Don’t get “HOSED” By the Insurance Companies

[11cdubyah]]]

Hi Everyone,

Newbie here… but long time OSA sufferer. I have put this off long enough. I need to do a full court press towards realizing a successful treatment for my Obstructive Sleep Apnea OSA. I have been have hearted about it but OSA is kicking my a__ now. My only concern is I know that I am in for a fight with my insurance company – United HealthCare, whom I recently read is currently the 3rd most hated company in the US.

My goal is to get an APAP and if that doesn’t work a UPPP. Would you please respond with advice on how to navigate while trying to get all the coverage afforded me while having to pay the least amount of “out of pocket expenses” possible? I have already had one run in with UHC. It wasn’t pretty.

Thank you from California

[robysue]

Start with reading Janknitz's blog about what you need to know before meeting the DME for the first time at: http://maskarrayed.wordpress.com/what-y ... me-part-i/

Because no matter how crappy your insurance is, one trick to get the most bang for your buck is to locate a DME that's willing to set you up with the appropriate equipment the first time.

And as much as you hate doing it, you need to call United HealthCare and find out exactly what they will cover and how they will cover it. (Is UHC an HMO, a PPO, or an insurance company? Because that's relevant too.)

And once you know what your coverage is, carefully consider whether it is worth it to you to simply go "out of network" and pay for things out of pocket. For folks who have decided to pay out of pocket, places like our host, cpap.com can be quite affordable---particularly if your insurance coverage is limited or if you've got high deductibles.

[archangle]

Think twice before getting surgery. Try CPAP again. Then think twice again. Then try CPAP again. Then think about it another two times.

Surgery has frequent bad side effects. It has a low success rate. Apnea often comes back after a while.

However, it does work for some people.

[chunkyfrog]

The actual success rate of the surgery is so low, I'd be ahead getting a tattoo, saying,"Wake me up if I stop breathing".
BTW, if the surgeon shows you good stats, they are, in all probability, immensely 'doctored'

[BlackSpinner]

The actual success rate of the surgery is so low, I'd be ahead getting a tattoo, saying,"Wake me up if I stop breathing".
BTW, if the surgeon shows you good stats, they are, in all probability, immensely 'doctored'

Because "success" as measured by a surgeon has nothing to do with OSA scores.

[fiberfan]

We are in different states but the same insurance company name. My DME had no problems getting approval for my S9 VPAP Auto (bi-level machine) and UHC paid the claim for the first month's rent in just a couple of weeks. I don't know how they would have processed a humidifier since I have the one from the S9 Autoset bought before my coverage changed to UHC last summer (earlier this year asthma got worse and I could no longer breathe out against the pressure even with the max exhale relief setting). UHC told me that if they had bought the cpap they wouldn't cover the bi-level for a couple more years so I was grateful the previous insurance company had bought that one. I didn't ask if they would have agreed to switch from the cpap to a bi-level if the problems with breathing out against the pressure had occurred just after starting cpap.