who decides when you get a new machine????

Kantou · Post by **Kantou** » Mon Mar 16, 2015 6:42 pm

I have had mine for over 6 years who decides when you get a new machine you,the sleep doc or the dme I would like to get a new one that keeps data,,please tell me what you have all done to get a new machine

BlackSpinner · Post by **BlackSpinner** » Mon Mar 16, 2015 7:11 pm

Your insurance.

If you pay for it yourself and buy online you can buy an new one when ever you want.

webbie73 · Post by **webbie73** » Mon Mar 16, 2015 7:18 pm

For me my insurance allowed for a new amchine after 5 years. I called the DME a and ordered a new machine.

Gasper62 · Post by **Gasper62** » Mon Mar 16, 2015 7:21 pm

I am about to find out what my insurance will be willing to cover very soon. While doing some research I discovered this site/article and found it to be very interesting and informative. I can't vouch for the content, personally, but you may find it's useful to you. (or not)

https://maskarrayed.wordpress.com/what- ... me-part-i/

Wulfman... · Post by **Wulfman...** » Mon Mar 16, 2015 7:46 pm

Kantou wrote:I have had mine for over 6 years who decides when you get a new machine you,the sleep doc or the dme I would like to get a new one that keeps data,,please tell me what you have all done to get a new machine

To echo BlackSpinner.......your insurance decides.

Personally, my insurance reimbursed me for most of my first purchase 10 years ago and the other nine machines I own were all purchased out-of-pocket. I also didn't and don't want "new" ones. I was happy with the ones of the "generation" I got back then and didn't want to have to play the game of trying to keep up with the software changes that occur every time they come out with a new generation. So, I acquired all I could find from that (Legacy) generation before they disappeared. In addition, all the supplies I've purchased over the last 9 years have been out-of-pocket and mostly from online sellers and forum members. I've done absolutely no business with local brick and mortar DMEs.
There's an abundance of relatively inexpensive machines of little to unused status out there that are waiting for a little TLC and use.

Den

.

dadbar1 · Post by **dadbar1** » Tue Mar 17, 2015 10:08 am

It's your life....so YOU decide!

After 5 years, I wanted a new machine so I called my DME. They told me that they wouldn't dispense a new one without a doctor's order so I made an appointment with my doc and she gave me a new prescription for a new unit. It was all pretty effortless and the insurance company paid for the majority of the unit.

My DME was a bit sleazy, though. When the bill came, they itemized just about every part of the unit (Resp. System 60) and billed for it separately- like the water tank, power cord, filter, mask, straps for the mask, etc. If I had more time and wanted to be an asshole back, I might have told them to keep some of the stupid parts and ordered them separately, or reused ones I had that were fine from my previous unit.

LSAT · Post by **LSAT** » Tue Mar 17, 2015 11:27 am

dadbar1 wrote:It's your life....so YOU decide!

My DME was a bit sleazy, though. When the bill came, they itemized just about every part of the unit (Resp. System 60) and billed for it separately- like the water tank, power cord, filter, mask, straps for the mask, etc. If I had more time and wanted to be an asshole back, I might have told them to keep some of the stupid parts and ordered them separately, or reused ones I had that were fine from my previous unit.

This is normal procedure...it doesn't matter how they bill, the insurance company pays a set amount that has been agreed upon by the DME.

kteague · Post by **kteague** » Tue Mar 17, 2015 12:13 pm

If you have a different insurance provider, getting a machine shouldn't be a problem if you have the required documentation from your physician. If it is the same provider as the 5yo machine, they may have a clause that requires the prior machine to be non functioning before they will replace it.

Kantou · Post by **Kantou** » Tue Mar 17, 2015 8:53 pm

since I have different ins. then I did 6 years ago I should be able to get a new one...can I pick the brand I want and model or do they control that, I would like one that keeps data I like resmed machines!!!

bwexler · Post by **bwexler** » Tue Mar 17, 2015 10:26 pm

Get Your doctor to write a prescription for exactly the machine you want. For example Resmed Airsence 10 Autoset for Her with heated hose and mask of patients choice, dispensers exactly as written. Then neither the insurance company or DME can offer anything different.
As to the seperate line item billing that is common practice and may allow the DME to squeeze a bit more cash out of the insurance company. It may also mean you own everything but the main blower unit in the event of a rental period.

Drowsy Dancer · Post by **Drowsy Dancer** » Tue Mar 17, 2015 10:37 pm

I decided that I was going to get a couple of additional machines, so I did...in the gray market (Craigslist). Insurance? Probably have another year or more to go, but I don't like Aetna's permarentals.

Jay Aitchsee · Post by **Jay Aitchsee** » Wed Mar 18, 2015 5:52 am

Depending on your insurance co-pay and any "hassle factor", you may want to consider STK Mark's viewtopic.php?f=1&t=103983&st=0&sk=t&sd=a#p979555

who decides when you get a new machine????

who decides when you get a new machine????

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