Hello All - I am about to buy a Resmed S8 for $750 out the door. Can anybody out there let me know about their experiences in trying to have your health insurance carrier absorb any of this cost? I am curious since I heard that unless you get a straight CPAP (which I do not want) then the insurance companies balk at the thought of covering any cost of an auto titration device.
By the way is $750 a reasonable cost for the new S8 with humidifier from Resmed?
any help is appreciated.
Insurance coverage
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I have not, and will not buy Resmed products, however this site is ran by CPAP.COM and the pricing is for all to see, BILLMYINS.COM can help you with your ins maybe, also owners of the site. Jim
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
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CollegeGirl
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Hi C-Man,
Who told you that? Your DME? Sorry, not laughing at you, but at the wool the DMEs like to pull over people's eyes. Your insurance pays the DME the same whether they give you an auto or just a straight CPAP, but the autos cost the DME more. So of course, they like to try to pawn off straight CPAPs on you. Stick up for yourself, demand your S8, and if the DME balks call your insurance company. They'll either deal with your DME themselves or tell you how to. As Goofproof mentioned, billmyinsurance.com is a great place to start, if they take your insurance.
Good luck!
Oh yeah, forgot to add - make sure the Rx from your doctor says "Auto CPAP" - that will help significantly. That's how I got my auto.
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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, DME, auto
Who told you that? Your DME? Sorry, not laughing at you, but at the wool the DMEs like to pull over people's eyes. Your insurance pays the DME the same whether they give you an auto or just a straight CPAP, but the autos cost the DME more. So of course, they like to try to pawn off straight CPAPs on you. Stick up for yourself, demand your S8, and if the DME balks call your insurance company. They'll either deal with your DME themselves or tell you how to. As Goofproof mentioned, billmyinsurance.com is a great place to start, if they take your insurance.
Good luck!
Oh yeah, forgot to add - make sure the Rx from your doctor says "Auto CPAP" - that will help significantly. That's how I got my auto.
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, DME, auto
which s8 model? I don't have a resmed, but I see multiple models of s8, escape, elite etc on the hosts web site all cost different amounts.
Is $750 reasonable?
Depends on which model, if it includes the heated humidifier, if it includes hose, bag mask?? Hard to tell from the info you provided.
You need to compare price to listed prices on this web site to determine that.
On the CPAP vs. APAP, I am one of those lucky ones who got the DME to give her what she wanted (and was prescribed). But it wasn't quick and easy. There are lots of threads on that if you look back and a couple of basic strategies.
First get the prescription to say what you want get your original copy and hold it (and a copy of your sleep study and hold on to it). Then if you get hassle keep telling the DME you want what was prescribed. n By having the prescription and sleep study you can check out multiple DME's rather than just the one your doc's office faxed the info to. Also allows you to buy online (don't need sleep study for that though). Consider multiple DME's that your insurance will work with, try bill my insurance. Some do well by taking a CPAP and reporting problems, (I assume the same problems that they were trying to avoid by wanting an APAP to begin with). Some then get the APAP that they wanted. I have no experience on that one. What I have seen though is some folks saying that once they took a machine from a DME, they were locked into that DME by their insurance co. So unless you are sure you can work with that DME, it is risky to initially accept a machine less than you want (in my opinion).
Another option is see what your deductable is for out of network. Some people find (I am in this group) that insurance will cover a cash purchase from CPAP.com but it is out of network. Unfortunately for me the out of network deductable is so high I would end up getting no insurance benefit by doing that.
Bottom line is you don't want to pay anyone (brick and mortar DME, or online DME) more (insurance copay) than you could purchase outright for from someplace else.
Is $750 reasonable?
Depends on which model, if it includes the heated humidifier, if it includes hose, bag mask?? Hard to tell from the info you provided.
You need to compare price to listed prices on this web site to determine that.
On the CPAP vs. APAP, I am one of those lucky ones who got the DME to give her what she wanted (and was prescribed). But it wasn't quick and easy. There are lots of threads on that if you look back and a couple of basic strategies.
First get the prescription to say what you want get your original copy and hold it (and a copy of your sleep study and hold on to it). Then if you get hassle keep telling the DME you want what was prescribed. n By having the prescription and sleep study you can check out multiple DME's rather than just the one your doc's office faxed the info to. Also allows you to buy online (don't need sleep study for that though). Consider multiple DME's that your insurance will work with, try bill my insurance. Some do well by taking a CPAP and reporting problems, (I assume the same problems that they were trying to avoid by wanting an APAP to begin with). Some then get the APAP that they wanted. I have no experience on that one. What I have seen though is some folks saying that once they took a machine from a DME, they were locked into that DME by their insurance co. So unless you are sure you can work with that DME, it is risky to initially accept a machine less than you want (in my opinion).
Another option is see what your deductable is for out of network. Some people find (I am in this group) that insurance will cover a cash purchase from CPAP.com but it is out of network. Unfortunately for me the out of network deductable is so high I would end up getting no insurance benefit by doing that.
Bottom line is you don't want to pay anyone (brick and mortar DME, or online DME) more (insurance copay) than you could purchase outright for from someplace else.
4 posts
• Page 1 of 1