Calling all Ontario Users

[justcaring]

Now that I have embraced (sort of) this therapy, I am going for my second sleep study with my loaner machine tomorrow night they had a cancellation. Also hoping to get Doctors final script on friday. I am currently with Medigas as my DME but it seems they do not have a good rep. What do I need to tell my Ontario doctor about my script to get the best machine. The current one script says Medigas Requistion with Loaner checked off and my pressure setting. It is also checked off Patients choice for equipment. They have written in a ADP# which I am wonder is that my case #

Anybody who has gone through this recently , like in the last 6 months, what were you good and bad stories. I want to know if I can change my DME? Get a prescription and work into any DME and get the best deal? How hard is it to negotiate an Autopap machine? Or should I even try. Also will the S9 elite be sufficient with the EPR and does it come fully configurable so I can manage my data and change my own pressures without having to go back to the doctor.

On last question do most people have a second machine as a backup, or do you get extended loaner service from the DME?

I want to take control of my therapy, but this current Ontario system from what I have been reading is slanted towards DME and the doctors.

Any advice would be appreciated.

[Hose_Head]

Now that I have embraced (sort of) this therapy, I am going for my second sleep study with my loaner machine tomorrow night they had a cancellation. Also hoping to get Doctors final script on friday. I am currently with Medigas as my DME but it seems they do not have a good rep. What do I need to tell my Ontario doctor about my script to get the best machine. The current one script says Medigas Requistion with Loaner checked off and my pressure setting. It is also checked off Patients choice for equipment. They have written in a ADP# which I am wonder is that my case #

Anybody who has gone through this recently , like in the last 6 months, what were you good and bad stories. I want to know if I can change my DME? Get a prescription and work into any DME and get the best deal? How hard is it to negotiate an Autopap machine? Or should I even try. Also will the S9 elite be sufficient with the EPR and does it come fully configurable so I can manage my data and change my own pressures without having to go back to the doctor.

On last question do most people have a second machine as a backup, or do you get extended loaner service from the DME?

I want to take control of my therapy, but this current Ontario system from what I have been reading is slanted towards DME and the doctors.

Any advice would be appreciated.

I went through this process with Vitalaire just over two years ago. Same scenario as you with a loaner first, then titration study, after which you are expected to buy equipment from the DME (in your case, Medigas).

I found this forum before my titration assessment, so I was well armed with information about what should be happening. Vitalaire was so hopeless that I refused to buy anything from them. I just returned the loaner equipment, made certain to get a receipt from them for it, and then went and bought from a DME of my choice.

I also informed my sleep doctor that I was unhappy about his all-too-cozy relationship with Vitalaire. He took interest in what I said and this complaint ***may*** have been why he was receptive to my request for an upgrade in my Rx to an auto-pap.

You asked how difficult it is to get an auto-pap in Ontario. Under normal circumstances, it is very difficult. The Ontario Assistive Devices Program (aka ADP) will pay a fixed amount for your cpap. To get them to pay the added cost of an auto, the sleep doctor has to justify a need for it. I'm uncertain what the benchmarks are, but they include things such as titration pressure over 10, positional sleep apnea, and possibly failure of straight cpap.

When you see your sleep doctor to discuss the findings of your titration study, be certain not to leave his office without a written Rx for your cpap as well as a copy of the sleep study and the doctor's notes. It should be no problem to get this information.

Do your homework now in finding a good DME. And good luck in finding one. I've not heard of any in the GTA and would be interested in hearing how you fare.

[justcaring]

I went through this process with Vitalaire just over two years ago. Same scenario as you with a loaner first, then titration study, after which you are expected to buy equipment from the DME (in your case, Medigas).

I found this forum before my titration assessment, so I was well armed with information about what should be happening. Vitalaire was so hopeless that I refused to buy anything from them. I just returned the loaner equipment, made certain to get a receipt from them for it, and then went and bought from a DME of my choice.

I also informed my sleep doctor that I was unhappy about his all-too-cozy relationship with Vitalaire. He took interest in what I said and this complaint ***may*** have been why he was receptive to my request for an upgrade in my Rx to an auto-pap.

You asked how difficult it is to get an auto-pap in Ontario. Under normal circumstances, it is very difficult. The Ontario Assistive Devices Program (aka ADP) will pay a fixed amount for your cpap. To get them to pay the added cost of an auto, the sleep doctor has to justify a need for it. I'm uncertain what the benchmarks are, but they include things such as titration pressure over 10, positional sleep apnea, and possibly failure of straight cpap.

When you see your sleep doctor to discuss the findings of your titration study, be certain not to leave his office without a written Rx for your cpap as well as a copy of the sleep study and the doctor's notes. It should be no problem to get this information.

Do your homework now in finding a good DME. And good luck in finding one. I've not heard of any in the GTA and would be interested in hearing how you fare.[/quote]


Thanks Hose-Head for your advice. Agreed it is about homework and asking the right questions. It is hard to find a set list of DME in GTA. You have to piece it together. As for getting Resmed equipment, I do have a US address to ship to, so I will do some shopping. I will keep you posted.

[DeeDeeD]

Where in Ontario are you? I've had really good luck with a place in sudbury. I just got my machine in February.

[justcaring]

Where in Ontario are you? I've had really good luck with a place in sudbury. I just got my machine in February.

Oshawa. Already went through 1 DME as the first one was like a used car sales person. The second one Medigas has been fine but looking over their quote and what they are offering it seems excessive. But the have said they will offer a S9 if I want it, but made inclinations that it is new, unreliable and the S8 is proven. This says to me everything to do with profit and not the patient.

[torontoCPAPguy]

For what I paid to Medigas for an S8 Escape on top of what the government kicked in, I purchased TWO S9 Auto's with several masks and the climate control hose and had money left over. You need to get a copy of your Rx and make your purchase stateside. I love my new S9 Auto and my numbers are down to next to zero. Now I get to play the mask thingy and thus far have been using a Mirage Activa LT with good results but occasional mouth breathing (which is immediately apparent from the data from the S9 by the way when you see the leakage rate and flow information). I have purchased several different masks to try along with a PAPCAP Plus 4 to play with over the next few weeks while I am able to catnap and sleep in and so on. ALL for less than the price that MediGas charged me for ONE nasal pillow setup by the way. And all stateside, mostly from folks that would ship into Canada or to our NY address as a last resort. To give you an example, what we paid MediGas $350 plus taxes for, we purchased stateside for $50. Something smell like a dead fish here? Just a word to the wise. ResMed policy, by the way, prohibits discounting (they do it anyway) and prohibits shipping trans-border (they do it anyway) and God bless them for it.

[AndrewB]

From my own experience when I was given my prescription, the doctor asked where I lived and then gave me the name of the DME closest to my home. I called them and got an appt the same day and came home with an S9 that afternoon.

That's the "good" part. I hadn't studied up before I went so I lucked out with what seems to be a good machine. The person selling them obviously at the time had no clear concept of what they're selling. I was given a choice between an S9 and what I think was an S7 and when asked what the difference was was told that it was only in the price and the length of warranty.

I've since called the DME back looking for pricing on replacement masks and wipes and they don't return my calls.

I live up around Owen Sound but work in Misissauga with regular trips into down-town Toronto so have a wide geographical area to look for a DME in. After much searching I found that the only DME that has hours that I can get to them at and has a retail operation is Shoppers. If there are others I'd be delighted to hear about them.

I think a large part of the issue is that really this is a rather new therapy. Most of the DMEs are amateurs who really don't know their product. Also, most of them are setting themselves up with more of a "therapist" business model rather than a retail model trying to tie the patient to their practice. For those of us that just want some supplies on our way home from work - there are limited choices. Hopefully the other major pharmacy chains will wake up and start carrying supplies too. The bulk of the pharmacists (including young ones) had no idea what CPAP was - and I talked to a lot hoping that they would have supplies.

[torontoCPAPguy]

From what I have heard from a friend just replacing his equipment after five years, Shoppers Health was the most reasonable of the lot. Hopefully we will see many more carrying CPAP supplies as the competition might force the prices down to where they should be; a reasonable profit rather than gouging or profiteering.

For my part, in the meantime, I will continue to visit the best doctors that I am able to and will continue to buy stateside where I am finding pricing to be 1/4 to 1/2 of the local prices in Toronto.

The problem is that I do not believe that the ADP will kick in any money for your purchase if it is made outside of Ontario; and your insurance may insist on seeing the ADP portion kicked in before shelling out any money themselves (the insurance companies in Ontario have become SOB's and are nickle and diming their clients to death - I know, my dad, in his 90's gets screwed by them regularly and does not have the strength to fight back. Tears me up. ATTO Insurance and AXA Pacific are to be shied away from. Trust me.)

[Guest]

From what I have heard from a friend just replacing his equipment after five years, Shoppers Health was the most reasonable of the lot. Hopefully we will see many more carrying CPAP supplies as the competition might force the prices down to where they should be; a reasonable profit rather than gouging or profiteering.

For my part, in the meantime, I will continue to visit the best doctors that I am able to and will continue to buy stateside where I am finding pricing to be 1/4 to 1/2 of the local prices in Toronto.

The problem is that I do not believe that the ADP will kick in any money for your purchase if it is made outside of Ontario; and your insurance may insist on seeing the ADP portion kicked in before shelling out any money themselves (the insurance companies in Ontario have become SOB's and are nickle and diming their clients to death - I know, my dad, in his 90's gets screwed by them regularly and does not have the strength to fight back. Tears me up. ATTO Insurance and AXA Pacific are to be shied away from. Trust me.)

Thanks for the advice. I just called my insurance company which thankfully my wife manages the plan at her work, and I am 100% covered but you are right, the ADP has to kick in first. Does any every Shoppers Health have a listing of stuff? I am pleased that I can get additional replacement mask, filters and stuff throughout the 5 years on my insurance, but no extended warranty will be covered. I guess I have to fine tune my purchases. I am still trying to figure on how to get a APAP.

[jeo49]

HI. My story is similar to others posted before except that ADP paid very quickly. I live in Ottawa and went through the same procedure of sleep study and then borrowing machines. My pressure is high (titration study 15 cm) Because of the high pressure I ended up trying three machines - straight CPAP first, then APAP and finally BPAP. I ended up purchasing a ResMed Auto 25 in March this year through Medigas. The Dr wrote a one page letter to ADP and they paid in less than 10 days! I understand that is unusual. Then I submitted the bill to my own insurance plan through work and they paid the rest except for the 5 yr extended warranty which cost me $300. So ADP and my own insce plan paid $3000.

That's the good part - getting the right settings was another thing and we have just now found them - but that's a story for another time. During this difficult process Medigas and the Dr were not of much help. On the other hand the ResMed tech rep was fantastic; lending me an S9 for over a month (for free) and taking lots of time to look at the results and getting things to work.

[torontoCPAPguy]

FWIW - you will find on cpapauction.com a bunch of sellers that are selling new and used blowers and gear and WILL ship to Ontario. I would like to repeat MY point and that was simply this. For what I paid IN ADDITION to the Ontario government 'grant' for my CPAP. For that ADDITIONAL PAYMENT, I could have (and subsequently DID) purchase TWO S8 Autoset II's (instead of the Resmed Escape II that they were giving me) along with a variety of masks, accessories and a Contac pulse oximeter! And I still walked away with change. So, my point is simply to suggest very strongly that you (a) keep a copy of your Rx and file it with CPAP.COM by email and with other suppliers; and (b) shop very wisely as otherwise the Ontario government is blowing their money out the window as are you and the vendors are making an absolute killing to the point of being almost criminal.

I have not purchased a single item in Ontario from a vendor since my initial purchase experience (and yes, they WERE like used car salespeople, with all due respect to used car salespeople) EXCEPTING some purchases online through cpapauction from Canadian (Ontario) vendors and they were both reasonable, accomodating and fabulous.

It is unlikely that, living in Ontario at present, I will ever purchase from a commercial Ontario vendor again, although I have no problems and have had no problems in dealing with private vendors in Ontario. I even got to meet a couple and have a quick coffee (turned into two hours with one) and it was overall a great experience.

For what it is worth.

[Sandra]

Reading with interest. I was fortunate and was handed a prescription with no restrictions on where I went.
I'm near Kingston, Ontario and am ready to purchase. MediGas has a bigger store front, if you will, looks like lots of selection on display. However when I popped in before my titration, just to see what there was, there were three ladies chatting behind the counter (no other customers). One finally asked if I wanted help, told her I was looking at my options for machine/mask. When she learned I didn't have a prescription yet, she said to come back when I have a prescription. Made me question future quality of service.
Yesterday I visited a Vitalaire. Totally different atmosphere. Smaller outfit, one person for consult. Very welcoming, took quite some time going over several machines, talked about masks, etc. She was a sleep technician for 15 years before this, so knows the ins and outs of the whole deal. Had a really comfortable feeling with her, feeling ready to go with them. However, reading above about some Vitalaire feedback, I'm now hesistating? My other choice is Shoppers Health, but the online inventory is very small and no products standing out. Perhaps I'll take a drive out and see if they have more in-store.

True, about coverage for AutoPAP. I was going to go for one, based on all the positive feedback, but learned both the provincial as well as my personal coverage will not pay for it as it was not deemed medically necessary (my pressure is 9, just short of the 10 needed).

[torontoCPAPguy]

Reading with interest. I was fortunate and was handed a prescription with no restrictions on where I went.
I'm near Kingston, Ontario and am ready to purchase. MediGas has a bigger store front, if you will, looks like lots of selection on display. However when I popped in before my titration, just to see what there was, there were three ladies chatting behind the counter (no other customers). One finally asked if I wanted help, told her I was looking at my options for machine/mask. When she learned I didn't have a prescription yet, she said to come back when I have a prescription. Made me question future quality of service.
Yesterday I visited a Vitalaire. Totally different atmosphere. Smaller outfit, one person for consult. Very welcoming, took quite some time going over several machines, talked about masks, etc. She was a sleep technician for 15 years before this, so knows the ins and outs of the whole deal. Had a really comfortable feeling with her, feeling ready to go with them. However, reading above about some Vitalaire feedback, I'm now hesistating? My other choice is Shoppers Health, but the online inventory is very small and no products standing out. Perhaps I'll take a drive out and see if they have more in-store.

True, about coverage for AutoPAP. I was going to go for one, based on all the positive feedback, but learned both the provincial as well as my personal coverage will not pay for it as it was not deemed medically necessary (my pressure is 9, just short of the 10 needed).

You are being a sheeple. TELL your MD that you would like to track your data and perhaps visit him on a regular basis if that makes him happy (if he is busy he will NOT be happy). Nontheless, if your MD is long term and a 'friend' he/she will change that CPAP to APAP with data in a blink. No supplier should be specified as it is not necessary and is simply an indication of the MD's preference or (Heaven forbid) a business relationship. Nudge. Nudge. Wink. Wink. If you receive an Rx with a specific supplier indicated I would ask for one without. If you get some BS I would simply white out the specified supplier. Ontario politicians are so busy covering their asses and trying to stay out of jail that they cannot be bothered with the other BS that is going on or I might suggest calling one. There are only a couple that I would trust.

So, here's the story. YOUR insurance company is going to want to see that Ontario has kicked in their part before paying out anything to you, either at present or with future replacement parts (filters, masks, etc.). That is a for sure. So get yourself a blower from the best deal supplier you can find. I would forget all about the masks, the humidifier and everything else that they are going to stick it to you with. You want the machine paid for by the government and that's it. Period. If they are going to give you an S9 Auto for that, great, but I doubt it.

I will just reiterate the story yet again that I had. I walked out of MEDIGAS with a nose pillow that didn't fit and a ResMed Escape II (a travel machine) and a bill for $1500 with taxes. Ripoff? Lessee $1500. I just bought TWO ResMed S9 Auto's online with climate control systems and humidifiers and a half dozen masks and all the accessories you might want including a pulse oximeter (The Contac 50E) and hose management and covers and clips and cases and thingies to cover the velcro and it ALL cost me less than the $1500 that I shelled out to MEDIGAS. I bought on the online autctions. Prior to that I bought two S8 Autoset II's for the same great deal and am now selling them for half of what I paid for them. They are great machines but I am a technogeek and have to have the latest and greatest.

If you are not in Ontario (I know the YOU are) I highly recommend going to either cpap.com or cpapauction.com and buying a new machine or a used machine from a reputable seller. You will save a bundle.

ASK your MD for a prescription without a supplier specified. Tell him NOT to set up an appointment with HIS supplier. Tell him that you DEMAND copies of all of your files; under the freedom of information act you have an absolute right to them all, failing which he is committing a criminal offense. (Don't tell him that... just insist). And if you still get a hard time I would be looking for another MD real fast.

I am truly sick and tired of all the nonsense that goes on in Ontario with regards to OSA therapy and price fixing. It is just not right. The insurance company will probably nickle and dime you to death. Fastest way to resolve that is to get what you need and then sue them in small claims court.... of course that negates any future insurance coverage, but at least you'll feel good about doing the right thing. ( I just bit the bullet and paid on my own... they'll get theirs).

Good luck.

[Antares]

I'm in Kingston too Sandra and used Medigas for my DME. I would not use them again or recommend them. They misrepresented themselves, blatantly lied to me then feigned ignorance and were just generally disinterested in anything but how cheap a machine they could get me and how fast they could get me out of the store.

If you had a good experience with Vitalaire, try them or maybe Kingston Oxygen medical supply.

[heatherbelle]

I wholeheartedly second the "Nays" of the other writers re: Medigas. The very worst service I have ever gotten ANYWHERE for ANYTHING !! (Here in Oshawa, Ontario, but it seems it applies everywhere.) The sales person was only interested in trying to rid the shelves of the oldest junk (at a very high price) when it came to masks, and was totally unhelpful and even rude when I asked to try another mask. She even tried to stop me from getting a data capable CPAP machine. It seemed like the doctor was in cahoots with Medigas (because they had provided me with a loaner machine), but I found out he wasn't, when I complained to him about the sales rep, saying I was willing to give Medigas a rental fee for the loaner just in order to get rid of them and then be free to purchase my CPCP equipment ELSEWHERE. He was surprised and willing to cut her loose ! It seems that the docs want you to purchase at these places simply for 2 reasons, firstly because they provide a free loaner and secondly because the docs think that a new user needs personalized service and support. Hah! No personalized service and support whatsoever....just rudeness ! If only the docs knew the underhanded tricks they try to pull, all with THEIR own agenda foremost (get rid of the old machines BUT AT THE SAME HIGH PRICE AS THE BETTER/NEWER MODELS !!! They have the integrity of corporate Canada.......which is to say NO INTEGRITY AT ALL !! I now need other supplies, new mask, year's supply of cushions for old and new mask, tubing, headgear, etc. etc. and you can bet I'm going to take torontoCPAPguy's advice and purchase through the auctions. When enough people do that, the greed of the local DMEs everywhere who presently enjoy a corrupt monopoly (with the govenment ADP Program's approval --wasting our tax dollars once again) will either be forced out of business (hopefully) or at least will lose enough of their market share to lower their ghastly and greedy prices. Let's ALL stop being apathetic Canadians -- sheep led to economic slaughter !! There is utterly no reason (other than greed) that prices for all CPAP related items are so much higher in Canada than in the USA. Our dollar is at par, or actually a little stronger the the US dollar. Think about it all, carefully.