What does your insurance cover?

[DiverCTHunter]

BCBS-TN PPO - have to pay %100 of the allowed amount until I hit my $500 deductible, then it's 25% copay. All of the brick-and-mortar DMEs have such a huge markup that it works out better to use our hosts once my deductible resets.

[Tino2You]

I have Cigna. They paid 80%, I paid the rest. I got my machine from Apria (my DME ) about four weeks after my sleep study ( 2 weeks to read test result, 1 week bouncing around Cingna, 1 week bouncing around Apria).

I just got my first 3 month resupply which was covered 100% to the tune of 280.69 (3 pillows (all medium so no swapping) and 3 short connecting tubes with swivel nozzel and three medium pillows ) and three filters. I could have received a non climateline hose but passed on it. I can still remember my frozen sinuses.

-tino

[Blindrage]

I guess I am one of the lucky ones. My BCBS plan has no deductible, copay, or limit on costs.

They bought me a CPAP machine in March when the doc first tested me. I then complained about the centrals I was seeing, and in July they bought me an ASV machine. So I am feeling much better, and I have a decent spare if anything happens to the ASV.

[cherylgrrl]

My BCBS Federal plan has no deductible and a 30% co-pay. They require me to rent the machine for 10 months at 1/10 of the cost of purchase, at which point I own the machine outright. Humidifier and everything else is direct purchase.

[KEQ5]

Our Oxford/unitedhealth plan is 100% coverage, with an annual limit on disposables of $1500/yr. Since I have yet to see any bills at all, I'm inclined to believe the insurance rep.

[dragon672]

I had to pay for the humidifer. BCBS pays 80% I think at least. I can find no replacement schedule anywhere for my plan. So I haven't had anything replaced since May. It's either 10 or 13 month rental then I own my machine. BCBS didn't use to check for anything but starting in October they will and everything has to be pre-authorized before they pay for anything.

[NeNeen]

Unfortunately I have Humana. That is the only insurance I can get since I am under 65 and on Medicare. In 2 years when I turn 65 I will check into other plans that I fo am eligible for. I have to rent the machine for 13 months at around $14 then it is mine. Also have to be in compliance for 3 months. Not sure about supplies. Just started about 3 weeks ago.

[MAXDRI]

Everyone seems to have different levels of coverage. I must be very, very fortunate. I have never paid a cent for several sleep studies, equipment, or masks. And no one has ever asked about compliance. I have the latest & best equipment that is recommended for patients with Central/Complex Sleep Apnea. I have Medicare through Kaiser, plus insurance from my last employer. I have never seen a bill for anything connected with my sleep apnea. I do have a co-pay of $20.00 for most office visits. Three months ago, I had spine surgery. The surgery at Kaiser's Regional Spine Clinic and three days in the hospital cost me $100.00. I might add that the spine surgery was very successful. I hope I don't sound like I am bragging. I am just very, very lucky. And somehow all of my insurance works smoothly, as I have never had to deal with paperwork or bills of any kind. I wish all of you were as fortunate as I am.

[justpam]

You are, indeed, very fortunate . I had no idea there were so many different levels of coverage, especially inside the BCBS giant.
I'm glad your surgery went well. Successful spine surgery and great insurance coverage is something you're allowed to brag about