DME who do u trust? Please help.

[reffus1881]

This just doesn't sound right. Based on what i have learned here. My DME called today to tell how much my co-pay was going to be 75.00 and the rent was 10.00 a month for a year. i called my insurance co. 2 weeks ago and they confirmed that my co-pay was 15% and i did not need prior approval. It seems like the DME is taking advantage of my dire need for the machine. They expect me to walk in and sign the papers without being part of the buying process. I was so close to getting a machine Wednesday night would have been the first night i am so ready for therapy. I feel like i need to switch DME's Can the insurance co. up and decide to pay for a rental the first year and is that a good idea? I hope this makes sense.

[archangle]

Have you figure out what CPAP machine they want to give you? Some are enormously better and probably don't cost any more than the bad ones with insurance.

Have you read the posts on what machines to accept?

[chunkyfrog]

By all means, Full data is best--even if you only refer to it once in a while.

[ChicagoGranny]

This just doesn't sound right. Based on what i have learned here. My DME called today to tell how much my co-pay was going to be 75.00 and the rent was 10.00 a month for a year. i called my insurance co. 2 weeks ago and they confirmed that my co-pay was 15% and i did not need prior approval. It seems like the DME is taking advantage of my dire need for the machine. They expect me to walk in and sign the papers without being part of the buying process. I was so close to getting a machine Wednesday night would have been the first night i am so ready for therapy. I feel like i need to switch DME's Can the insurance co. up and decide to pay for a rental the first year and is that a good idea? I hope this makes sense.

Talk to your insurance company. Tell them exactly what the DME said. Rely on the insurance company. They set the terms with the DME.

Yes, as I learned late in the game which machine you get (one that works with the software) is very, very important. Make sure you get one which works with software. Ask here if you don't know.

[Cotay]

This just doesn't sound right. Based on what i have learned here. My DME called today to tell how much my co-pay was going to be 75.00 and the rent was 10.00 a month for a year. i called my insurance co. 2 weeks ago and they confirmed that my co-pay was 15% and i did not need prior approval. It seems like the DME is taking advantage of my dire need for the machine. They expect me to walk in and sign the papers without being part of the buying process. I was so close to getting a machine Wednesday night would have been the first night i am so ready for therapy. I feel like i need to switch DME's Can the insurance co. up and decide to pay for a rental the first year and is that a good idea? I hope this makes sense.

Definitely check which machine they want to give you.

Those dollar figures don't seem that high to be honest. $75 is only 15% of $500...which is entirely possible for a first month rental and initial mask/filters on a CPAP. The $10/month is also pretty low...that would be a monthly rental charge to insurance of about $70.

To put things into perspective, my first DME submitted a bill for $2,100 the first month and a monthly rental of close to $300 to my insurance.

I'm wondering if they are giving you a low spec machine.

[LSAT]

This just doesn't sound right. Based on what i have learned here. My DME called today to tell how much my co-pay was going to be 75.00 and the rent was 10.00 a month for a year. i called my insurance co. 2 weeks ago and they confirmed that my co-pay was 15% and i did not need prior approval. It seems like the DME is taking advantage of my dire need for the machine. They expect me to walk in and sign the papers without being part of the buying process. I was so close to getting a machine Wednesday night would have been the first night i am so ready for therapy. I feel like i need to switch DME's Can the insurance co. up and decide to pay for a rental the first year and is that a good idea? I hope this makes sense.

Many insurance companies and Medicare require a rental for 12-13 months and then you own the unit. They do this in case you are not compliant and do not use the CPAP....in that case, they can take it back.

Was the $75 co-pay for the machine or was it for machine, humidifier, mask and hose ??????