New insurance, new problems?

[Zoopshine]

Changing jobs, and therefore changing insurance companies, at the start of the new year. I'm only a few months into my CPAP therapy. My current insurance is renting my machine until it's eventually paid for. But what happens when my new company comes along? They specifically state they need to prior auth all medical equipment. But they can't prior auth a machine I already have! Am I going to end up losing my machine? I can't pay for it out of pocket!

Looked for an answer from the new company, and naturally, couldn't get one. Anyone else experience this?

[LSAT]

Changing jobs, and therefore changing insurance companies, at the start of the new year. I'm only a few months into my CPAP therapy. My current insurance is renting my machine until it's eventually paid for. But what happens when my new company comes along? They specifically state they need to prior auth all medical equipment. But they can't prior auth a machine I already have! Am I going to end up losing my machine? I can't pay for it out of pocket!

Looked for an answer from the new company, and naturally, couldn't get one. Anyone else experience this?

Talk to your current insurance company....
1. Assuming you are in compliance...Can they accelerate payment and pay up the machine?
2. Since this was started with them is it their responsibility to complete payments even though you are no longer insured with them?

[chunkyfrog]

Ask the benefits manager (personnel dept.) at the new job how their plan works in your situation.
It may be easier than you think.

[bwexler]

Wild guess, new insurance company, new year, new machine, new rental period, new deductible, new copayment.

As suggested talk to the old and the new insurance folks. Get answers from both in writing.
Also talk to current DME for payoff on current machine.

Compare costs at CPAP dot com and secondwind dot com.
Do your arithmetic and decide which solution is best.

[lindalrc]

Went thru this a few years ago when my husband retired and went on Medicare. We were about 1/3 thru the rental period. Had to make sure that Medicare had the Rx and tell people again and again - but eventually all got straightened around. Treat it psychologically like a bunch of small hills - one month at a time and assume there may be extra phone calls, late notices, maybe even an edgy letter from the DME. Hang loose - not worth getting hot under the collar. Not sure what happens if you are forced to change DMEs, but some thoughts in the next paragraph. The DME we had in Minnesota was also in Maine, so it was mostly a matter of nattering at them nicely for a few months.

Also, remember that the machine IS a rental for 12 or 13 months. So, if you like the one you were given, then ask for the same one from the new DME. And, if you don't, here is the chance to do a bit of research and request something different. Also, don't forget the often-given advice that ANY doctor (especially your primary doc) can write the Rx. Just be sure you get a copy of the study results and the original Rx that were generated thru the prior insurance. You ARE entitled to this info by law.

Good luck.

[Janknitz]

Make sure you have a copy of your sleep study and your prescription. Often with a new insurer you have to start from the very beginning--that is show them the sleep study and RX, they will start you over with a brand new machine rental--along with a new deductible and co-pays starting over too. If you already have your RX and sleep study, you may get out of having to do a new sleep study (with deductible and co-pays) with the new insurance company.

Be sure to look at what it will cost you out of pocket. Would it be worth it to work out some deal to buy your own machine and avoid all the hassle? You already OWN the humidifier and the mask, hose, etc. All you would need to buy is the blower. It may save you money to just go ahead and buy it in the long run--don't forget secondwind.com.

[Cathyann]

This is similiar to what I'm going through. Ive decided it's easiest and cheaper for me to just buy my own. Avoid insurance and the DME. I don't need the hassle.

[library lady]

Last year, I switched plans. In January 2015 I had three months left of my original 13-month plan. I didn't sweat it, but wondered what would happen. Nothing happened, new insurance picked up those last 3 months, and I continued to pay my share. FWIW, I switched from a UCare Medicare Advantage Plan to a BC/BS Cost Plan. I do like UCare, just felt that BC had better coverage for my RX needs, and I'm staying with them this year as I really haven't seen much difference otherwise except in the premium.