Does Medicare pay for repairs to 4yr old machines ?

[JohnMudie]

Originally I bought my machine (a Respironics M-series Auto with humidifier) from BillMyInsurance and Medicare paid for it. It broke recently and I am wondering if Medicare will pay for the repairs. It broke while still under warranty from BillMyInsurance and they fixed it at no cost to me even though BillMyInsurance had nominally gone out of business. Thanks guys.

But now its about four years old and so not yet eligible for replacement. According to my DME ,it is now considered obsolete.
I am gatting a quote from a private firm Advans http://www.advanscpap.com for $211. They say they cannot bill Medicare.

Is there anyway to get the repairs paid by Medicare? I also have a Medicare supplement.

John
PS , my new DME, Lincare, lent my a Remstar Auto with humidifier and its gorgeously quiet.

[avi123]

I got my CPAP from Medicare thru a DME on a rental basis for 13 mo. Afterwards I'll own the machine and probably need to take care for repairs and send claims to Medicare. After 5 years from the beg I'll be qualified to rent another machine. I assume so.

You don't give enough info to understand why you need to pay on your own for a CPAP or accessories.

[sleepycarol]

Your machine is a Respironics model and not a ResMed model if it is an M series. Although that doesn't really matter as a broken machine is still a broken machine.

I don't know about Medicare, but have you thought about having a back-up for times like this? Is Lincare charging you for the current machine? Will Medicare pay for this rental?

It looks like it would be more cost effective if Medicare would just replace it -- but then I am not the government.

[Crayongrl]

Medicare will pay for repairs - labor and parts as long as they are necessary for the item to function. If the company doing the repairs will not bill Medicare, you can submit your claim to your Region or Zone carrier.

Repairs are billed as K0739, replacement parts as E1399. If you submit the claim yourself make sure you submit an itemized bill from the company doing the repairs and documentation that the unit will not function as intended without the needed repairs.

*I worked for a Medicare DME contractor for 8 years. We did medical review for DME and received documentation/requests from Benficiaries fairly frequently. Currently work for a commercial insurance who has a Medicare Advantage program.

[JohnMudie]

wrote..

Medicare will pay for repairs - labor and parts as long as they are necessary for the item to function
......
Repairs are billed as K0739, replacement parts as E1399. If you submit the claim yourself make sure you submit an itemized bill from the company doing the repairs and documentation that the unit will not function as intended without the needed repairs.

......

Well I submitted this information to my DME this morning and in the afternoon I got a phone call that they were authorizing the repair of my CPAP. Thanks Crayonglr. This information saved me $211 !!!!!!

John

[kteague]

Good to see you John!

[Slinky]

And by the way, just for the record, RemStar doesn't tell us anything except that the PAP is manufactured by Respironics. They tack the "moniker" on all their PAP devices. Its jaded and old but they just don't seem to want to give up on it.

There was the Respironics RemStar pre-M Series (Legacy series) Plus, Pro, Pro 2, Auto, BPAP .....
Then there was the Respironics RemStar M Series Plus, Pro, Auto, BPAP .....
Now there is the PR RemStar SystemOne Plus, Pro, Auto, BPAP .....
or is it
PR SystemOne Remstar Plus, Pro, Auto, BPAP .....

[marmah]

Medicare along with many insurances work with its members to get this repaired or replaced. One thing to look at is the warranty information, although the business you purchased it from is out of business respironics is not and should stand by their product. One thing many people do not consider is the cost of this to insurance agencies. Insuranace premiums are based on utilization; meaning if we over utilize premiums are going to go up to pay for the utilization. People are on a craze lately to replace thier C-PAP machines wanting new and improved ones when there is nothing wrong with the old ones. At what point do we, as a people, consider medical expenses a personal responsibility instead of the communities? Users need to be more responsible and utilize insurance for what it was inteded; medical necessity and not WANT. If you had paid 211.00 it would have saved Medicare 1300.00 and allowed this to be utilized somewhere else; for example medication coverage. 211.00 is not that much to pay for your own health.

[JohnMudie]

When I pointed out Crayongirls recommendations to my DME , they accepted rfesponsibility for it and paid for the repairs . I am guessing they charged Medicare. So now my machine is repaired and happily humming away next to my bed.
Thanks Crayongirl

John

[chunkyfrog]

Of course, the repair is cheaper; and advisable as long as the machine will provide effective therapy for the patient.
A nice machine as a loaner is a way the DME can set themselves up for a sale when the 5 year limit is over.
Even if the old machine still works then, it is far more advisable to replace it and keep the old one as an emergency back-up.
No provider is open 24/7. Cover your own rear, dear.

[JohnMudie]

My rear is overly covered. A couple of days ago I had five machines in my possession!!!!. I have turned the loaner back to the DME and am offering a Remstar plus for sale on Craigslist Santa Barbara which will leave me with three.

I am considering forming CPAP Machine Anonymous for those of us who have an addiction to CPAP machines !!!!!

John recovering CPAP Machine owner !

[gsims8@carolina.rr.com]

I have a sleep apnea machine. It is not working. I think it is the switch on the back of the machine. Do you make repairs

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[chunkyfrog]

Is the dot-com post spam? Odd request for a dot-com. My mouse wants to zap it.

[JohnMudie]

I have a sleep apnea machine. It is not working. I think it is the switch on the back of the machine. Do you make repairs

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No, gsims, I don't repair machines. I suggest you contact the person who supplied your machine.

john

By the way, do you eat spam ?

[Slinky]

Gettem, Chunky!!!!! Slurp, yum, yum, burp.