Recently diagnosed. Trying to navigate insurance/apria/carecentrix and determine best options

[chunkyfrog]

When I started cpap, I was still working, and BCBS' deductibles, copays,
and wait intervals got in the way of my finding the right mask.
I bought from cpap.com, using return insurance several times, to get a mask that works.
After about a year, BCBS sent me a "reminder" letter, because apparently
they were missing the kickbacks from my first two DME's.

[imbaker]

I've called multiple times now and received at least 6 different answers on what it will cost. Not screwing with these people, they seem incredibly dishonest and opaque.

[AirMech74]

Sucks to hear what you are going through...I have Cigna which uses Carecentrix for medical equipment...used them when my wife was pregnant, supplied breast pump and accessories at no cost to us. i have had to call them a couple of times here recently and they resolved my issues pretty quickly....I made sure to tell them that I did not want to use Apria as my DME here in OKC...they marked it in my record....of course, my sleep center sent my prescription to apria...but it was quickly sent to a different DME....and that is where I picked up my machine and mask earlier this week. I was told that my machine is covered 100% on my plan...we'll see here shortly.

[imbaker]

Sucks to hear what you are going through...I have Cigna which uses Carecentrix for medical equipment. I was told that my machine is covered 100% on my plan...we'll see here shortly.

Probably has a lot to do with my plan... Either way I picked up a dreamstation for a great price locally so I'm just gonna cut my losses and call it a day.

[BTS]

I was told that my machine is covered 100% on my plan...we'll see here shortly.

It will be once your done the compliance period .. I still have a week or so left with mine then my machine will be 100% covered as well .. I really hope this all works out, I am a little paranoid myself seeing how it's been this far with the DME but there isn't any reason I would have to return it unless I wasn't using it ... It will be so nice not having anyone watching over me once I'm finished ... I was sent a copy of the bill they sent insurance, they are charging $990 a month during compliance .. Couldn't believe it.. DME tried telling me if it wasn't for them I wouldn't be covered for ASV and that none of the other DMEs around me would ever let an ASV go out on insurance because it just isn't worth it for anyone .. Yeah, real nice to hear how much they just don't care and it's all about $ ... So gross ...It is actually coming to these forums that got me my machine, if I didn't know anything and was still so ignorant I'd be on a brick and a xPAP not treating me correctly ... So thankful to everyone here so I knew my rights and what I was entitled to..

[LSAT]

I was told that my machine is covered 100% on my plan...we'll see here shortly.

It will be once your done the compliance period .. I still have a week or so left with mine then my machine will be 100% covered as well .. I really hope this all works out, I am a little paranoid myself seeing how it's been this far with the DME but there isn't any reason I would have to return it unless I wasn't using it ... It will be so nice not having anyone watching over me once I'm finished ... I was sent a copy of the bill they sent insurance, they are charging $990 a month during compliance .. Couldn't believe it.. DME tried telling me if it wasn't for them I wouldn't be covered for ASV and that none of the other DMEs around me would ever let an ASV go out on insurance because it just isn't worth it for anyone .. Yeah, real nice to hear how much they just don't care and it's all about $ ... So gross ...It is actually coming to these forums that got me my machine, if I didn't know anything and was still so ignorant I'd be on a brick ... So thankful to everyone here so I knew my rights and what I was entitled to..

Without the $$$ the DME would not be in business...It's the insurance company that makes the rules. Often they pay such a low price that the DME loses money...I have copies of my statements that show how much the insurance paid for items and often it's a
rediculous amount. Now, granted, there are DMEs that lie and take advantage when they can, but overall, DMEs need to cover their overhead and can't sell at the same price an internet providor can.