Newbie intro, thanks and questions

[candem]

Hi, first let me start by saying thanks to everyone who has contributed to this forum - a ton of information that I have found very useful - although overwhelming as I start on my learning curve.

I was diagnosed with sleep apnea and have done both the sleep study and Titration tests. Diagnosis was Obstructive sleep apnea-hypopnea, moderate-severe overall and severe in REM sleep (55 events per hour). I don't have the Titration results yet but the lab tech said he took it up to 9.

Now for my questions. I am trying to work my way through the minefield of insurance and what is going to be the best deal for me. My insurance is through UnitedHealthcare (GoldenRule) and I have a deductible of $3800 - nothing used so far this year.

I called them up and they said that they only do rentals and will not cover a humidifier. They were not able to give me any guideline on pricing and said they would pay what ever the DME billed them at the preferred negotiated rate.

When asked if they would cover out of network suppliers I was told that it would double my deductible PLUS a 25% penalty.

The person I spoke to was not aware of any mechanism for me to get a pre-approval before going ahead with a DME.

I have got a list of local DME's but have not spoken to any of them.

I have a good relationship with my doctor and I am confident that he will prescribe what ever I decide I need.

Would welcome some input on the following:
If anyone has any experience with UnitedHealthcare I would love to hear about your experience.

I am debating in my mind if it is worth even going the DME route or if I should just buy from cpap.com and get on with it. I do have a HSA account that I can use for tax purposes.

I have concerns about the rental issue. On the one hand it might be nice to have a rental to try out the equipment but I am not sure that the extra expense is worth it. I am a sound sleeper and go to sleep easily. I had no problems at the sleep lab and during the titration test I used a nasal pillow mask which I was okay with (don't have anything to compare it against).

I am keen to get going as I slept really well during my titration test and felt much better and more alert the next day.

Thanks for your input.

[Wulfman]

With that kind of crappy arrangement (coverage), you'll be money ahead to purchase outright from CPAP.COM. Just get your prescription in hand and fax or scan and upload it to them and you'll be able to get what you want with much less hassle and headaches than going through a local DME.

And, welcome to the forum.

Den

[rested gal]

Won't cover a heated humidifier, eh? That's pathetic on the part of the insurer.

If you do end up using your insurance to get a machine via a DME, but have to buy the humidifier out of your own pocket, I'd suggest you buy your own heated humidifier separately...online. And I'd suggest this stand-alone heated humidifier so you could use it with ANY machine of any type that you get, now or later:

Fisher & Paykel HC 150 heated humidifier.

That humidifier works great with any brand/model of cpap, autopap, bipap. You wouldn't have to worry about getting a new "integrated" humidifier if you changed machine brands later.

[tangents]

Hi, Candem, welcome to the forum!

While I think Rested Gal has a great suggestion about the F&P HC 150 humidifier, I wonder about travel, and whether you would have to choose between packing/carrying two devices or going without humidity.

Good luck, and keep posting!

Cathy

[candem]

Thanks for the responses.
In case this helps anyone else - based on another post I found I called Goldenrule (my healthcare) and asked if they would reimburse or apply "out of pocket expenses" to my deductible. No problem was the answer. Essentially I have to invoice them myself and probably have to apply to purchase the equipment instead of renting. My sleep doctor wants me to see a Gastroenterologist so that might take me up to my deductible and make this worth the effort.

I have decided to buy the Goodknight 420 E bundle from cpap.com. I got a new Mirage Swift II nasal pillow mask on cpapauction for $58.50 shipped.

Is there anything else I should be buying with the bundle. I see there are filters but don't know how often they need to be replaced. Any recommendations?

[Wulfman]

Congratulations! Quite a few of us have done it that way. MANY insurance providers are willing to help you save YOUR money.

I would (and did) get some extra filters and hose(s). Here's a link to the (washable) foam filters for that machine:

https://www.cpap.com/productpage/reusab ... level.html

And the disposable fine filters:

https://www.cpap.com/productpage/purita ... level.html


Den

[rejoicem56]

First want to say welcome glad to have you in our group. Now I have a question. I want to change my sign in to Tired Ladybug from rejoicem56. Now I have it on my posts but the rejoicem56 is still there. How can I just have one of them an not both or is that not possible without starting over. Thanks,Melinda

[ozij]

Congratulatios!
Before you buy cpap.com's disposable filters, ask them if those were manufactured by PB.

Last time I bought disposable filters from cpap.com they were much too thick, caused my machine to wheeze - and I returned 5 unopened packages and was reimbursed for them.

O.