Ontario ODSP and CPAP's covered

[slideshowstan]

Hi I live in Brockville Ontario, and just went threw the whole over night sleep study thing in Kingston.
I do not have a CPAP as of yet, but have an appointment to get 1 on Feb 19 2009 this thursday.

My question is for anyone who is on ODSP.

when you went to get your CPAP what unit did you get?
did you have a choice in the model?
did you have to pay any money out of pocket on top of what ODSP and ADP covers?

I want to get the S8 Elite from ResMed sold at Medigas in Brockville..... if anyone on ODSP has recived this model please reply to me
I need any and all info on getting this unit without paying anything outa pocket

Thank you for your help

[MoneyGal]

Here's a link, if you haven't seen it before:

http://www.health.gov.on.ca/english/pub ... /cpap.html

It says that ODSP will pay 100% of the approved price for a prescribed CPAP. The challenge will be to find a supplier who will sell you one at the "approved" price. However, if you have a sympathetic doctor who has a good relationship with a supplier, you may be able to work with him or her to get the price you need.

[slideshowstan]

ya i been there and seen that site.

I'm hoping somone on ODSP is a member here and can tell me what they were able to get etc

[MoneyGal]

Sorry; after I posted that I realized you probably already knew everything it said.

[Hose_Head]

Hi I live in Brockville Ontario, and just went threw the whole over night sleep study thing in Kingston.
I do not have a CPAP as of yet, but have an appointment to get 1 on Feb 19 2009 this thursday.

My question is for anyone who is on ODSP.

when you went to get your CPAP what unit did you get?
did you have a choice in the model?
did you have to pay any money out of pocket on top of what ODSP and ADP covers?

I want to get the S8 Elite from ResMed sold at Medigas in Brockville..... if anyone on ODSP has recived this model please reply to me
I need any and all info on getting this unit without paying anything outa pocket

Thank you for your help

I'm not on ODSP and I'm unfamiliar with it. However, you also asked about ADP. I got an APAP through ADP.

ADP pays 75% of the approved price for an xPAP. For CPAP, that's 75% of $1040 = $780. You must pay the balance (possibly, ODSP will pay the balance for you).

When you go to the DME, you will chose from among the types of CPAPs that the DME sells. Some DMEs have a greater variety of CPAPs than others. It's likely that they will try to give you the cheapest model that they have; they will be paid the same regardless of the model of CPAP.

If the DME does not have, or is unwilling to sell you the model you want, then go to a different DME. You are free to buy from a different DME.

Make sure that you get a data-capable model. The ResMed Elite is data capable and is an excellent choice. Make sure that you get the S8 Elite II model, which is an update that was released in late 2008. The newer model is quieter.

Note that some CPAPs record compliance data (e.g. how many days and hours you use the machine), only. A data capable machine records much more than this. To read the data from the CPAP, you will also need to buy a card reader and computer software; ADP does not cover this cost. You can find the costs on cpap.com's web site.

You didn't ask about buying a mask. This is FAR MORE CRITICAL than the selection of a CPAP. Success in this therapy is directly linked to how well the mask fits. Make sure that the DME takes the time to fit you properly for a mask, and lets you try different masks. This is part of the service that they are supposed to be offering you and for which ADP/ODSP/YOU are paying them.

To answer the rest of your questions about what I bought (March - Apr 2008):
I bought a Respironics M Series Auto, with Activa mask and Respironics high performance hose. The DME was Home Life Care. I had the option of buying machines from Respironics, Resmed, Fisher Paykell, and two or three other brands. Several different models from each company. I tried a half dozen masks before settling on the Activa. ADP paid for 75% of the purchase of the APAP. The APAP approved price is $1585 and ADP paid $1188.75 of this. ADP did not pay for the mask.

Fortunately, I have additional insurance which paid for whatever ADP did not cover. The exception here was a card reader and software, plus snugglehose, extra filters, from our host, cpap.com. I had to pay for these items out of my own pocket.

Home Life Care was my second DME. I had started out with Vitalaire which was connected with the sleep clinic that I went to. I was very unhappy with the service they provided. I am happy with Home Life Care.

[slideshowstan]

UPDATE:

Thank u for all your info, I called the ADP today, and a Dr Hawke's office.
armed with new info I called medigas and told them the info i found out and said I wanted the S8 Elite

from the sounds of it I can pick up my S8 Elite 2 yes I did say S8 Elite 2 for FREE thanks to ODSP on thursday
I will post what type of mask they give me on thursday.

this site is great.

and anyone eles on ODSP or OW dont let the stores force u into a CPAP that is the lowest of the low

[MoneyGal]

I'm really glad you are getting what you need. Dr. Hawke is my doctor and although I don't know whether his office was helpful to you, I hope that it was and congratulations to you on your success!!!!

[slideshowstan]

it was his office that was the most help, and his name came up in the live chat on here also.
so i thought if like 4 ppl are telling me to call him, hey why not, wut do i have to lose.

the info i recived from his store, was the nail that sealed the coffin for medigas

[MoneyGal]

Good to know...I go and get my equipment from "his" store tomorrow!

[slideshowstan]

I picked up my S8 Elite 2 today and I got a Mirrage Quattro Mask also got a free hose cover and free mask wipes

after picking it all up and doing some running around i came home around 12 so tired i was ready to passout,
so i hooked up my cpap and laid down with it and just woke up 2 and 1/2 hours later feeling like i had slept for a
week, i hope this is how things r gona be from now on, i'm looking forward to sleep

[MoneyGal]

Hooray! That was my experience too - that first nap with the machine was just heavenly. Welcome to the rest of your life!!!!

[Baldrick]

Glad to see someone was not screwed by the system.

I honestly wish I was armed with this information 3 years ago when I got my CPAP machine. I had coverage on my mom's common-law's benefits, however Medigas gave me what I considered to be a cheap model. I actually never got a choice of machine. I walked in and was taken to a room and sitting on the table was the machine they were giving me. I got to try two different masks and that was it.

I no longer do any business with Medigas after I found another business in my area owned by a very nice lady who actually takes the time to come to some of the homes of her clients who are unable to physically make it to her store. I am now on ODSP so I might look into seeing if I can get a new machine as the one I had is 3 years old, is noisy and doesn't seem to work as it did when I first got it.

Medigas as a whole seems to have absolutely no scruples! I am sure some employees are not like this, however they are forced to do as corporate dictates.

I do think 5 years through ADP for a replacement is a bit lengthy. Things aren't really built to last anymore.

[Paul56]

Home Life Care was my second DME. I had started out with Vitalaire which was connected with the sleep clinic that I went to. I was very unhappy with the service they provided. I am happy with Home Life Care.

Service from VitalAire? What service?

I'm "with" VitalAire. It became very clear to me after my 2nd visit at their offices that their goals and mine were very different.

VitalAire goals with each patient:

-Get the patient to purchase the machine and as much associated equipment as possible at the outset as this may be your one and only sales opportunity with them.
-Focus on the sales side... therapy is just a side effect of sales.
-Once the customer... er patient has purchased the equipment cut them loose and provide NO followup.

Patient goals (at least mine):

-To obtain best therapy possible and have follow-up with a qualified professional.

-----

To VitalAire's credit... they did not stonewall me when I requested a higher-end machine and requested the ability to adjust the machine myself. But, I have to laugh when I see their slogan about being health care professionals... more like sales professionals as the focus never was on therapy.