Which Machine??

[allenc3]

Well, I have been diagnosed with Sleep Apnea, and have to go back for a SECOND STUDY TO SET UP MACHINE i THINK. Question, I see these machines at prices from $300 to more than $3000. What is the difference. How do you choose one from another? I am a camper so I guess I will need one that runs on 12 volt as well as AC. Is there a such a thing? What about a used machine?

Last but not least, how does insurance (in my case Medicare and Aetna as a supplement). I am not prepared to just to stroke out a check for $1500.

Claude Allen
Green Cove Springs, florida

[VikingGnome]

If Medicare is PRIMARY, this is how it works: Medicare requires you to RENT the machine for 13 months to prove compliance. Your DME supplier will check your machine between days 61-90. If you used the machine at least 70% of the nights AND at least 4 hours on those nights, you meet compliance. If not, Medicare makes you give back the machine as "Not Medically Necessary" since you didn't use it enough.

The rental cost of the machine depends on which state you live. You can goggle to find the schedule for DMEPOS for your region. In my region Medicare allows the DME provider $97 per month. Medicare pays 80% and I co-pay of 20% (about $20 per month). That is just on the CPAP/APAP/BiPAP machine itself. The other stuff like masks, hoses, humidifiers, you have to purchase them and Medicare pays 80% and you pay 20%. Medicare is NOT going to pay for 12-volt DC power it don't think.

After you have paid 13 months of rent on the machine, you own it free and clear. Since you have a secondary insurance (Aetna), they may pick of the 20% for you so the machine costs you nothing. But you'll need to check with them on how they cover Durable Medical Equipment.

BE SURE you get your machine and supplies from a MEDICARE PARTICIPATING DME or you'll end up paying A LOT MORE.

[Cotay]

The DeVilbiss IntelliPAP series and the Phillips Respironics System One series all will work off of a DC power source without need for an inverter. You off course need the appropriate cords, but you can run them (sans humidifiers) off of deep cycle marine batteries while camping or off your cigarette socket in a camper/rv.

[archangle]

Well, I have been diagnosed with Sleep Apnea, and have to go back for a SECOND STUDY TO SET UP MACHINE i THINK. Question, I see these machines at prices from $300 to more than $3000. What is the difference. How do you choose one from another? I am a camper so I guess I will need one that runs on 12 volt as well as AC. Is there a such a thing? What about a used machine?

Last but not least, how does insurance (in my case Medicare and Aetna as a supplement). I am not prepared to just to stroke out a check for $1500.

Claude Allen
Green Cove Springs, florida

Try to get the Philips Respironics System One Auto (PRS1) CPAP machine, unless your doctor decides you need a "bilevel" machine. Your doctor and DME may resist giving you an auto CPAP and feed you misinformation about how auto machines will "run away" or your insurance won't pay for it. An Auto CPAP can be set to run in manual CPAP mode in the rare cases where it can't be set to work well on Auto. Try to get the doctor to prescribe you an auto pressure range, even if it's a small range like, for instance, 8-12 instead of specifying manual pressure of 10.

In general, your cost with insurance is the same no matter what CPAP or APAP machine you get. The DME may try to give you a cheaper machine because he gets the same amount of money no matter which machine he provides.

If you can't get an Auto machine, get a PRS1 PRO machine. Avoid the PRS1 PLUS machine at all costs. PRO is much better and costs you the same.

There is a PRS1 AutoIQ machine, but this is not a real, full time Auto machine. I hate the AutoIQ, but it can be used the same as the PRO machine.

The PRS1 Auto and Pro are fully data capable machines. They record every breath and try to detect apneas you have during the night. You or your doctor can look at this data and tell you how your therapy is working. Having a fully data capable machine is like having a mini sleep test every night. It may allow you to avoid having to have another sleep test in the future.

The PRS1 Plus has a data card, but it only records when you turn the machine on and off. Some DMEs will lie to you and tell you it is fully data capable.

PRS1 machines will run off 12V with a $25 cable you can buy online from CPAP.com. Insurance probably won't buy it for you, so don't let the DME rip you off for one at a high price.

ResMed S9 machines are excellent, but don't have an easy 12V option. You have to buy a $89 DC-DC converter to use 12V.

Find out who the in-network DMEs are for your insurance. Get a copy of your prescription, don't let the doctor or sleep lab choose the DME for you. You have a better chance of getting good equipment if the DME knows you'll go to another DME if he doesn't make you happy.

[archangle]

The DeVilbiss IntelliPAP series and the Phillips Respironics System One series all will work off of a DC power source without need for an inverter. You off course need the appropriate cords, but you can run them (sans humidifiers) off of deep cycle marine batteries while camping or off your cigarette socket in a camper/rv.

You can run the PRS1 machine, WITH the humidifier, off of batteries or your cigarette lighter, but you'll get fewer hours before you run the battery down if you use the humidifier. I suspect you can run the IntelliPAP humidifier off DC as well, but I'm not sure.

The PRS1 does better data collection than the IntelliPAP, which helps give you better treatment. Data collection is an extra $99 cost option on the IntelliPAP, and your insurance probably won't pay for it. Your out of pocket cost will probably be the same for PRS1 with data as the IntelliPAP without.

[Cotay]

The DeVilbiss IntelliPAP series and the Phillips Respironics System One series all will work off of a DC power source without need for an inverter. You off course need the appropriate cords, but you can run them (sans humidifiers) off of deep cycle marine batteries while camping or off your cigarette socket in a camper/rv.

You can run the PRS1 machine, WITH the humidifier, off of batteries or your cigarette lighter, but you'll get fewer hours before you run the battery down if you use the humidifier. I suspect you can run the IntelliPAP humidifier off DC as well, but I'm not sure.

The PRS1 does better data collection than the IntelliPAP, which helps give you better treatment. Data collection is an extra $99 cost option on the IntelliPAP, and your insurance probably won't pay for it. Your out of pocket cost will probably be the same for PRS1 with data as the IntelliPAP without.

Good to know...could've sworn the manual said without humidifier but it has been awhile since I've read it. Maybe I've just confused it with the DeVilbiss manual which states no humidifier.

[cflame1]

What about a used machine?

Try either secondwindcpap or craigslist if you're interested in going that way. Sometimes they get advertised in here.

[-tim]

The DeVilbiss IntelliPAP series and the Phillips Respironics System One series all will work off of a DC power source without need for an inverter. You off course need the appropriate cords, but you can run them (sans humidifiers) off of deep cycle marine batteries while camping or off your cigarette socket in a camper/rv.

You can run the PRS1 machine, WITH the humidifier, off of batteries or your cigarette lighter, but you'll get fewer hours before you run the battery down if you use the humidifier. I suspect you can run the IntelliPAP humidifier off DC as well, but I'm not sure.

The humidifier will use more power at higher settings. From what I can tell, my ResMed S9 uses far more power for its humidifier than its pump but I haven't plugged it into the good power meter. The heated tube will also use lots of power. The S9 comes with a 90W power supply for the humidifier and heated tube but can run at some level with the 30W optional supply. I'm guessing others will work about the same way.

[Pugsy]

With Medicare and your supplement you will most likely have minimal out of pocket expense no matter which machine you get prescribed (either cpap or bipap or the high dollar machine). Your supplement (depending on which plan you have) typically picks up the 20 % that Medicare says is your portion and if any deductibles apply the supplement will pay that portion if your supplement plan pays the deductible.

Main thing is to make sure that the DME that you choose is a fully participating provider with Medicare so that they write off the difference between what they bill and what Medicare says is the allowable amount that the DME should be happy with and won't ask you to pay the difference.

Depending on how your supplement works..they may either pay the provider directly after Medicare pays or they may pay the 20% to you and you pay the provider. Hopefully they will pay the provider directly and make is simple for you.

Depending on where you live you may have several DME providers to choose from. You can start calling them to find out who is a Medicare participating provider and asking which machine brand they normally supply. Find one that supplies the brand you want (based on your camping needs) and then make sure you get a full data model which the others have already told you about.

Medicare bases their reimbursement on billing codes and not machine brand or model. CPAP and APAP and full data and compliance only data are all billed under the same billing code. BiPaps have a different billing code but same thing with them. Some DMEs will offer full data machines right from the start but a good number of DMEs will want to supply a machine that only gathers minimal data...compliance hours of use to satisfy insurance requirements because there is a higher profit margin on the machines that offer minimal data.

Make sure you get a full data machine..one that shows AHI, event breakdown, leaks as well as how many hours you use the thing. So make sure you know which models do what in the brand you decide will work best with your camping needs.

[rfwjr]

I have the Devil Bliss Intellipap machine and purchased a Group 31 marine deep cycle battery and a 400 watt inverter. I have the 12 volt cigarette power cable also but tried using my machine with the inverter so I could use the humidifier also and have run it for 3 nights so far on the battery using the humidifier. I am not sure I want to try and run the battery down using just the 12 volt cable that will not power the humidifier, I bet it will take more than a week if not longer.

[Uncle_Bob]

ResMed S9 machines are excellent, but don't have an easy 12V option. You have to buy a $89 DC-DC converter to use 12V.

a few bucks extra for the unlikely event I'm going to run it off 12v is pretty insignificant.

I would consider the following more relevant if 12v is not a priority :

The resmed S9 has a superior humidification system with the H5i and climateline (heated) hose with the temperature sensor at the end.
The resmed has better software with Rescan than the Respironics machine.
The resmed has a better review rating than the Respironics machine at sites like cpap.com.

[chunkyfrog]

Are you overwhelmed yet?
Everybody has their favorite machine--more or less.
Sometimes it sounds like a Ford vs Chevy discussion, but the differences are not as significant as the data.
All machines have compliance data--that is how insurance pays (or not)
Efficacy data is important to YOU--but not available on all machines.
AHI and leak are the two biggest items--even my sleep doc uses them.
Others are also useful--especially if your case is complicated.

[Super Iridium]

I'm new to this, but I can add one thing to the discussion -- get an AUTO-adjusting machine WITH exhale relief, like A-Flex or EPR.

I have the new Respironics auto-adjusting machine with A-Flex, and I sleep like a baby using it, from the very first night I tried it. Last weekend, I had to go in for a follow-up sleep study, and the nurse hooked my mask up to an older Resmed non-auto, non-exhale-relief machine (is that the right word for it?). Anyway, I was up all night with that thing blasting away at my lungs, and it was completely uncomfortable. I understand now why some have difficulty adjusting to this therapy, and I'd never want to spend a night like that again.

For what little I have seen of these machines, the ones with the auto-adjusting and exhale relief are the ones to get.

[robysue]

For my advice to the newly diagnosed---go to my blog

For extremely good advice on navigating the DME process, check out JanKnitz's What you need to know before you meet your DME. JanKnitz also has a nice thorough rundown on all the various machines commonly sold to newies

Best of luck!