United Health Care, Apria, and rental/Purchase

[elfranzen]

Ok I am getting a new CPAP and this is my first one with United health care. They have pointed me to Apria. Sounds like i am going to have fun with Apria. I did have my doc right the script at "autosense 10 autoset"

Now I am guessing United health is going to want me to rent for 3 months first. Since this is my first CPAP with UHC.
I have already covered my deductible and almost have my out of pocket covered for the year. Now I will rent for 3 moths so will the rest of the purchase price will hit after the first of the year and the new plan year.

Or do you think since I have had a CPAP for 8 years they wont make me rent one.

[Okie bipap]

That is dependent upon your insurance coverage. Contact your insurance company and ask what your policy dictates.

[Guest]

Now I am guessing United health is going to want me to rent for 3 months first. Since this is my first CPAP with UHC. Or do you think since I have had a CPAP for 8 years they wont make me rent one.

This depends entirely on your policy. Discuss this with UHC directly.

I have already covered my deductible and almost have my out of pocket covered for the year.

You may want to wait until next year to get this if you can wait. Run the numbers with UHC to see if you will pay more out of pocket starting in Jan.

Rule #1 when dealing with Apria Do NOT give them a credit card for any reason. If they insist use a pre-paid card. Search this forum if you need more info on this.

[SleepyMcgee]

Ok I am getting a new CPAP and this is my first one with United health care. They have pointed me to Apria. Sounds like i am going to have fun with Apria. I did have my doc right the script at "autosense 10 autoset"

Now I am guessing United health is going to want me to rent for 3 months first. Since this is my first CPAP with UHC.
I have already covered my deductible and almost have my out of pocket covered for the year. Now I will rent for 3 moths so will the rest of the purchase price will hit after the first of the year and the new plan year.

Or do you think since I have had a CPAP for 8 years they wont make me rent one.

What's the rental for? They want to make sure you will comply or something?

United has been a nightmare for me. They won't pay for a sleep study since my take home study was negative. I'm trying to pay for a sleep study OOP but the doctors don't seem to want to take my money, they are dead set on continually appealing uniteds decision.


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[elfranzen]

UHC has kind of been hit and miss. My daughter has type 1 and we usually get what we want it just might take a week of phone calls.

I am kind of rethinking Apria but I also want to get my CPAP as soon as possible. I am not on my CPAP right now and I can't wait to get back on it. It was a pain to get where I am now because of moving from Iowa to Maine having new doctors and all that stuff.

I just have this feeling that when it finally gets to insurance they will have some curve ball to throw back at me.

My sleep study is 8 years old and my CPAP is also 8 years old.

[JimW159]

I am not on my CPAP right now and I can't wait to get back on it. It was a pain to get where I am now because of moving from Iowa to Maine having new doctors and all that stuff.

If you are anywhere close to Portland you might check with Maine Medical Center. Their neuroscience Institute includes their sleep disorder practice. http://www.mmc.org/maine-sleep-institute
MMC is also affiliated with Tufts University School of Medicine in Boston. Through Tuft's Maine MD Track they provide clerkships and clinical training opportunities at a series of sites in rural areas of Maine as well as their main site in Portland. If the sleep doc you work with is affiliated with the Sleep Institute, they may well be able to help with the problems inherent with dealing with Apria or suggest an alternative acceptable to UHC.

[elfranzen]

We are about 30-45 mins from Portland we go down there about every other week.

[chunkyfrog]

If your UHC plan is a PPO, you will have more choice of providers and equipment.
I hope that is the case, as their HMO is a nightmare.

[JimW159]

We are about 30-45 mins from Portland we go down there about every other week.

When you say "down" I assume you mean you go South (as opposed to a common Maine usage such as "down East" which often means North). If so, you may be closer to Waterville and Maine General Hospital. Their sleep laboratory is well regarded though not with the range of services or staff offered at MMC. https://www.mainegeneral.org/Pages/Care ... linic.aspx
OTOH, if, as I suspect, you are closer to Bowdinham or Lewiston, then MMC is a much better option.

[Janknitz]

Now I am guessing United health is going to want me to rent for 3 months first.

Don't guess. Find out for sure from your insurance company (a corollary to the rule that you never give Crapria your Credit Card is that you never believe a word anyone from Crapria says. ALWAYS do your homework and know the correct answer BEFORE they lie to you). Then run the numbers.

What will your out of pocket costs be for co-payments on the co-payments this year and then hitting your 2017 deductible??? It may be that you can do MUCH better buying from our hosts or Secondwind.com, unless you calculate that helping you reach your deductible sooner is beneficial.

[Guest]

I am kind of rethinking Apria but I also want to get my CPAP as soon as possible. I am not on my CPAP right now and I can't wait to get back on it.

Going thru insurance can take a month or more to get approved then the DME might say we wait for approval before even ordering your equipment.

What if you have to take another sleep study? You need to talk with UHC right away to get some answers and hopefully you have in your possession some documentation to convince UHC not to require a PSG.

Knowing that I would be checking the local Craigslist under Health and Beauty for some affordable options. You should always have a backup cpap on hand anyway.

[elfranzen]

Apria said I would need my old study and RX since it is for lifetime and a new script from my general doctor saying I need a new one and continued CPAP is needed. I am trying to get into a sleep lab but I am on about a 4 month waiting list before I can even see the doctor. Right now i am trying to get into CMMC in Lewiston but I might call MMC in Portland and see if they have anything sooner.

[Guest]

Apria said I would need my old study and RX since it is for lifetime and a new script from my general doctor saying I need a new one and continued CPAP is needed. I am trying to get into a sleep lab but I am on about a 4 month waiting list before I can even see the doctor. Right now i am trying to get into CMMC in Lewiston but I might call MMC in Portland and see if they have anything sooner.

So I'm gonna guess you don't have your old study?
Most labs maintain a cancellation list. Ask your lab about that.

As mentioned above even after a recent sleep study it can take a month or more to get your equipment.

[elfranzen]

After talking with insurance and DMEs they would have to rent this year and then i would be hit with the purchase next year after all my deductibles reset. So it will be cheaper for me to just order one from CPAP.com and I can have it tomorrow. So that is what I have done.

[Pugsy]

Saving money and avoiding the "hassle" factor. Pretty much a win-win in my book.