Moving from APAP to Bi-Level and Insurance....

[Lucky7]

Specifically Medicare. This is a family member. How much of pain is this to get done?

NOTE: The also have COPD, so my argument for Bi-Level is it descreases the work of breathing in COPD patients plus treats their OSA.

Any advice would be appreciated.

[Pugsy]

You have to get the doctor on board and he/she has to provide necessary documentation as to why bilevel is needed over single pressure cpap/apap.

It all has to start with the doctor.

[Lucky7]

Yeah, talking to him Tuesday. The plan was yesterday but emergent problems prevented that.

I'm just wondering what they are going to want for documentation.

Thanks!

[NoOnesPerfect]

I'm just wondering what they are going to want for documentation.

I just made that transition myself - as far as I can tell, all that was required was a diagnostic (not titration) sleep study that showed a need for treatment, and a something from the doctor stating that regular cpap/APAP treatment had been tried but found not to be adequate. My sleep study was from 2019, so apparently it doesn’t need to be a new study.

Needless to say, your doctor hopefully has done this before and knows what is needed.

[Lucky7]

Thank you. I had heard similar. "Person is already on therapy" so it's up to the doc to decide appropriate device.

Was yours Medicare thing? Thank you!

[NoOnesPerfect]

Thank you. I had heard similar. "Person is already on therapy" so it's up to the doc to decide appropriate device.

Was yours Medicare thing? Thank you!

My original sleep testing and machine purchase was under private insurance, but the switch to bilevel was under Medicare.

[Deborah K.]

I'm in the process of trying to do the same thing. I read that Medicare may like to hear about some of the following things to approve the switch to Bi-Level: excessive daytime sleepiness, impaired cognition, mood disorders, insomnia, hypertension, ischemic heart disease, or a history of stroke. If any of those apply, mentioning them to your doctor would probably help.

[Lucky7]

Thank you. I had heard similar. "Person is already on therapy" so it's up to the doc to decide appropriate device.

Was yours Medicare thing? Thank you!

My original sleep testing and machine purchase was under private insurance, but the switch to bilevel was under Medicare.

Thank you, most helpful!