Annual Sleep Doc Visit?

[Jeanne Ellen]

I'm wondering how many of you make an annual or semi-annual visit to your sleep doctor. That made sense to me the first year or so, when I had big trouble adjusting to cpap, but at this point I've come to the conclusion that I really don't need to do this. Of course, it's nice to have Medicare pay for my supplies through the DME, but they require a visit the doctor every six months, which seems crazy. I've just been purchasing what I need online and trying to stay away from doctors as much as possible.

[khauser]

You have an actual sleep doctor? I was never so fortunate.

[chunkyfrog]

I knew early on that I would need to use the insurance (including Medicare) that I PAID FOR.
It made sense to utilize a sleep doc--only once a year, anyhow.
I have only seen the assistant for the last few years. This year was via Zoom.
My case is simple. Saving the doc's time for those who really need him.
I am cool with that.
Lord knows they certainly have their hands full these days.

[zonker]

I'm wondering how many of you make an annual or semi-annual visit to your sleep doctor.

once. the first year. the doctor's assistant couldn't access my card. said to not worry about it.

i didn't as the doc only asked how i was doing and that he'd see me next year.

he didn't. i never have gone back.

now. i'm not dependent on medicare to get my machine or supplies. i'm privileged in that regard. just went on medicare last year. i don't think i'll be using them at least until things get really tight and i'm forced to.

but i can certainly understand why others do.

[Julie]

Now that we have Oscar, or at least most do unless their machines are unusual, there doesn't seem to be the need to see MD's as long as we can learn to interpret our own results and, with advice from experts here, make any changes necessary. And possibly do follow-up home studies along the way.

[Pugsy]

Gosh, I haven't seen a sleep doc since August 2009 and Medicare still pays for my cpap supplies.

Now your DME or doctor may have such a requirement and they put it off on Medicare instead of owning up to their own rules (which they can do).

[zonker]

Gosh, I haven't seen a sleep doc since August 2009 and Medicare still pays for my cpap supplies.

Now your DME or doctor may have such a requirement and they put it off on Medicare instead of owning up to their own rules (which they can do).

ah! thanks for that bit of knowledge. maybe when the time comes, i'll go the medicare route.

[Wulfman...]

I'm wondering how many of you make an annual or semi-annual visit to your sleep doctor. That made sense to me the first year or so, when I had big trouble adjusting to cpap, but at this point I've come to the conclusion that I really don't need to do this. Of course, it's nice to have Medicare pay for my supplies through the DME, but they require a visit the doctor every six months, which seems crazy. I've just been purchasing what I need online and trying to stay away from doctors as much as possible.

I haven't been to a sleep doctor since June of 2005......about a month after I started therapy. I had met my deductible prior to that and my insurance provider reimbursed me for 80% of my initial equipment purchase. After that, I have purchased all of my equipment and supplies from online suppliers (like CPAP.COM) or private sellers (like forum members) out-of-pocket. Same thing since I've been on Medicare........have never used them to help me pay for my "anything". I just buy some quantities of supplies when they're on sale and machines (new or like new) when I found good deals on them. Right now, I think I'm stocked up on everything for the rest of my life.


Den

.

[klm49]

I'm wondering how many of you make an annual or semi-annual visit to your sleep doctor. That made sense to me the first year or so, when I had big trouble adjusting to cpap, but at this point I've come to the conclusion that I really don't need to do this. Of course, it's nice to have Medicare pay for my supplies through the DME, but they require a visit the doctor every six months, which seems crazy. I've just been purchasing what I need online and trying to stay away from doctors as much as possible.

My DME requires a new prescription every year and my Sleep Dr. wants to see me once a year. I know of no Medicare requirement to see a Dr. every 6 months, I only go annually. I don't get much of anything out of the visit but at some point, hopefully this year, I will get a new Bipap. My Dr. has already commented I probably should have been on one to begin with.

[MarylandCPAPer2]

I'm wondering how many of you make an annual or semi-annual visit to your sleep doctor. That made sense to me the first year or so, when I had big trouble adjusting to cpap, but at this point I've come to the conclusion that I really don't need to do this. Of course, it's nice to have Medicare pay for my supplies through the DME, but they require a visit the doctor every six months, which seems crazy. I've just been purchasing what I need online and trying to stay away from doctors as much as possible.

May I ask what DME made up this requirement? I have been on Medicare for 5 years and my DME has not required me to see a sleep dr. ever. I get supplies, as needed, every 3 months from the DME and covered by Medicare. They required a copy of my initial sleep study, done 11 years ago, to get me started with them on getting a new CPAP machine and supplies when I switched to this DME 5 years ago because my previous DME was not a Medicare-approved provider.

If Medicare required a visit to a sleep dr. annually or semi-annually, my DME would require it. They are a real stickler for getting things done to meet Medicare requirements.

I have needed a prescription and other paperwork that my primary care dr. can provide when I need a CPAP new machine, which has occurred every 5 years. No visit to a sleep dr. was required even for a machine.

I am having difficulty getting medicine for a nebulizer from my DME because they say that the dr.'s prescription has misplaced the word "and" in the prescription. Then the DME rejected the prescription because it did not have a diagnosis that justified medicine for a nebulizer. It has taken 3 weeks to get all this straightened out between my DME and my pulmonologist, who also happens to be a sleep dr. The medicine I am having trouble getting is not CPAP related.

Today, my DME told me I have COVID, which I don't have. A diagnosis of COVID would surely justify the medicine for the nebulizer, yet they couldn't get the dr. to put that diagnosis on the prescription. Then, they tried to get the dr. to say I have COPD, which I also don't have. DMEs are strange folks and you can't believe everything they say, if you haven't already discovered that.

Maryland CPAPer2

[Okie bipap]

I have used a nebulizer for almost 30 years, and have never gotten medication for it from a DME. I have always gotten it from the pharmacy. I admit I haven't needed to get any recently, but will most likely need to some time in the not too distant future. I am down to my last five tubes of medication.

[klm49]

I have used a nebulizer for almost 30 years, and have never gotten medication for it from a DME. I have always gotten it from the pharmacy. I admit I haven't needed to get any recently, but will most likely need to some time in the not too distant future. I am down to my last five tubes of medication.

Same here. The DME supplied the nebulizer/supplies, pharmacy supplies the drugs. Medicare part B pays 100% for some drugs like Albuterol.

[MarylandCPAPer2]

Today, I finally got a 3-month supply of liquid Albuterol sulfate for the nebulizer from a pharmacy the DME orders from, Reliant in Florida. It came by UPS. I believe it is covered under Medicare Part B if I get it this way. If I go to a local pharmacy, it would be put through using Medicare Part D. I use the pharmacy in a Giant grocery store. The wait in line is exhausting for me, so it seems wiser to conserve my personal energy by getting it by mail. I have not yet started carting around oxygen tanks when I go out. It seems a waste to have to carry a 4+ lb. oxygen tank to stand in the pharmacy line to get a nebulizer prescription filled when there is a convenient mail option.

The DME seemed to think the coverage is better under Medicare Part B than Part D. I don't know, but I would be using Medicare Part D (prescription coverage) if I went to the local pharmacy. It took 3 weeks for the pulmonologist, DME and pharmacy to agree upon the proper wording and diagnosis for the nebulizer liquid prescription. It is supposed to be refilled automatically every 3 months and come via UPS. If it works, I am not messing with that if I can help it. i think I found a great pulmonologist who may also be a great sleep dr., but paperwork with pharmacies and DMEs does not seem to be her office's strong point. I have called to see it my oxygen level (2L) can be increased, as I am still out of breath a lot of the time now that I am using home oyxgen, but returning phone calls also seems to be a problem.

I have lived without a APAP without a sleep dr. for 11 years, thanks to the great advice I have gotten here.

Maryland CPAPer2 (prevciously Maryland CPAPer until the board ate my sign-in credentials a few months ago)

[klm49]

Today, I finally got a 3-month supply of liquid Albuterol sulfate for the nebulizer from a pharmacy the DME orders from, Reliant in Florida. It came by UPS. I believe it is covered under Medicare Part B if I get it this way. If I go to a local pharmacy, it would be put through using Medicare Part D. I use the pharmacy in a Giant grocery store. The wait in line is exhausting for me, so it seems wiser to conserve my personal energy by getting it by mail. I have not yet started carting around oxygen tanks when I go out. It seems a waste to have to carry a 4+ lb. oxygen tank to stand in the pharmacy line to get a nebulizer prescription filled when there is a convenient mail option.

The DME seemed to think the coverage is better under Medicare Part B than Part D. I don't know, but I would be using Medicare Part D (prescription coverage) if I went to the local pharmacy. It took 3 weeks for the pulmonologist, DME and pharmacy to agree upon the proper wording and diagnosis for the nebulizer liquid prescription. It is supposed to be refilled automatically every 3 months and come via UPS. If it works, I am not messing with that if I can help it. i think I found a great pulmonologist who may also be a great sleep dr., but paperwork with pharmacies and DMEs does not seem to be her office's strong point. I have called to see it my oxygen level (2L) can be increased, as I am still out of breath a lot of the time now that I am using home oyxgen, but returning phone calls also seems to be a problem.

I have lived without a APAP without a sleep dr. for 11 years, thanks to the great advice I have gotten here.

Maryland CPAPer2 (prevciously Maryland CPAPer until the board ate my sign-in credentials a few months ago)

Some regulae Pharmacies will fill your Albuterol prescription with Medicare Part B, you have to check. It should cost you nothing as Part B covers it 100%. If you are getting it by mail I would stick with that as I have had problems with regular Pharmacy workers (CVS) cant figure out how to process the Prescription through Med. Part B.

[D.H.]

You have an actual sleep doctor? I was never so fortunate.

How did you get your CPAP? How were you diagnosed and titrated?