Finally got prescription. A few newbie questions

[Tracy1968]

I just got a voice mail from my pulmanologist's office saying I'm approved for CPAP. I'm sooo happy. Why? My apnea is "mild" enough to not look horrible on paper, but it's severely negatively impacting my life. I think most of you are familiar with the word "zombie." During the second CPAP study, I didn't like the nose pillows or just nose mask, but I had no major issues wearing the full face mask.

A few questions:

1) The office called and said to let them know which DME I prefer so they can fax the prescription. I know that "DME" stands for "Durable Medical Equipment" (I had to Google it) but does that mean the brick and mortar "store" or is DME the actual manufacturer of the masks, machines, etc?

2) On another post, several people were kind enough to offer suggestions regarding what kind of machine to get (data capable and/or "for her" for example). Can any DME get the same kind of machines or is the idea to shop around and call different DMEs to see what they do and don't offer and THEN decide which DME to have my prescription faxed to?

3) Is there one brand of full-face mask that's better than others or is it a matter of trial and error based on personal preference/face shape, etc?

I live in a really small town and even larger cities 60 miles away don't always offer much choices on anything (retail, restaurants, etc.) so trying to do this right from the get go.

Much thanks in advance for any advice!

[tuna]

I will say this. Have your doctor put the specific machine you want on the script or the DME will get you the cheapest machine they have. I learned this after being burned by my EX DME.

[BlackSpinner]

Call your insurance company and find out who is in network.
Get a copy of your prescription and find out what is on it.

Go online at our host and look for the data capable machines which give you AHI and leak rate. Print them off.

Now call around and find out who will supply this.

Make 100% sure by taking the papers with you that you actually get one of those machines.

Treat the whole thing as if you were buying a second hand car from a dubious dealer. If they say it is light outside, check out the door to see if it is true.

[Julie]

Read this - http://maskarrayed.wordpress.com/

[SGearhart]

You might try calling DMEs "near" you and ask them if they have whatever brand/model you're looking for. Also, check to see if they are in your insurance network**. Just make sure that the xPAP you want is in the family of machines used to treat your apnea. Once you've found the DME that has your little puppy, call the doctor and give them the DME's information and request that the script be written to specify that make and model along with pressure data to support their requirement.

** - Being "out of network" is becoming more common. When you are signing all the paperwork, you don't realize that you've signed a form that states that you will be responsible for any debit that is not covered by insurance. Since the DME is not bound by negotiated pricing, they can go after you for any and all monies that are not paid by your carrier. This debit can wind up being more than if you bought a CPAP out of pocket. I'm not saying that this will happen, just please be on guard. . . I learned that hard way with a Holter monitor.

[amenite]

Don't forget - the prescription and your medical records are your property. You are entitled to a copy of the Rx and any study results etc. This gives you a bit of market power if your DME turns out to be "less than ideal". Get copies of this stuff now so you don't have to jump through hoops later on.

[palerider]

1) The office called and said to let them know which DME I prefer so they can fax the prescription. I know that "DME" stands for "Durable Medical Equipment" (I had to Google it) but does that mean the brick and mortar "store" or is DME the actual manufacturer of the masks, machines, etc?

it's a seller of medical equipment... could be brickymortar or online.. just a seller, not a mfgr.

2) On another post, several people were kind enough to offer suggestions regarding what kind of machine to get (data capable and/or "for her" for example). Can any DME get the same kind of machines or is the idea to shop around and call different DMEs to see what they do and don't offer and THEN decide which DME to have my prescription faxed to?

it's up to the business (DME) as to what brands and models and such they carry. you then pick which dme you want to deal with, based on insurance and their attitude, and recommendations and such.

3) Is there one brand of full-face mask that's better than others or is it a matter of trial and error based on personal preference/face shape, etc?'

alas, there's no clear winner, different folks like the fit of different things. one of the more popular ones these days is the airfit F10 masks from resmed.

I live in a really small town and even larger cities 60 miles away don't always offer much choices on anything (retail, restaurants, etc.) so trying to do this right from the get go.

depending on insurance and costs and such, you might be as well, or better off dealing with an online supplier, their base costs are often much lower.

[sleep_quest]

Another thing to research is whether your insurance company is paying to rent the machine for you versus buying you one outright. That might make the price you pay more than it seems in the beginning.

[sthnreb]

A lot depends on your insurance as stated. With Medicare and no supplemental one pays 20% in network and normally 25% out of network. When I began bipap treatment I had private insurance. Mine at the time was limited to $2500 total. I had two sleep studies and I believe it left only about $300 to purchase a machine. Therefore I searched the internet for the best price. Also now with Medicare, they rent the machine for 13 months now before it becomes mine. I just got a new machine, Resmed Air Curve 10 VAuto and I did get it on my prescription. Find what you want and if necessary call your doctors office and have him make you a Rx showing the machine and accessories. Masks really are a personal preference and some DME's have some you can try. There are also as someone stated DME's online who will ship supplies to you after you get a machine. Some will file insurance for you and with some you may have to file your own claim. First, check your insurance. Is it a cpap or bipap machine prescribed? With either, the auto seems best as it will titrate and adjust the air pressure as needed. It does need to have a method of reading therapy such as a card. You can also get the Sleephead software here. Best of luck and if you still have questions, post them, everyone here is glad to assist.

[Tracy1968]

Thank you so much everyone.

I'm on with my insurance company for the second time today and I would have NEVER thought to ask for all the info you all posted here.

THANK YOU THANK YOU THANK YOU