How long do you use your mask before replacing the seal ?

[Quinda]

I learned from Resmed that the Mirage Quattro FFM seal (cushion & clip) was engineered for a life expectancy of 3 - 6 weeks, the entire mask for 4 - 6 months ... I'm lucky to get four weeks from a new seal (cushion & clip) but my last mask made it for 7 months ... ...

[plr66]

... Again, my view re Medicare is that they are not what I consider generous. If they have deemed that something is replaceable at a given point, I'm going to go with the assumption that they've done their homework before setting any criteria.

Are you kidding?? Well your first assumption is so far off base that you can even look at today's NPR report on how ridiculous this assumption is....and please know that this is pretty well known.

...I guess one way to look at it is that if I'm paying for all this through my insurance premiums ... why shouldn't I be getting what I'm paying for and entitled to?

How many reasons would you like? Or can you please stop and think about where this money is coming from and who is affected besides your singular entitled self?

... By the way, I'm not punishing anyone ... I'm merely using the resources that I'm paying for and that's available to me.

OMG. Please educate yourself and look beyond self-interest and feeling you are justified to be a glutton for anything you believe you are entitled to. If you are unable to do so, then will you bask in the closet full of wasted mountains of mask pillows and hoses that you never needed, but that are YOURS?? Great. Does that punish anyone? Please ask yourself about that many times before you repeat or admit to this behavior again.

[congahands]

I learned from Resmed that the Mirage Quattro FFM seal (cushion & clip) was engineered for a life expectancy of 3 - 6 weeks, the entire mask for 4 - 6 months ... I'm lucky to get four weeks from a new seal (cushion & clip) but my last mask made it for 7 months ... ...

That's really interesting about the Quattro because I am just completing month 5 on my first Quattro with the original seal. At my pressure of 16, the Quattro manual says I should be at a leak rate of 45L/min. With the plumbers tape fixes and finally getting the straps perfectly adjusted for me, I often see average leak rates of 39 or 40.

The silicon is hazy, to say the least, but I have attributed that to my beard scratching the silicon.

I am up for a new mask, and hose in a month, so I am trying to figure out whether to buy a nasal mask or another Quattro to have in reserve. Interesting.....

[congahands]

pir66, The things you just stated are exactly the reason that socialized medicine is doomed to failure. It is not human nature to under consume anything that does not cost. Look at the way people eat at an "all you can eat" buffet. "Well, I paid to eat all I can, and I'm gonna eat until I get sick because I am entitled to it."

How many more people get hammered at an open bar than a cash bar?

Don't get down on janp. That's just how humans work. We get it now because we may not be able to get it later.

Just remember this concept when you go to the polls.

One last thought..... I have a friend who called and requested one of those envelopes to send your "unused gold" in, but she didn't have any gold to send in. "Why?", I asked. Well, they said it was free.......

[plr66]

pir66, The things you just stated are exactly the reason that socialized medicine is doomed to failure. It is not human nature to under consume anything that does not cost. Look at the way people eat at an "all you can eat" buffet. "Well, I paid to eat all I can, and I'm gonna eat until I get sick because I am entitled to it.":

I'll not argue your valid points at all. But I do not want to de-rail this to a political discussion or a generalized "that's human nature" dismissal---and wnat to bring it back to our individual responsibility to behave in a more intelligent manner. Hording and gluttony and entitlement get very little that is positive in return.

[DoriC]

To add to this discussion, my husband was "entitled" to a new mask after 3months but we didn't want to charge Medicare for a whole mask which was perfectly fine, all we needed was a new cushion. The DME would not sell us just a part so we had to get a whole new mask. I think they charged Medicare $325. The new mask had a defective noisy exhaust vent(which she disagreed with) but when we asked for just a replacement for this little rubber thingy, she said she couldn't do that but would exchange the whole mask for a credit from Medicare. We just ordered the part ourselves from cpap.com for $10.00 and the mask is now very quiet . I also hate the fact that Medicare is paying the Cpap rental to DME at $295/month for 13months until we can own it, that's almost $4,000! When I called Medicare after 3months usage to tell them we were satisfied and compliant and would they purchase the machine now, they said they couldn't, "it's the law". That's my vent,plr.

[azmanatheart]

My mask seals seemed to last fine, but when I started using the Silicine putty on them to stop leakage, they quickly lost some their shape and rigidity, so while the silicone helps stop leaks, for me, it appears I will have to replace the seal at least every month if I can't find a FFM that doesn't leak and continue to use the silicone.

[CEH877]

As I understand it, Medicare allows a new mask every 3-4 months. That's pretty aggressive in my opinion. My patients get a new mask every six months despite the fact that most seem to last for about a year. One problem more common than the seal is the stretching out of the head gear. Removing the mask using the clip on or snap on feature rather than adjusting the Velcro straps every time also extends the mask life.

[Slinky]

Actually, Medicare will replace the mask every 3 months - but the headgear only every 6 months. Most local DME suppliers, altho they bill separatly for mask and headgear, will only sell the two as a bundle, hence you are told Medicare will only replace your Mask every 6 months. Few carry the "extra" parts separately despite Medicare will replace the cushion or pillows once a month. The "key" here tho is few of us NEED a new cushion or pillows once a month so why put Medicare to the expense if you don't need them. On the other hand, it doesn't hurt to have one extra cushion or pillows or mask, or hose on hand because the local DME suppliers seldom have them on hand and have to order them in for you once you convince them like it or not you are eligible for them.

And, unless you have a bi-level or one of the more sophisticated xPAPs, most likely that $249 a month for 13 month billing you are seeing is only the 'billed' price, not the amount Medicare actually pays. For instance (and these are 2006 amounts for a straight CPAP):

Billed: $135.00 - Medicare allowed: $99.95 - Medicare paid: $79.96 - CoPay: $19.99
Reduced in 2007 to:
Billed: $135.00 - Medicare allowed: $74.96 - Medicare paid: $59.97 - CoPay: $14.99 DME

And for the accessories: (outright purchase)

Billed: $548.00 - Medicare allowed: $499.63 - Medicare paid: $399.70 - CoPay: $99.93
broken down as:
a7037 - tubing used with positive airway pressure device - $48.00 - $32.82
a7034 - nasal interface (mask or cannula type) used with positive airway pressure device, with or wi - $130.00 - $94.11
a7035 - headgear used with positive airway pressure device - $45.00 - $31.80
e0562 - humidifier, heated, used with positive airway pressure device - $325.00 - $240.97
Billlings, but not reimbursement, changed in 2007 to:
a7034 - nasal interface (mask or cannula type) used with positive airway pressure device, with or wi - $144.00 - $94.11
a7035 - headgear used with positive airway pressure device - $70.00 - $31.80
a7037 - tubing used with positive airway pressure device - $54.00 - $32.82

And for a bi-level auto for 13 months in 2008:

Billed: $239.92 - Medicare allowed: $218.11 - Medicare paid: $179.49 - CoPay: $43.62
reduced in 2009 to:
Billed: $239.92 - Medicare allowed: $148.04 - Medicare paid: $118.43 - CoPay: $29.61

Billing and Medicare allowed amounts can vary somewhat, tho not a lot, amongst the 3-5 CMS "districts" in the US. These amounts were all in Michigan and I forget which "district" Michigan is in.

[DoriC]

Slinky, that makes me feel better knowing Medicare doesn't pay the full amount, I should have known that. I just got the EOB the other day, will check to see what they actually paid and what our union copay paid.

[RipVW]

Bill, how do you do the "ultrasonic clean?

I use a small ultrasonic cleaner I bought off Australian eBay.....



http://cgi.ebay.com.au/Ultrasonic-Multi ... 240%3A1318

I'm sure you will be able to find a similar unit (at a variety of prices) on US eBay.

Cheers,

Bill

Bill, one last question (I promise): Do you use a special ultrasonic cleaning solution in the unit? Thanks!

[riverdreamer]

Slinky is right about what Medicare pays. In fact, looking at my recent EOB, they are now paying even less. Medicare is one of the few places that LOWERED the re-imbursement rates the last two years. My DME will receive $95.26 per month for 13 months for my Autoset II, after paying $272.60 up front for the humidifier. The copay or secondary pays $19.05 of the $95.26 and $54.52 of the $272.60.

Replacement pillows for the Swift LT are re-imbursed $25.71, which is slightly less than cpap.com charges.

[TheDreamer]

Bill, how do you do the "ultrasonic clean?

I use a small ultrasonic cleaner I bought off Australian eBay.....

Yay...the ultrasonic cleaner I bought off of US eBay arrived today....though I probably won't try it until Sunday when I plan to do my weekend cleaning....

Though I did try it quick with my glasses....sure was interesting watching the gunk flow out from the rim, hinge and nose pieces....

Guess I should brew up some more distilled water on the weekend....

The Dreamer.

[dreamchick]

DSM:

I bought my Fisher Pakel 431 FFM when I started my CPAP treatment last year. I have used it for one year today! I have replaced the cushion after 6 months because it started to really leak. My second cushion started really leaking last week so I treated myself to a new mask the Mirage Quattro I hope I like it better than my FP. Tonight will be my first night with my new mask. I am hoping the seal will last longer than 6 months.

DC

[grandmma]

Although it's not my favourite in terms of weight, I get far better and longer uninterrupted sleep with the Mirage Activa. I've used the same one for over 16 months, and it's only now that the seal is starting to seriously cause problems. I'll replace them this week, but the rest of the mask & headgear are fine.

I'm opting out of private healthcare other than for hospital only - I intend to research it more fully, but I'm betting I'll find the refund on anything at all is not worth the extra I'm paying. Drives me so mad the way you pay through the nose month after month, and so many things are either not covered at all, or at a minimum, as DSM has pointed out with the $500 per 5 years or whatever. Nasty.

I joined my healthcare in 1967 (!). When my ex and I divorced he would not go into MBF and separate himself from the cover, so I was required to. Had to take out a new, although I'd had that number & cover for 40 years (we divorced long after separating). So when the healthcare demutualised, he received over $8k, and I got $800 despite an appeal on that. Disgusted me, I can tell you, and I'm intending to swap providers whenever I can get my a**e into gear & do so!