Clinic vs Online

[draw]

I have recently be diagnosed with sleep apnea (2 weeks) and need to purchase a machine and all the associated supplies. The sleep clinic who diagnosed me is lending me a machine for the first month. After that i will need to purchase a machine which they said is $2300 cdn for a dream station pro which when compared to what i can buy it for online (725 cdn) seems crazy. The benefit they said of buying through them is that i get unlimited appointments at the clinic for the life of the machine along with a loaner machine if i have problems with my unit. If i buy through the online supplier i would have to pay $75 per visit and would be on my one to find a loaner. So i guess my question is how often do people need to go into the sleep clinic for an appointment once they are setup and running? Does $2300 sound right?

Thanks,

Draw

[BlackSpinner]

Watch that price. It is not $750 Cdn online.
A machine plus humidifier plus hose plus mask is what you are looking for. You also need to know what exact type of machine you need.

Depending on your issues you might be a natural and the mask might fit 100% the first time. Or you might have problems of all sorts. It may take several masks to find one that fits right and works for you. Masks are like specialty shoes - you may need to try on a few before you hike that 500 km trail through the mountains.

[Wulfman...]

I have recently be diagnosed with sleep apnea (2 weeks) and need to purchase a machine and all the associated supplies. The sleep clinic who diagnosed me is lending me a machine for the first month. After that i will need to purchase a machine which they said is $2300 cdn for a dream station pro which when compared to what i can buy it for online (725 cdn) seems crazy. The benefit they said of buying through them is that i get unlimited appointments at the clinic for the life of the machine along with a loaner machine if i have problems with my unit. If i buy through the online supplier i would have to pay $75 per visit and would be on my one to find a loaner. So i guess my question is how often do people need to go into the sleep clinic for an appointment once they are setup and running? Does $2300 sound right?

Thanks,

Draw

For many typical DMEs dispensing the equipment (particularly through insurance here in the states), that sounds about normal, price-wise.
However, for many who "do the math", the costs for the payouts with insurance are really pretty close to what can be purchased out-of-pocket from online sellers. Lots of this varies by countries and insurance providers.
Several of the big manufacturers have restricted their products from being sold to users in other countries, but there are ways of getting around those situations.

Your call. Do the math.


Den

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[palerider]

and would be on my one to find a loaner.

buy two online and still save.

[yaconsult]

The DME prices are the highest you will find. Our host, cpap.com, has about the best online prices. But to answer your main question, most people only use a DME if their insurance company requires it. And the folks who work at the DME do not have the kind of long term usage and experience of the posters here. So if you are footing the entire bill, I would say buy from cpap.com and if you want to save some money with a used but test machine check out secondwindcpap.com. Current machines are very reliable. But things do fail sometimes - often at the worst possible times. That is why experienced cpap users have a backup of all components of a cpap system. But you don't need that right away. As you replace things, keep the old one just to have a backup. The lifespan of a cpap machine is generally considered to be about five years, but for many they last for years beyond that.

New machines come with a warranty. Secondwindcpap.com also provide a warranty. But even with a warranty, the machine has to be shipped off somewhere and it's going to take time. That's the only time that a potential loaner would come in handy. But how often is warranty service required on cpap machines? I think that the general feedback here would be very, very seldom. You could probably buy two machines for what the DME would charge you for one. Especially if the second machine was a used one. There are long term posters on this forum that sell used machines as well.

Now, the trying out of masks is another good question. Again, our host cpap.com offers some of the most popular masks with free return insurance so that if a mask doesn't work for you, you can return it and get another. This is a huge advantage if you're not sure which mask is best for you as finding the right mask is the single most important factor in how well cpap will work for you. I would recommend trying the most popular masks first, like the AirFit P10.

[draw]

Thanks for all the input. With the trial period I'm hoping to have the mask thing sorted out (i have a Airfit P10 and the n10) and although I'm not footing 100% of the bill the more it costs the more it costs me... Really though i just don't want to buy the machine online then it turn out that i need to go to The clinic a 100 times. I know everyone is different but is it safe to say that after 30days the settings and everything are stable and clinic visits would be few and far between?

[zoocrewphoto]

I think it depends on how often you think you will need to try on masks. I have been using cpap for 4 years now, and I have only been to a DME twice. Everything else has been purchased either by phone and mailed to me or online. My first machine came from the initial dme, and the backup machine was purchased used and cheap on craigslist.

Unless you are really struggling with mask issues, I would buy a machine online, and look for another one new or used as a backup/travel machine. I prefer the same model so it feels the same. And then use the forum to help with any issues. No need to pay for a ton of appointments you will never need. And most DME employees have never used a machine and really don't know how to solve basic problems.

[LSAT]

Thanks for all the input. With the trial period I'm hoping to have the mask thing sorted out (i have a Airfit P10 and the n10) and although I'm not footing 100% of the bill the more it costs the more it costs me... Really though i just don't want to buy the machine online then it turn out that i need to go to The clinic a 100 times. I know everyone is different but is it safe to say that after 30days the settings and everything are stable and clinic visits would be few and far between?

I for one have never been back to the DME that sold me my equipment. I realized that having the Clinical Manual for my machine and utilizing software and the members on this board, I could analyze my progress and make any needed changes by myself.

[BlackSpinner]

Thanks for all the input. With the trial period I'm hoping to have the mask thing sorted out (i have a Airfit P10 and the n10) and although I'm not footing 100% of the bill the more it costs the more it costs me... Really though i just don't want to buy the machine online then it turn out that i need to go to The clinic a 100 times. I know everyone is different but is it safe to say that after 30days the settings and everything are stable and clinic visits would be few and far between?

If you are successfully using it at 30 days then go for it online.

Be aware that most online suppliers can not ship Resmed or Resperonics to Canada so you either buy privately or from Secondwind or from a Canadian online supplier.

Oh and don't forget to calculate exchange rates and shipping. Also if you buy privately you might not be able to use it as a tax deduction.

There is software called Sleepyhead available here that will show you every breath you take. Plus the people on site here are often far more knowledgeable then your average DME employee.

You need to look at your machine for ALL the numbers and names so you know EXACTLY what you are looking for. You will also need to know what its settings are.

You can install Sleepyhead right now and see exactly what is happening and the machine settings.

[egzbuen]

If you decide to buy online and they can't ship to your place, you can do what I did.

I got 2 machines online, a home and a travel one, and had it shipped to a relative based in CONUS. My relative then simply reshipped it to me in Asia.

The price you were quoted for sounds kinda similar in my territory but mines a tad bit worse. For 2200USD, I would only get a cpap machine. When I opted to get online, I was able to get an APAP and a travel machine for 440usd and 189usd, respectively.

Sent from heaven

[yaconsult]

You say "clinic", but I think you mean DME. The DME is not allowed to make any changes to the machine therapeutic settings unless the doctor sends them a prescription with the new settings on it. And all of the changes that they can make, you can make yourself - with the help of the experienced users of the forum.

You need to get out a calculator or make a spreadsheet and run all the numbers and compare the bottom line of what you pay out of pocket both with insurance and without insurance. And there may be other factors, like if you have already met a required annual deductible or if you want use the cpap purchase to meet your deductible for the year. Compare those costs with what you can buy a lightly used machine for on secondwindcpap.com and what you can buy a new machine for on cpap.com. Then consider all the factors and make your decision.

The people at the DME can not and do not study the detailed data and make adjustments based on it the way that people here do. The experienced people here will only go through a DME when it saves them money. They will not give you advice like that you will see here. They will tell you to have your doctor send them a new prescription with the new pressure settings. And your doctor may not be willing to do that unless you have an office visit with him and convince him. There are lots of variables.

DMEs are good for trying out masks, but even that isn't as useful as you might think because trying a mask for five minutes while sitting in a recliner is really not the same thing as sleeping in a bed at night with the mask with your body changing positions throughout the night.

All in all, if you use a DME, you will pay more - unless insurance pays a big part of it. Some people have run the numbers and found that they could buy a machine outright for less than the amount of their deductible which is based on the very high "list price". And, by the way, DMEs never repair the machines in-house. They always send them out to a repair facility. We have one such business that posts here regularly and will repair machines sent to them quickly and test them completely. Ask the DME if they are available to help you with a replacement machine on the weekends or in the middle of the night.

My current machine came from a DME. Why? Because insurance paid for it 100%. My previous machine, which is now my first backup, I bought on craigslist for $100. The one before that was free on craigslist after its owner had it replaced by his insurance company. When I got my new machine I ended up giving this one to a friend that had a very old fixed pressure cpap machine as it was an autoset.

[palerider]

You say "clinic", but I think you mean DME.

you say "this is how it is here" when I think you mean "I don't know how it is in canada".

[BlackSpinner]

You say "clinic", but I think you mean DME.

It is different here. I know the DME down the street does sleep studies too (for free - probably in home studies) There are big posters in my doctors office advertising the same thing. Most of the newer places I see around town are both clinic and DME and they handle only xpaps and accessories. The laws are different too between provinces.

On Clinicalsleep.com (a Canadian site - no shipping costs) a APAP dreamstation with humidifier and hose is $1195.00

[draw]

that is exactly it the clinic I'm dealing with is both a registered respiratory therapist and DME (that way they get you coming and going...). When i go in there they look at my results and adjust pressures. I have run the numbers and i come out ahead by a few hundred if i buy online from one of the Canadian CPAP suppliers. Again thanks for the input

[chillAtGVC]

I went through Coastal Sleep, but my work insurance paid for everything. I will say that the sleep therapist was very helpful in getting me accepting of and using CPAP. Unlike the USA, the people at the clinics here do analyst your sleep data (from the CPAP machine) and make changes in your therapy. My therapist was supporting in making changes to lower my AHI> The question you need to be asking is not "how much can I save?" but "how much effort am I willing to put into learning about CPAP therapy and analyzing my own data and making changes based on that?" If the answer is "a lot" then buy online. If the answer is that you don't have the time or confidence, then go through the clinic. Although I went through the clinic initially, I have now taken over responsibility for my therapy. But I love geeking out on stuff like this.