Replacement Schedule

[bsclarks]

I just checked with my Insurance which is Hometown Health in Reno Nevada and they told me they don't have a standard replacement schedule for masks, hoses, filters etc. They told me I need to have my doctor send my DME a prescription when i need replacements. Is this manner of replacement very common?

[chunkyfrog]

BCBSNE in my office just pitched their schedule--or so they say.
The thought is too frequent replacement or too much variety would be considered abuse, and you would get shut off.
They apparently believe that a schedule encourages 'stocking up'--and they couldn't allow that.

[Gerryk]

My insurance changed this year. In the past they allowed the following
one mask every three months,
two replacement cushions a month
one hose a month
one white fine filter a month
one gray filter every six months
one headgear every six months

They recenly changed to one hose every three months and one cushion a month.

[VikingGnome]

Here's a link to 2012 Medicare Reimbursement costs and Replacement Schedule from ResMed's Wesite:

http://www.resmed.com/us/documents/1013 ... sories.pdf

[Pugsy]

Replacement parts..not the full mask..don't require RX anyway.
Like my nasal pillow mask...each part to my mask can be bought separately without a RX.
To require a new RX for each replacement part is overkill and not common. Some DMEs may want a new RX annually depending on your insurance and DMEs in house policies.

My DME still sells me masks and whatever supplies I need after 3 years now and only has the first original RX.