Is A RX Brand Specific?

[IRONFISH]

I need a bit of help. I recently started receiving Medicare, I selected a Insurance Carrier, the problem is I selected one that will be accepted by my Electrophysiologist. I had a Sleep Study done through the Providence Health System in the past. The machine they ordered for me was a C.P.A.P. Respersonic. I hated it, I could not adjust to it, the setting was too high, the ENT refused to discuss the issue with me. I put the device back in the box and it is in the garage. I finally became seriously ill, I wiggled around and purchased a ResMed, which I just love. Now it has died, can not get it repaired by the locals because I no longer am with the doctor that ordered the machine. My RX is no longer valid.

My question is if I get a Rx for a Respersonic Autoset, how would I go about obtaining a ResMed device instead? I realize we all have our preferences, lots of people love/like/tolerate their particular brand of device. I just really like my ResMed.
Thank you in advance for your helpful suggestions.

[nanwilson]

I need a bit of help. I recently started receiving Medicare, I selected a Insurance Carrier, the problem is I selected one that will be accepted by my Electrophysiologist. I had a Sleep Study done through the Providence Health System in the past. The machine they ordered for me was a C.P.A.P. Respersonic. I hated it, I could not adjust to it, the setting was too high, the ENT refused to discuss the issue with me. I put the device back in the box and it is in the garage. I finally became seriously ill, I wiggled around and purchased a ResMed, which I just love. Now it has died, can not get it repaired by the locals because I no longer am with the doctor that ordered the machine. My RX is no longer valid.

My question is if I get a Rx for a Respersonic Autoset, how would I go about obtaining a ResMed device instead? I realize we all have our preferences, lots of people love/like/tolerate their particular brand of device. I just really like my ResMed.
Thank you in advance for your helpful suggestions.

If your Resmed is still under warranty, just take it back to where you bought it... its got nothing to do with the doctor that ordered the machine. An RX is an RX, you can buy any cpap related item with it, does not matter what brand.

[Sheriff Buford]

Any doctor can prescribe you a new cpap machine. I have never seen a sleep doctor and my primary care doctor writes mine. Ask them to write down" Resmed Autoset S9 with Humidifier". Also ask them to write you a separate one for a cpap mask (of patient's choice) and supplies.

Sheriff

[squid13]

Medicare is your primary insurer and they don't really care which machine brand you get, because there billed by a billing code. If you have never gotten a machine since you've been on Medicare they will probably require you to have a sleep study before they give you a machine and then they rent it for 13 months and then it's your's. They also require compliance and a doctors visit within the first 90 days.

[IRONFISH]

I need a bit of help. I recently started receiving Medicare, I selected a Insurance Carrier, the problem is I selected one that will be accepted by my Electrophysiologist. I had a Sleep Study done through the Providence Health System in the past. The machine they ordered for me was a C.P.A.P. Respersonic. I hated it, I could not adjust to it, the setting was too high, the ENT refused to discuss the issue with me. I put the device back in the box and it is in the garage. I finally became seriously ill, I wiggled around and purchased a ResMed, which I just love. Now it has died, can not get it repaired by the locals because I no longer am with the doctor that ordered the machine. My RX is no longer valid.

My question is if I get a Rx for a Respersonic Autoset, how would I go about obtaining a ResMed device instead? I realize we all have our preferences, lots of people love/like/tolerate their particular brand of device. I just really like my ResMed.
Thank you in advance for your helpful suggestions.

If your Resmed is still under warranty, just take it back to where you bought it... its got nothing to do with the doctor that ordered the machine. An RX is an RX, you can buy any cpap related item with it, does not matter what brand.

The ResMed came from Kaiser Permanente, they refused to touch it since I was no longer a member. I offered to pay cash for the repairs or to purchase the necessary parts, nope. I then took the machine to a different DM same thing, I did not purchase my machine from them, they were not going to repair it for me.

[squid13]

Give these people a call, there also a member here. http://www.acbio.com/cpaprepair.htm

[kaiasgram]

The ResMed came from Kaiser Permanente, they refused to touch it since I was no longer a member. I offered to pay cash for the repairs or to purchase the necessary parts, nope. I then took the machine to a different DM same thing, I did not purchase my machine from them, they were not going to repair it for me.

Kaiser uses Apria to provide machines that Kaiser then dispenses to patients. Are you saying that Apria is refusing to help you?

[StuUnderPressure]

If you have never gotten a machine since you've been on Medicare they will probably require you to have a sleep study before they give you a machine and then they rent it for 13 months and then it's your's.

If a person's prior Sleep Study meets the "current" Medicare requirements for a Sleep Study, Medicare does NOT require a new Sleep Study.

They also require compliance and a doctors visit within the first 90 days.

If a person was "successfully" & "continuously" using an XPAP before entering Medicare, Medicare does NOT require either compliance nor a doctor's visit.

But, all Sleep Doctors & DMEs "think" that both ARE a Medicare requirement & one will never be able to convince them otherwise. So, basically, they WILL force one to meet those 2.

If one was previously using an XPAP, meeting compliance will be a piece of cake anyway. One just has to also waste the time going to see the Sleep Doctor 1 additional time. There is also the cost of seeing that Sleep Doctor (if one's secondary insurance does not pay 100% of whatever Medicare does not pay).

Both people I have assisted in getting a machine through Medicare did NOT have ANY out of pocket cost, so we did not see an urgency to fight that battle.

However, Medicare is needlessly paying for services that it does not even require.

[StuUnderPressure]

My question is if I get a Rx for a Respersonic Autoset, how would I go about obtaining a ResMed device instead? I realize we all have our preferences, lots of people love/like/tolerate their particular brand of device. I just really like my ResMed.
Thank you in advance for your helpful suggestions.

Some people have been able to get the machine they wanted withOUT the Rx specifying a particular brand. But, if it "specifies" Resperonics & that is what the DME would like to give you anyway, I think you will have an uphill battle.

I personally think one will just get less grief from the DME if the Rx specifies the exact brand & model of machine you desire. And, if it is an Auto, make sure the Rx also specifies a pressure range. Otherwise, they will try to just give you the straight CPAP version of that brand.

[chunkyfrog]

Check my Medicare provider link (below--enter zip code for your area)