new masks how often??

pharmwoman · Post by **pharmwoman** » Sat Apr 01, 2006 4:15 pm

for the long term c-pap users here, how often should the mask be replaced? My insurance states they will pay for a new mask whenever the current one is "unusable" which seems kind of silly because Im not goung to wait till mine is broken to replace it. just curious--thanks:)

Guest · Post by **Guest** » Sat Apr 01, 2006 4:21 pm

I guess it depends on your insurance. I've seen a lot of people say their insurance covers a new mask every 6 months.

pharmwoman · Post by **pharmwoman** » Sat Apr 01, 2006 4:24 pm

I specifially asked for a timeframe and she said there was none, just when the dr considered my mask unuseable--I figured 6 months is a good time to not have the mask totally used up so i can collect and have a back-up.

chdurie2 · Post by **chdurie2** » Sat Apr 01, 2006 5:55 pm

pharmwoman:

that's a wonderful, patient-friendly clause in a policy. unless there is another clause barring replacement because of patient negligence, accident, or friviolousness, it means your insurance company is more committed to compliance than it is to fighting over mask replacement. your insurance company is not going to risk your being without a mask, because it recognizes that a mask could become unusable in a day. it's no-fault mask replacement, with the doctor as arbiter. my reading of this is that if you can show a doctor that the mask was never usable for you, the insurance company may replace it immediately. of course, if your doctor won't recommend anything but a respironics mask, that's a problem. but my doctor, not that he's so wonderful or unusual, probably would agree if i specifically showed him, that a certain mask was unusable for me the second i got it and order replacement according to my suggestion. as long as i wasn't finicky about everything.

LocoLouie · Post by **LocoLouie** » Sat Apr 01, 2006 6:30 pm

I was given the impression from my DME that masks could be replaced every 90 days but the headgear would be replaced every 180 days. Upon resrarching this, there is a Medicare guide to CPAP replacement parts with different time frames for masks, seals, nasal pillows and so on. I wish i could refer you to the site I saw this in but iI can' seem to find the bookmark. LL

Swordz · Post by **Swordz** » Sat Apr 01, 2006 6:32 pm

I've always read the "average" time for mask replacement is 6 months. Of course its "mileage may vary" kinda thing as each user is going to experience different mask degradation over time, and dependent on what mask.

For LocoLouie, you like frightening like the actor who played Mario in the Mario Brothers movie. I am young, but how can you forget a movie that horrible! Hopefully no offense is taken, either about your similiarity or the horrible movie.

Wingman · Post by **Wingman** » Sat Apr 01, 2006 9:12 pm

Swordz,

First: What part of Kentucky you in dude?

Second: At 34, I thought I was young to be on this treatment, you look 10-12 years younger than me. I didn't think apnea was common in young, fit folks, such as yourself

Moogy · Post by **Moogy** » Sat Apr 01, 2006 9:22 pm

Wingman wrote:Swordz,

First: What part of Kentucky you in dude?

Second: At 34, I thought I was young to be on this treatment, you look 10-12 years younger than me. I didn't think apnea was common in young, fit folks, such as yourself

Haha, Swordz has a very OLD photo of himself for his avatar!

Moogy
53 and getting older by the minute

ozij · Post by **ozij** » Sat Apr 01, 2006 11:11 pm

Haha, Swordz has a very OLD photo of himself for his avatar!

Sure. About 2 years old (the photo) at most....

O.

Swordz · Post by **Swordz** » Sat Apr 01, 2006 11:27 pm

Apparently the Swordz fan-club is in session and I didn't even know. I'll have you know I'm 24 on Monday, an old and weathered 24. Hand me my geratol, bedpan, and put me in a home.

Wingman wrote:First: What part of Kentucky you in dude?

Lex/Berea/Pville/Mo'Head: Yah, I drive alot.

Complicated, way too much time, too tired to explain it all, and i'll prob 4get some of it anyways.

Wingman wrote:Second: At 34, I thought I was young to be on this treatment, you look 10-12 years younger than me. I didn't think apnea was common in young, fit folks, such as yourself

Add that to the list of common misperceptions. Kids can have apnea, as you'll hear hospitals are increasingly adding pediatrics to sleep labs. I'm 6'0, 170 lbs, I'm defintely fit, but bad genetics and small airway.

From all the reading and information I've found, the usual component to OSA and "skinny/fit" people is a recessed jaw. This is not in all cases, but is very frequent and should definitely be discussed with the appropriate doc, which is usually Oral-maxofacial surgeon. CPAP can even be unproductive/unresponsive in people with certain physical builds, ie. recessed jaw.

pharmwoman · Post by **pharmwoman** » Sun Apr 02, 2006 6:26 am

I wouldnt call myself "skinny" but I am fit and trim and my issue is the soft palate and tongue collapsing.......

SleeplessinBradenton · Post by **SleeplessinBradenton** » Sun Apr 02, 2006 6:36 am

Apparently my insurance (which is not all that great) replaces every 3 mos. I thought that was pretty crappy when I still haven't found a mask I can live with and can only change every 3 mos., but I guess I should consider myself lucky if some only allow every 6 months!! It is my understanding also that whatever the Medicare guidelines are is what determines the insurance companies' policies on equipment and replacement, etc.

cybergoon · Post by **cybergoon** » Mon Apr 03, 2006 11:06 am

I'm not sure what to think on this issue. I have gotten 6 masks so far, and have only been on therapy since October, 2005. The most I have been billed is $15 for a mask. I think I finally found what is going to work for me.

I have Blue Cross/Blue Shield through AllianceSelect. I have been having issues with my current mask (Ultra-Mirage FF size medium/standard), as it feels a little bit too big for me. Friday, while off work, I walked into my DME (lincare) and asked if they had a small/standard I could get. She went back, grabbed it, had me sign and I was out the door. No questions asked.

Davidmcc · Post by **Davidmcc** » Tue Apr 04, 2006 10:00 pm

I am staggered by the suggestions of replacing masks evey 3 to 6 months. Here, in Australia, the Comfort Gel costs $235 AUD and the Activa $235 AUD, with almost no benefit payable for replacements. When I inquired of Respironics and friends also on CPAP how often they changed/repleaced their masks, I was advised that putting breakage to one side, most replace cushions or silicone seals at intervals of 12 - 18 months and complete masks at intervals of 2 - 3 years. Given I have now been using my initial Comfort Gel for just on 12 months I have no reason to doubt these indicators.

sleepyred · Post by **sleepyred** » Wed Apr 05, 2006 6:07 am

I called my insurance company (BCBS) and the were very vague. She said "Any item may be replaced when medically necessary."

So I said - "so if my hose breaks in half two days after I get it, I call me dme and order another one?" She said yes. I'm still unclear. I would not hesitate to call and order more pillows for my breeze, filters, tubing, but would be afraid to order a new mask until 6 months is up. She said if something is not working and you cannot use your cpap, what is the use of having it? Sounds reasonable to me - if I lose a blessed little green pillow down the drain or the dog eats, it, I still need my cpap. I am going on vacation this summer and will make sure I have new pillows - just in case!

I did order one with my own money - comfort lite II, but don't have it yet. $109 at cpap.com and my breeze was $375 (paid by my insurance company) from my dme - CRAZY stuff!

Mask

Additional Comments: Aussie Heated hose for rain out/PapCap Headgear and chin strap

new masks how often??

new masks how often??

Replacement stuff