Using Tricare...buying own equipment?

[rottyjohn]

Hello All,

I was curious if any ex-military types out there that buy their own equipment online and try to get reimbursed via Tricare? I know this is like a broken record but DME I have is useless to me! He provides no service that I can't do myself. Stopped fighting him to try and get an APAP and just bought it on my own. The machine I have he informed me early on was purchased outright which he said was unusual? But a very good thing... well good for him I suspect. I suspect that way he does not have to mess with compliance times as he's been paid in full? I was pretty much railroaded into using him by the sleep center that did my test! Sleep Center- Sleep Dr - DME seems more like a underworld syndicate than a medical team? I just didn't know any better? Wish I would have had the strength of the collective knowledge that exists here at cpaptalk. I suspect like many I found this great forum after I had initial troubles and the whole process had already been set in motion and felt like I was on an island. I suspect I will never hear from him which is fine with me. I do get a reorder card from them every 3 months. Still not sure how much of the supplies Tricare will pay for annually? The second I figure it out I will just handle all of it myself via online ordering.

Appreciate any thoughts,
John

[RUFFSTUFF]

Tricare pays to replace my mask and accessories, hose and filters every 3 months. Rumor has it that schedule shifts to every 6 months when retired, but I'll find out soon if that's true.

[rottyjohn]

Can I assume your still active duty? I retired myself from USAF in 2000 Wash D.C. area. I would be interested how your equipment was handled? Did you deal through a civilian dme and sleep dr? Or was it handled by a military sleep clinc? I myself was diagonosed by a military dr but refered to a civilian dr when my orgional sleep dr was reassigned to middle east short notice. I have heard there is a very good sleep clinic at Walter Reed Medical Center but only Active duty members are eligible. I am asked by DME to replace stuff every 3 months and as far as I know Tricare has covered it? i WOULD LOVE TO CUT HIM OUT OF THE LOOP!

Thanks for responding...

John

[Tom R]

I'm USN ret. using TRICARE North / Health Net Federal Services in Virigina Beach, VA. They allow replacement filters and pillows monthly, tubing quarterly and mask and water chamber every six months. Of course this is all done through the DME and I am billed by the DME for 20% of the negotiated price of the parts. I also get an invoice from TRICARE showing what was charged and what was paid by them and what I should owe the DME. I originally went to my PCM, they put in a referral to TRICARE who assigned me a Pulminologist who ordered and read the sleep study. He faxed the prescription to the DME of my choice and now he is out of the loop after two follow ups. Each month the DME calls me and lets me know what I am eligable to replace and I order what I need... I have had outstanding luck so far. I also had the choice to rent or buy outright, I found that out by calling TRICARE before I ordered the machine. It worked out about $40 cheaper for me to buy outright. I originally got the S9 escape auto but after getting it home and reading this blog I was able to trade it in for the AUTOSET the next day!!! I am very thankful for what I learned on here.

Give TRICARE North a call and let them explain it to you, the were very helpful!

Hope that helps...

[Lizistired]

I'm retired Army on Tricare. I was lucky and found this and another forum before I had my titration, so I got my reports and script, made copies and went DME shopping until one sounded like they knew what they were talking about. I use Apria. We danced a bit, and then he gave me what I wanted.
My S9 Autoset was a 10 month rent to own. I can get 2 pillows a month, a new hose, mask and filters every 6 months. I haven't even thought of the humidifier tank, I can't imagine what would go wrong with it. I still have to pay the 20% so there is no reason to stockpile anything.
I get the pillows and filters when I can and will probably call them about a full face mask for winter stuffiness.
I haven't had a problem with them other than a few delayed orders.
I need to call TriCare and see about ordering the sleepweaver mask online and how to get reimbursed, or if it's easier to try to get my DME to get it. Any input on that??
I did call them and ask if I needed to go to the 1 year follow-up with the sleep doc and they said they had no requirement for it. I got my script renewed and took a copy to Apria just to keep my bases covered in case I am traveling and need supplies.
My DME did call me at about 6 months for my SD card. He said he never knows when they will ask for compliance data. He did give me a new card in exchange for mine so I didn't lose any data.
Can't complain.
Now if I could find a new PCM with TriCare!!