118.00 and free shipping
https://www.cpap.com/productpage-bundle ... ifier.html

AND ordering the CPAP or APAP online you get BOTH the Users Manual AND the Clinicians Manual!!!! No way you are going to get the Clincians Manual from a local DME supplier!!

You're getting the idea! You would be better off requesting her equipment order (script), the doctor's dictated results (1-2 pages) and the full scored data summary report w/condensed graphs (5+ pages) from both her in-lab sleep evaluation study AND her in-lab titration study and buying online.

AND you could always ask your insurance company if they would consider you "in network" if you purchased her equipment out of pocket and provided them w/a paid invoice w/the proper HCPCS and CPT codes and if they would reimburse you in full or a percentage.

Heck, even a complete bi-level package can be gotten from cpap.com for under $2000!
For instance:
Resmed S8 VPAP Auto (fully data capable) complete w/all accessories except the mask, including both manuals:
$1725 and free shipping
https://www.cpap.com/productpage-bundle ... undle.html

[dieselgal]

If you go through the regular DME that your Dr. will probably suggest you will be soaked for probably the worst machine they can pass off on you . To the tune of 1500.00 plus most likely.
If you are mostly going to pay out of pocket anyway I would get the prescription and buy from CPAP.com . I originally got the ResMed Elite through my insurance and a mask that didn't work for me. I already knew a small amount before I got that or they were going to put me into the bottom of the line machine and charge my insurance the same thing, which was about $2000.00.
As it is about a year later I purchased myself the M Series Auto with A-flex and that is when I really begin to like my therapy.
I paid less than $600.00 for the entire setup. The one thing I would change today would be that I would add the F&P 150 humidifier because the built in humidifier for the M-series is very small. In either case I know you would get everything for less than $1000.00. Once you get her prescription call Cpap.com and others and get some quotes but really check these machines out because they are not created equal.

[NeurosurgeryNP]

In your case, CPAP.com is the way to go if you can get local support as a new CPAP er.

[Guest]

I found mine on Craigslist.org brand new for $400

[lindyjoy]

You have to do your research. That being said, for service and price I haven't been able to find better than cpap.com. Good people, really. Whatever you choose, make sure your decisions are informed ones. Good luck.
lindyjoy

[JayC]

Local support is hard to find for those of us who DID by locally!! !!!

My stress level would be much less if I had had the opportunity to purchase via CPAP.com

J

In your case, CPAP.com is the way to go if you can get local support as a new CPAP er.