Will Medicare DME suppliers supply me parts without having gotten the CPAP machine from them?

[mileena]

To make a long story short, I had a falling out with my former DME supplier whom I got my CPAP machine from. So I have been using the same filters, mask, gel cushion, headgear, tube, and water tray for 8 months now. I didn't know what to do, so I have just been using the same supplies provided to me initially. (I refuse to pay cash for parts when I have Medicare, on principle.)

Can I just choose a new supplier to just get the supplies for my CPAP machine and have them bill Medicare?
And do I need a prescription to show them to get these parts?
Can I get nasal pillows from them instead of my current mask?
Are all tubes for CPAP machines the same size, and does a single tube fit all masks/pillows?

[D.H.]

Since they're not sending the supplies for free, they'll be happy to send them and bill you and/or your insurance. You do have to make sure that your new DME takes your insurance (unless you want to pay out of pocket). Also, your profile says that you'll be replacing your machine soon. I'm sure they'd love to provide your new one.

It's possible that you'll need a prescription. If you have the original prescription, you should be able to order from any DME.

If that's not good enough, your primary care physician can write a prescription as long as (s)he has the report form the sleep doctor.

[chunkyfrog]

Please refer to the link to Medicare providers in my sig.
Enter your zip code for a listing of Medicare-approved providers.
The search radius can be adjusted if needed.
Medicare covered my supplies for over a year while I was using a machine purchased from cpap.com.
They only needed records, a prescription, and a report from my doctor.
The Medicare site has all the info you need.
Make sure your doctor writes the prescription to specify "mask of PATIENT'S choice".
Most masks, tubes, and machines are compatible--except for some tiny travel machines.
Read the product info at cpap.com to determine compatibility.

[mileena]

Since they're not sending the supplies for free, they'll be happy to send them and bill you and/or your insurance. You do have to make sure that your new DME takes your insurance (unless you want to pay out of pocket).

Thanks so much D.H.

I looked up old prescription. There is a problem. On top of the prescription, there is listed a specific DME supplier that I don't want to use (circled in red in the pic below):

rx-cpap-post-edited.jpg (331.3 KiB) Viewed 9765 times

Can I give the new DME supplier this prescription with a different supplier's name?

Also, the prescription says length of need is "99" days (circled above in red). Will this be a problem if the prescription was written last September?

[prodigyplace]

Since they're not sending the supplies for free, they'll be happy to send them and bill you and/or your insurance. You do have to make sure that your new DME takes your insurance (unless you want to pay out of pocket).

Thanks so much D.H.

I looked up old prescription. There is a problem. On top of the prescription, there is listed a specific DME supplier that I don't want to use (circled in red in the pic below):


rx-cpap-post-edited.jpg


Can I give the new DME supplier this prescription with a different supplier's name?

Also, the prescription says length of need is "99" days (circled above in red). Will this be a problem if the prescription was written last September?

Could you ask your doctor for a new prescription since CPAP seems to be working for you?

[chunkyfrog]

The rx is on a form from that DME. (Of course, their name is on it)
Prescriptions are TRANSFERRABLE. Just XXX out the poopy provider and give to the new guys
They will tell you if they need a new RX.
The 99 means months, not days.
Apnea is assumed to be lifelong, but computers like a number.

[mileena]

Since they're not sending the supplies for free, they'll be happy to send them and bill you and/or your insurance. You do have to make sure that your new DME takes your insurance (unless you want to pay out of pocket).

Thanks so much D.H.

I looked up old prescription. There is a problem. On top of the prescription, there is listed a specific DME supplier that I don't want to use (circled in red in the pic below):


rx-cpap-post-edited.jpg


Can I give the new DME supplier this prescription with a different supplier's name?

Also, the prescription says length of need is "99" days (circled above in red). Will this be a problem if the prescription was written last September?

Could you ask your doctor for a new prescription since CPAP seems to be working for you?

I will! It just that I might be gone for 6 weeks in September, and I don't see the doctor until October. So in the meantime, I just want to find a supplier to get the supplies. When I get back in October, I will get the new ResMed bi-level VAUTO APAP and nasal pillows.

[mileena]

The rx is on a form from that DME. (Of course, their name is on it)
Prescriptions are TRANSFERRABLE. Just XXX out the poopy provider and give to the new guys
They will tell you if they need a new RX.
The 99 means months, not days.
Apnea is assumed to be lifelong, but computers like a number.

Awesome news!

99 months; so the prescription is good for 8 years and 3 months?! Wow. That DME supplier said I need to get a new sleep study and CPAP machine in 5 years, since they stop servicing it then.

[mileena]

Also..on the prescription form I posted above, the doctor did not check nasal cushions, but the DME supplier did offer to have me try them in our initial meeting. How can the DME supplier offer me me nasal cushions when they were not prescribed??

[chunkyfrog]

. . .. That DME supplier said . . .

Yep, they tend to do that.
Q: how can you tell if a DME is lying?
A: if his lips are moving.

[chunkyfrog]

Also..on the prescription form I posted above, the doctor did not check nasal cushions, but the DME supplier did offer to have me try them in our initial meeting. How can the DME supplier offer me me nasal cushions when they were not prescribed??

Nasal cushions are included under "supplies". Cannot use cpap without spare parts.
The DME wants to sell as many of these as possible--"cash cow"

[mileena]

. . .. That DME supplier said . . .

Yep, they tend to do that.
Q: how can you tell if a DME is lying?
A: if his lips are moving.

Haha, just like car salesmen and politicians!!

[mileena]

Also..on the prescription form I posted above, the doctor did not check nasal cushions, but the DME supplier did offer to have me try them in our initial meeting. How can the DME supplier offer me me nasal cushions when they were not prescribed??

Nasal cushions are included under "supplies". Cannot use cpap without spare parts.
The DME wants to sell as many of these as possible--"cash cow"

Agreed! But to be honest, as long as Medicare is paying, I don't mind!

It is just like the colonoscopy I have scheduled for next week...big cash cow for that industry. And the dermatologist told me that all people need to come in once a year for skin cancer checks. And the urologist said all patients should come in once every three years for a cystoscopy (where they look into your bladder with a small camera scope to check for cancer).

[D.H.]

It's good that you were smart enough to back out the identifying information!

I don't know if having another DME on the top of the form is a problem if you take it somewhere else. It's still a prescription.

[mileena]

It's good that you were smart enough to back out the identifying information!

Thanks D.H.! Well, other than the DME supplier, but I don't care if that is out in public. It took me a while to learn how to redact information on a computer.