Do all insurance plans follow medicare guidelines for CPAP?

[CPAP Lady]

Do all insurance plans follow medicare rules for replacement of CPAP parts such as masks and nasal pillow parts? I ask because a neighbor has a blue cross plan ans was told by the DME that he can only get a mask every 3 months but no replacement pillows in the meantime which wear out about every 2 weeks for me. My insurance does use medicare guidelines.
I appreciate any help:)

[jabman]

Do all insurance plans follow medicare rules for replacement of CPAP parts such as masks and nasal pillow parts? I ask because a neighbor has a blue cross plan ans was told by the DME that he can only get a mask every 3 months but no replacement pillows in the meantime which wear out about every 2 weeks for me. My insurance does use medicare guidelines.
I appreciate any help:)

I have blue cross blue shield and can only get replacements every 6 months but I can get just the cushion if i want. I think it has more to do with the DME then the Ins.your frind should contact her Ins and ask them thier policey.

[LittleRedTruck]

Im sorry but I know this reply is not answering your question! Im wondering in what way have your pillow's become worn out in 2 weeks! Ive used the same pillows on my Opus360 for over a year. What should I be looking for to determine they need replacement ? Thanks, Dan

[CPAP Lady]

Im sorry but I know this reply is not answering your question! Im wondering in what way have your pillow's become worn out in 2 weeks! Ive used the same pillows on my Opus360 for over a year. What should I be looking for to determine they need replacement ? Thanks, Dan

Perhaps I should be looking into the Opus? They wear out in the sense that do not seem to work as well. There is nothing visibly wrong with them. They just seem more leaky and more uncomfortable. Other users have posted the same thing here and I found that to be true in my usage since the beginning of May.

[Pugsy]

No. Not all insurance plans will reflect Medicare guidelines. Each company is free to choose their own replacement schedule. Many do, but not all.

Medicare will allow 2 replacement pillows per month for the Swift FX. Some people do seem to feel they start to fail after 2 weeks. I get multiple months out of mine. So not everyone will need to replace that often.

If your neighbor feels the need to replace more often and his/her insurance doesn't allow replacement soon enough you might point them to Ebay. I have seen the nasal pillows there in bulk quite reasonable. Like 3 for $15 or so.

[chunkyfrog]

I, too may be looking into the Opus360--Swift FX is nice, but the pillows are so flimsy!

[soundersfootballclub]

They can do whatever they want. My insurance doesn't cover any equipment at all.