Feeling a little jerked around by suppliers

[Isadora]

The sleep place I went to keeps trying to get me to buy the ResMed S9 autoset which is of course a lovely machine but with the mask and all it comes out to like about $1800. My insurance covers only up to $1000 and I have to pay it out of pocket first then get reimbursed. I don't have $1800 just laying around for a CPAP (as much as the machine is needed), so I tried to work out a payment plan with them but still they said I had to pay $1000 then split the rest into 2 payments since they had problems with people not paying in the past. I don't actually know what the resMed S9 Autoset goes for in general (I'm in Canada) or where I could buy it cheaper, though there must be somewhere. I asked the guy for my prescription and he is trying to get me to look into the Phillips Respironics Sleep Easy I (http://sleepeasy1.respironics.com/) for $785 or something with mask included (it does have a humidifier but it's a fixed pressure and very little data if any).

This is my first machine and I want to make sure I get something that is appropriate but also comfortable and will last. I don't want to blow $1000 on a crappy machine. I do feel though that all these suppliers and sleep places don't want to work with me to find a solution, they just want to get paid. I have to see the physician there now before they will give me a scrip, so I am seeing them next week. The folks at this place have been exceptionally NICE, that's not a problem, but when it comes down to the money aspect, there's not a lot of wiggle room or compromise and I feel almost like they want to almost force me to buy through them rather than let me shop around for my best solution.

What say all of you on this? I have never had to deal with this kind of thing so I'm taken aback by the idea that it should be so difficult to get someone to put your health needs first instead of making a buck off your vulnerability (yes I know, welcome to planet Earth!)

[ironhands]

lol get used to it, they will often try to suck you dry

You're in Canada? There's a set limit on how much you have to pay if OHIP is contributing. IIRC, for a standard CPAP machine (including the S9 Elite) will only cost you something like 300$, with a mask

[LSAT]

You can purchase the S9 Autoset with humidifier and hose for under $1000 at the host of this site....cpap.com. Shipping included...or there are several members on this board that have access to deals on that machine. Don't spend $1800 at a DME.

https://www.cpap.com/productpage/resmed ... chine.html

[ironhands]

If you're in Ontario -
http://www.health.gov.on.ca/en/pro/prog ... manual.pdf

This is the list of approved devices. OHIP covers 75% of the listed cost of any device in that list

[oak]

LSAT, I would question if Isadora could get reimbursed by ins. co if buying online or from a private party. It would be a good thing to check with ins co to be sure, because you are right; the DME is charging WAY too much for that machine. OP would do well to shop around at other DME's also.

[STL Mark]

Take a look at this option for an new DS560 Auto CPAP at $400. If you have any questions, PM me.

[Julie]

Hi - if you want to go private and Canadian, look at Coastal Sleep.com (or .ca?) in BC - they charge about the same as U.S. dealers and have Resmed.

[khauser]

Take a look at this option for an new DS560 Auto CPAP at $400. If you have any questions, PM me.

And the suggested option is a machine that is generally considered on a par with the S9 Autoset.

You won't have to involve your insurance at all, and yet it STILL is less than you co-pay would be.

Seems Canada and the US have a bit to share on the stupidity of pricing these things....

[BlackSpinner]

Take a look at this option for an new DS560 Auto CPAP at $400. If you have any questions, PM me.

I bought from STL Mark. I am in Alberta and it worked out fine. Very reliable person. People here will walk you through the setup. Use the local DME to get a mask that fits.

[caffeinatedcfo]

Know everything up front when choosing a DME and get it in writing. LINCARE has been over-billing me on each and every invoice. Most recently trying to bill me $630 for my (50%) share of the CPAP purchase, which based on my confirmed and documented quote on day 1 should really be $230. The good news is this is the last phone call I expect to make to them to correct their billing for them.

[Isadora]

Wow it seems this sort of thing is par for the course with all sleep apneacs. (I just made that word up. I must wrangle the prescription out of the DME's hot little hands now which will take some elbow grease. I had the home sleep study and home titration through them without seeing a doctor yet (though they kept mentioning their doctor is really great). I looked on CPAP.com and found a lot of good choices and I will check out STL Mark's offer as well. I have only tried a Fisher and Paykel (sp?) nasal and also full face mask and preferred the nasal but can't remember exactly which model it was. The place I have been going to only offers a few different kinds so I don't know if there's enough to try out and see what feels best. I have only tried those two. Do nasal pillows feel any better? I have no idea what that feels like. I do prefer the nasal because I feel claustrophobic in the full face.

Good point on the insurance! I will call and find out exactly what I must do to get reimbursed and ask about restrictions.

I am in Quebec and I emailed the RAMQ (Medicare) to ask if they cover anything. I checked the website and it doesn't say it's covered but under the list of things that aren't covered I didn't see anything about CPAPS. It's a great mystery!

There are good machines out there for $400-$500, right? I figure if I can get one of those then I can get the rest of the stuff (hoses, filters, mask) and not break the bank.

BTW, does anyone know if it is worth it to go for a very fine particle filter like for bacteria? Or should I be fine with just a regular filter? (I saw like, 3 levels of filtration on cpap.com for certain machines and don't know if they're worth it.)

[BlackSpinner]

Quebec doesn't cover it unless you are on welfare - then maybe.

We do have a few members in Montreal. I used to live there too.

Mark does a great job is sending stuff. The set up is easy. Getting an auto is great - it is much more flexible and there is software for his machine available for free. That is important if you do it on your own. Fine filters are a boon if you live in a polluted city - it means that for 8 hours you are breathing clean filtered air.

[ironhands]

Wow it seems this sort of thing is par for the course with all sleep apneacs. (I just made that word up.

It's generally referred to as getting "hosed"