replacement schedule

[kit15]

I am one month in to therapy, and my filter is starting to look a little gray-ish, but I'm not sure when I am covered for a replacement.
I am wondering what kind of replacement schedule people have. I have been trying to figure out how often I am covered for, but I haven't had much luck. The DME says to ask the insurance company, and my insurance company says that the DME determines the schedule and that they have to follow Medicare rules (even though I'm not covered by Medicare). Does that sounds right? Maybe there is some kind of universal replacement schedule that is based on Medicare? Does anyone know where I could find a copy? Thanks!

[Pugsy]

A good many insurance plans mimic Medicare's replacement schedule.
Your Respironics machine uses the gray filter which is considered the "non disposable" filter and the optional white fine filter which is considered the "disposable" filter and probably what you are referring to when you say it looks gray. Whether your DME and/or insurance goes by this schedule...you will have to ask.
I buy my filters in bulk...saves money. I can get 6 filters for what my insurance co pay would be for 2 filters. I usually buy in bulk of 12 or 24.

http://www.cpapsupplyusa.com/CPAP-BiPAP ... edule.aspx

Item (number) HCPCS Code Replacement Frequency
CPAP Mask A7034 Every 3 months
CPAP Headgear A7035 Every 3-6 months
CPAP Tubing A7037 Every 3 months
Disposable Filter A7038 2 new filters every month
Non-disposable Filters A7039 2 new filters every 6 months
CPAP Chin strap A7036 Every 6 months
Full Face Mask A7030 Every 3 months
Oral CPAP Mask A7044 Every 3 months
Humidifier Chamber A7046 Every 6 months
CPAP Machine E0601 Generally, every 3-5 years, or as necessary

[Nick Danger]

Same here - I buy filters for my Resmed S9 in bulk. They are so cheap, I don't even worry about insurance (I think I paid under $20 for 12 of them).

[kit15]

Thank you both for your replies. If I am interpreting the insurance EOB correctly (which it's possible that I may not be), my 20% for 1 disposable filter was $27 so it sounds like I would definitely be better off not going through insurance.

[Nick Danger]

I didn't do a detailed search, but CPAP.com sells 6 disposable filters for the 60 series for $11.95. Oh, and I found these through a quick EBAY search: http://www.ebay.com/itm/12-Respironics- ... 0339673211 for $15 with free shipping.

Not sure which of those fit your specific machine (I don't really know much about the Respironics machines)

[kit15]

Thank you! This is a steep learning curve.

[Krelvin]

Thank you both for your replies. If I am interpreting the insurance EOB correctly (which it's possible that I may not be), my 20% for 1 disposable filter was $27 so it sounds like I would definitely be better off not going through insurance.

WOW what an absolute rip off.

When I got my new machine in Sep from the DME, I paid for 2 filters (despite the fact the machine should have come with them)...

My copay is on the right. Allowable is on the left.



The $10 was for no insurance.

I use the Hypoallergenic filters now which they say they can't get. So I buy the 6pk Hypoallergenic filters now from cpap.com and order them when they have no shipping cost specials.

[kit15]

My statement is not quite so easy to read. I could be wrong, but only 2 items were marked as "purchase" and the cheaper one is $27 and is called "F STR Kit", which I thought might mean "filter starter kit." I guess it's possible that it is billing for both the disposable filter and the reusable filter? Although it does seem like those should come with the machine. Hopefully I'll be able to get more clarity from the insurance company at some point.

[Nick Danger]

The EBAY link included 2 of the gray filters and 12 of the white filters for $15.

[Woody]

Thanks for posting the replacement schedule. So if you can get a hose every 3 months
I guess I can't complain that mine is just about shot after only 6 years of use ! I really
hate to get rid of it, it's been my friend for so long. But 30 min. ago I retired it from
6 years of trusty service.

[Deep Sleep]

If car dealers operated like DMEs, you'd be billed for a list of every part in the car with the replacement cost and a Honda Civic would cost over $100,000.

[englandsf]

Ask your sleep doctor to specify all your parts replacement schedules on the RX. It cuts out a lot of insurance issues I have found.

[kit15]

Ask your sleep doctor to specify all your parts replacement schedules on the RX. It cuts out a lot of insurance issues I have found.

Thanks for the suggestion. Sounds like a good next step

[tedburnsIII]

Could someone please respond to OP's inquiry? Oh, thank you, Pugsy, above!

[Krelvin]

Could someone please respond to OP's inquiry?

Several people have already.

If insurance is paying then it is up to them to provide the schedule regardless of what the DME says. If he is buying without insurance he can replace whenever he wants to. we are talking about a very inexpensive part.