What does your DME offer that you can't get online?

[jab1972]

After 2 months, it's clear CPAP is for me. Now it's time to figure out the best way to get the equipment permanently. My health insurance will cover part of 3 month's rental and 50% of the purchase price after that. My purchase options seem to be:

1. Buy it from the DME recommended by the sleep doc. It's a brick and mortar vendor associated with the sleep center that has treated me well and didn't try to pawn off a cruddy machine on me. They gave me a pretty good initial fitting (no lying down with the mask), and programmed the SD card when I needed a pressure change. My out of pocket is more expensive this way, and the total cost (including the health insurer's outlay) is much more expensive this way.

2. Buy it online. I would have to figure out how to program new pressures myself. I would also have to jump through a couple hoops at the insurance company to make this happen. But financially, it would probably save me at least a couple hundred dollars.

Financially, this seems like a no brainer. But I'm new to this, and was wondering if there are things I'm missing in the equation. Are there things a DME offers that I just haven't thought of? Loaner machines if mine breaks down?

[DavidCarolina]

I wouldnt either/or that question. I think a DME has its place, or better yet, a pulmanologist/oral surgeon who's seen every aspect of osa and knows every cutting edge option as your needs change. You find these guys in bigger cities and theyre more expensive.

Id also learn it all yourself and buy your own machines. Heck, you can buy one on craigs and program it yourself.

Dont forget the resource of mobile providers to retirement homes who rent machines of different types. Theyre always selling equipment. I bought from one, and he was supposed to see a scrip but lol he never asked me for it.

I havnt made the foray into sleepyhead technology and chip reading yet but thats coming soon.

I also want to do oximetry studies by purchasing that stuff myself.

But a loose connection to a sleep doc cant hurt for when you may need it. For one thing, they can prescribe meds, whereas
your general practitioner probably knows as much about apnea as about the surface of Jupiter. Not that he wont pretend he knows all about it.

[jnk]

A good local DME can be great for trying out masks for a month, if they are on board with letting you turn one back in to them that didn't work for you. Buying from CPAP.com may get you "mask insurance" from them, which is almost as good, though. Good local DMEs aren't all that common, but when you find one, it is nice to give them the business, I feel.

CPAP.com will set your pressures according to your doc's Rx, so don't worry about that.

It may be that paying 100% online is cheaper than paying your share of an insurance purchase from a local DME. Do the math to be sure what is best for you.

Fellow patients here and elsewhere can provide better support than all but the very best brick-and-mortar DMEs give, in my opinion, if you are a plain OSA patient.

[Slartybartfast]

more expensive this way, and the total cost (including the health insurer's outlay) is much more expensive this way

From my twisted perspective, I would consider it unethical to use the bricks/mortar DME if they are charging more than I could get the same item for online. Everyone seems to think someone else is paying for it, and that kind of thinking is one of the things that makes health insurance costs so high. If I can save my health insurance company some money by not using the more expensive DME, I will do so. Eventually that savings will be passed on to the consumer in the form of lower rates. If my out of pocket cost is also less, then the decision is a no-brainer.

[Pugsy]

Loaner machines if mine breaks down?

Or immediate swapping out and new machine for a dead machine instead of waiting to send the dead machine back to online supplier who then sends it on to manufacturer to address any possible warranty issues assuming still within the warranty period.
This is why we have a backup machine though...

It isn't hard to program the machines so that is pretty much a non issue.

The bottom line dollar cost was part of the reason I bought my machine privately. I found what I wanted at a price that was actually a little less than my co pay with using insurance. So it was a win win for me. No hassle and I saved a bit of money.
I could still fall back on insurance bought machine if I had to because I do use a DME for masks because the bottom line savings there for me with my co pay is substantial. Most of the other supplies (filters and such) I have found online cheaper than my co pay but not masks. My insurance is an 80/20 thing though...not 50/50 so we have to do the math and figure out which way we want to go.

[nanwilson]

DME- A heck of a lot of grief!
On- Line supplier- you get what you want, when you want it!

[LoneStar]

"What does your DME offer that you can't get online?"


- higher prices.
- grief.
- lack of integrity.

Lisa

[chunkyfrog]

In-network insurance coverage, Medicare taking care of the paperwork.
My deductible is so high that it is foolish to use the DME as long as all I can get is LIES.

[DreamLady]

I've done it both ways, DME and online. For me, self-pay is the way to go so long as I can afford it.

In my case, though, I bought a machine out of pocket from a DME for about the same price as online. It worked out great, because I took it home with me immediately rather than waiting for it to ship. They were pretty shocked that I was willing to do so, but they were willing to heavily 'discount' the cost because I was paying cash. I got my brand new, still in the boxes, S9 Elite, w/climateline hose and humidifier for $800.

It soon became apparent that the DME was billing insurance for each part of the interface separately, thus creating a substantial 'markup' for themselves. They would bill for the interface, headgear, cusions, short hoses, long hose (whatever would come off the unit, they billed separately, even though it was given to me in one piece). They did this each time I got a new mask. It only took twice before I realized my insurance co-pay was costing as much or more than buying the entire mask (or the relevant parts I need) out of pocket. So that's what I've been doing since. While I wasn't paying that much for the deductible, the insurance was paying almost double what I could buy the mask for online.

The DME still calls me monthly. When I say I don't need anything, there is this confused silence on the line. Then they ask, "Are you using your machine?" When I reply "Every night," there is more confused silence. I tried explaining the above to them a couple of times, but eventually gave up. I just get too many chuckles out of their dismay and confusion. I don't pay more than $100 every three months for my supplies. I will continue doing that as long as I can afford it. I can always take the costs out of my flexible spending account, too.

[jen4700]

Someone can correct me if I'm wrong. But I thought I read CPAP.com does not process insurance of any kind.

[chunkyfrog]

The knowledge that your are helping finance the lavish lifestyle of a really deceitful dirtbag.
to Jen:
Cpap.com does not process insurance, but one other online vendor will--for a significant fee (unless it's Medicare)

[Pugsy]

Someone can correct me if I'm wrong. But I thought I read CPAP.com does not process insurance of any kind.

They do not accept insurance in lieu of payment but they will furnish you with a universal insurance form to add your own insurance information to and submit for reimbursement.

So they don't bill your insurance company but they will supply you with a form via email that can be printed off and you can submit and get reimbursed for if your insurance offers it...most likely as an out of network provider if there is any coverage available.

[Janknitz]

A really good DME is worth his weight in gold, but anything less than a really good DME is not worth a cent.

A good DME furnishes you with the best machine for your needs--EFFICACY data is a must, plus whatever bells and whistles are important to YOU that will keep you using the machine comfortably every night all night.

A good DME has a liberal mask return policy and will KEEP working with you until you have the right mask. Even better if the DME lets you take sample masks home to try before committing to a purchase.

A good DME will help you troubleshoot problems and help you understand your therapy and monitoring so that you get the best treatment possible.

A good DME isn't about to sell out to a crappy national chain that will treat you like dirt.

IF you find a DME like that, the extra cost is worth it. If not, you, as a reasonably intelligent person, will do fine ordering your stuff online and coming here to gain the knowledge you need to take care of your own treatment.

[xenablue]

I'm lucky to have an awesome DME - I CAN go to whomever I choose, however the one I go to was recommended by my neurologist. It's a storefront which is owned by the Sleep Wellness Institute and all they have is XPAP equipment and supplies.

I go there to pick up my supplies, they let me know when I'm there if I'm eligible for any other replacements, without pushing me to take them - I usually decline. The employees know about OSA and can assist with some issues. They also ask my opinion on different things because they know I come here a lot, so they're willing to listen and learn! Some things they've even taken to staff meetings to discuss.

I can order ANY mask I want and they'll get it in for me.

They know my insurance and there's never a problem in that regard.

I like to be able to speak with the DME face-to-face.

Cheers,
xena

[Goofproof]

The ability to soak your INS and You for the most money for the cheapest product, while also giving you the most hassle, run arounds and lies. Jim

They are professionals........