Looking for a little advice.

[Derbysaddle]

I was just recently diagnosed sleep apnea. Yep came to the conclusion that I'm going to have to deal with it. But I haven't been pleased with my sleep clinic. I guess I don't have the best insurance in the world and they realize they aren't going to get any more money from me. Translation insurance only covered a home sleep study which my copay way 250. And anything else like the calibtating has to be done at home. The sleep center wants to charge me 800 dollars and I can be on my way . In between that my insurance co changed and the sleep clinic made me wait and wait to see if it would make. Diffrence. Surprise it didn't.
So my question is do I just get my script and buy my own machine rather then having to deal with the dme and the insurance co. The thought of having the extra pressure of making sure I'm compliant with the insurance company as im try it adjust to everything make me a little nervous. So am I better off buying one online and being done with it or being hassled with insurance and other bs ?

[Wulfman...]

I was just recently diagnosed sleep apnea. Yep came to the conclusion that I'm going to have to deal with it. But I haven't been pleased with my sleep clinic. I guess I don't have the best insurance in the world and they realize they aren't going to get any more money from me. Translation insurance only covered a home sleep study which my copay way 250. And anything else like the calibtating has to be done at home. The sleep center wants to charge me 800 dollars and I can be on my way . In between that my insurance co changed and the sleep clinic made me wait and wait to see if it would make. Diffrence. Surprise it didn't.
So my question is do I just get my script and buy my own machine rather then having to deal with the dme and the insurance co. The thought of having the extra pressure of making sure I'm compliant with the insurance company as im try it adjust to everything make me a little nervous. So am I better off buying one online and being done with it or being hassled with insurance and other bs ?

In my opinion......YES!
As long as you can get your prescription (or even if you couldn't) there are a multitude of options for getting equipment outside of the usual (DME) channels.
Our forum sponsor CPAP.COM, secondwind.com, craigslist, some of the forum members who also have machines to sell, some mask options are available on Ebay and other places........etc., etc., etc.
Even with using insurance, many times the costs of the deductibles, co-pays and such are about the same as buying outright.


Den

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[Elle]

Since you have to be compliant anyway in order to live longer and be able to wipe your own butt why not let them pay part of it?
I have very little to do with dme and am never checked for compliance. They only did that in the beginning. I think they figure if you've used it a few months you will either continue or not need supplies.

[Elle]

Or what Dem said.

[Oughtsix]

Insurance companies will have an agreed upon price they wil let the DME charge them and you, This might help with the cost a bit.

Even with lousy deductibles insurance can cover a large portion of consumables. This might also offer an advantage to going through your insurance company.

I have not had a problem with compliance data. I usually just brng in my data card when picking up suppies from the DME. Pretty simple.

Instead of asking here the only way to tell if the insurance company will be a benefit to you is to calculate the cost of a CPAP goin through them and the cost of buying one yourself. If the cost is the same I would bypass the hassel of dealing with the insurance company.

Remember, DME's are not doing you a favor by supplying equipment for you, you are doing them a favor bringing your business to them. Don't let them forget that!

[palerider]

Insurance companies will have an agreed upon price they wil let the DME charge them and you, This might help with the cost a bit.

Even with lousy deductibles insurance can cover a large portion of consumables. This might also offer an advantage to going through your insurance company.

er, yeah, so, like the guy that posted the other day that the DME had just billed him 88$ for two nasal pillows and 12$ for two filters, when you can buy the same pillows on amazon for 23$ and the filters for about a buck...
gonna take a long time to meet my deductible at that rate.

[Derbysaddle]

Yeah I tink I'm going to just buy my own. For a few hundred dollars more I can pick a machine that recommended on here rather then being stuck with what ever they deem I can have. The sleep clinic wouldn't spell out what was included in the 800 they want to charge. I think I'm probably going to need a full face mask because im a mouth breather. I didn't care a lot for the 2 thermocouples up my nose for the home sleep study so the thought of the nasal ones in my nose for life doesn't apeal to me. The sleep clinic has been less then helpful helping me and I feel lost. I know the DME isn't going to have my best intrest at heart.

[JimP]

I'm a mouth breather when asleep without cpap but a nose breather when on cpap.

So just because you think you're a mouth breather doesn't mean you will be on cpap.

To me, the full face mask were a difficult mask to use and the nasal pillow one (P10) is almost like not wearing one.

[yaconsult]

Mouth breathing can be dealt with using a comfortable chin strap like the Ruby Red. Getting a good seal all the way around a full face mask is much more difficult than getting a good seal around a pair of nasal pillows - especially at higher pressures. So try different types before making a decision on what works for you.

[Oughtsix]

Yeah I tink I'm going to just buy my own. For a few hundred dollars more I can pick a machine that recommended on here rather then being stuck with what ever they deem I can have. The sleep clinic wouldn't spell out what was included in the 800 they want to charge. I think I'm probably going to need a full face mask because im a mouth breather. I didn't care a lot for the 2 thermocouples up my nose for the home sleep study so the thought of the nasal ones in my nose for life doesn't apeal to me. The sleep clinic has been less then helpful helping me and I feel lost. I know the DME isn't going to have my best intrest at heart.

I told me DME the exact model of CPAP I wanted. They told me they didn't carry it. So I told them I would have to check around for a DME that did carry it. A half hour later they called and told me they located the CPAP I wanted.

They are also helpful for exchanging masks when you are first startingout to find one that works for you. Some people like full face masks, some like nasal masks, I could not stand either. Nasal pillows don't really go into your nose, they more sit on the bottom of your nose. I think nasal prongs are the ones that go into your nose like oxygen prongs. I thought I wanted a full face mask before I started my CPAP because I am a mouth breather. My DME talked me out of the full face mask and into a nasal mask. I learned how to breath with my mouth shut and I am glad I didn't go with a full face mask. Later I switched to nasal pillows and I am much happier than I was with a nasal mask that left a soar on the bridge of my nose.

Don't get me wrong, I firmly believe both my sleep clinic and DME are crooks... so I use them at my convience... not theirs! I don't blame you for not wanting to deal with them. It is possible that you might save money going through the local DME and insurance company.... you could just as likely if not more so likely be taken for a ride by them. Educating yourself here is your best defence! You can always turn around and walk out of your DME if they aren't being reasonable or helpful. You know you can order what you want online and you know how much it will cost you to do so.