Medicare & a new machine

[gerry]

My CPAP, paid for by Medicare,is closing in on it's 5 year birthday. I understand Medicare will pay for a new machine every 5 years, but I was told the old one must be inoperable before my DME will supply me with a new one. Does anyone have experience on obtaining a new unit after 5 years?

[GumbyCT]

Has the M been out for 5 yrs already?

See if your doc will write another script w/o going for another sleep study.

Or try another DME - of course that would assume that you already have your script - in hand. Could always ask your DME for a copy - that might get their attention.

[Slinky]

Yup, that is what I would suggest - go to another local DME provider. HOWEVER, I am pretty sure that Medicare will require a recent/current PSG and new equipment order (script).

[SleepingUgly]

The old machine has to be inoperable??? So you can't get a new machine every 5 years on Medicare??

[xyz]

> I was told the old one must be inoperable before my DME will supply me with a new one.

Who was the DME?

[gerry]

DME is Lincare. The machine to be replaced is a Remstar Pro, old style. I have an M series I purchased out of pocket for travel.

[cpapquuen1]

Unit does not have to be inoperable. However, you need to have a face to face evaluation with the doctor (dr must document that you still need the cpap) to obatin the rx for a new unit. This eval cannot be done before your 5 year mark.

[6PtStar]

Unit does not have to be inoperable (I can make it inoperable with a large hammer) but the 5 years is from "time of purchase". Medicare defines the "time of purchase" as after the 13 month rental when you actually take posession of the machine. That makes it the requirement of 6 years and 1 month (5 years + 13 month rental) for them to pay for replacement!!

Jerry