Time for a new Auto-Pap

[kempo]

Pugsy,thanks for that information. My original sleep test I spent all night in the hospital hooked up to a couple a dozen wires glued all over my body. I wasn't a sleep long before they awoke me and put on a mask. I remember being told in the morning after getting dressed to go directly to a DME and rent a machine until my insurance bought me one.

My DME did not have a copy of the sleep test in my folder but called the hospital to obtain copies. I did not buy hardly anything from my DME after purchasing the s9 from them. I figured out I could buy hoses and mask parts off Ebay cheaper than meeting my insurance deductible.

[avi123]

And maybe not? My last study was in 2003, I had not seen a sleep doctor in 9 years and I turned 65 in December 2015. I took the new Doctor a 6-month compliance report from ResScan on 01/11/16 and received a new S10 and supplies paid at 100% the beginning of March from Nationwide Medical. Medicare B and Anthem/Blue-Cross F.

Question,

How have you arranged with Nationwide Medical to get the S10?
What is a 6-month compliance report, are these ResScan nightly graphs like these?

My ResScan graphs as of 5-14-2016:

[hobbs]

And maybe not? My last study was in 2003, I had not seen a sleep doctor in 9 years and I turned 65 in December 2015. I took the new Doctor a 6-month compliance report from ResScan on 01/11/16 and received a new S10 and supplies paid at 100% the beginning of March from Nationwide Medical. Medicare B and Anthem/Blue-Cross F.

Question,

How have you arranged with Nationwide Medical to get the S10?

New doctor arranged everything. He went through (2) providers before Nationwide. Nationwide seems to be the preferred Medicare provider in our area, Southern California.

[avi123]

hobbs, Nationwide Medical is my provider, do I need to see a Docter for it?

My CPAP is 5 years old.

[hobbs]

hobbs, Nationwide Medical is my provider, do I need to see a Docter for it?.

Call and ask. I would assume a doctor will have to be involved.

[robysue]

hobbs, Nationwide Medical is my provider, do I need to see a Docter for it?.

avi,

If you are trying to get a new machine while on Medicare, the short answer is yes, you'll need to see a doctor first.

[kempo]

I carried my card to my DME to print off my therapy results to show my GP. I stop by my GP's office to make an appointment and talked to his nurse. She told me she was sure the new rules for medicare require a new sleep study after 5 years. My appointment for my GP is this Wednesday so I will let everyone know what he says incase anyone else here is fixing to go through this process.[/quote]

And maybe not? My last study was in 2003, I had not seen a sleep doctor in 9 years and I turned 65 in December 2015. I took the new Doctor a 6-month compliance report from ResScan on 01/11/16 and received a new S10 and supplies paid at 100% the beginning of March from Nationwide Medical. Medicare B and Anthem/Blue-Cross F.[/quote]


Thanks hobbs, good to know. Maybe the nurse didn't understand my circumstance but anyway I'll find out Wednesday when I see my GP.

[Midnight Strangler]

It depends on the original sleep study (type of study and criteria used to diagnose) as to whether Medicare will be okay with that sleep study or require a new one.

I don't think that Medicare has changed this part for people new to Medicare but already cpap users.
I used to have a link to Medicare page that explained all this but I can't find it now.

The DME that you are using (who should have all your sleep study data because they needed it in the first place) would be the ones to help you figure out what you may or may not need to convert to Medicare payor...they are going to have to do it for cpap masks, etc anyway.

Now if you do get Medicare to okay a new machine (with or without that new sleep study)...then you will have to jump through all the normal hoops that any Medicare cpap patient has to go through....
13 month rent to own...part B deductibles...requirement for a face to face interview with your doctor sometimes within the 31 and 90th day of therapy for the doc to say "it's working and you are using it"...and the minimum compliance requirement of 4 hours a night for 70 % of the nights within 30 consecutive days prior to that 90 th day after getting the machine but we assume you won't have the compliance issue.

I know very little about Medicare rules, but getting a new machine for me was much simpler. When I turned 65, the doctor sent Medicare a copy of my sleep study which was over ten years old. He also sent a signed statement that I was compliant with CPAP. I got a new machine with a three-month rental period, after which, I owned the machine. The doctor said for existing CPAPers the rental period is only three months. For new CPAPers the rental period is 12 or 13 months.

[kempo]

OK, went to see my GP today and he looked at all of the material from my DME ( original prescription, charts from old sleep test and current compliant charts from my card). I walked out with a prescription for a Resmed AirSense 10 autoSet, Climateline hose, and all supplies. My DME didn't have one in stock but said it shouldn't take more than a week or two.

I hope it works as good as my s9 auto.