Starting to think about a new machine

[JeffV]

Greetings everyone - been a long time since I needed to post here! (Yay, I guess?) The time has come to pick insurance coverage for next year (boo, definitely) and that's gotten me thinking about whether it's time to pick up a new machine. I've read on here that the "standard" life tends to be 5 years / 15,000 hours, and I've been using my PR Auto 560 since November 2014, and it has about 13,500 hours on it. I've never had any issues with it, as far as I know I've never dropped it or mistreated it or anything. So far where my thoughts are:

Pro (get a new machine)
- I don't have a backup, this is the only machine I've ever used. At some point it WILL fail, and from what I understand this machine tends to fail suddenly rather than gradually. Better to get a new one and have the old on hand while it still functions.
- Technology's probably advanced, there may be something better out there. (I've seen a bit about the Dreamstation and the new ResMed, but not really how it compares to what I've got.)

Con (wait a year or two)
- It's working fine, never showed the first sign of any problems, and I'm still a ways off from hitting the magic 15k.
- The technology hasn't advanced that far. I have a good data-capable APAP that's dialed in well, been keeping me below 1 AHI for years with very rare exception. Why mess with what works?
- $$$. With my current machine, I paid nearly nothing for it and stocked up on a bunch of supplies for free because I had emergency surgery that year and maxed out my insurance. Not likely to happen again (at least I hope not), and my insurance sucks now. I'm likely paying out of pocket for whatever I get.
- I don't want to deal with a DME again if I can avoid it, but I pretty well screw myself to buy online. Naturally f@&k dealing with Crapria ever again (I haven't contacted them since the end of 2015, and was still having them try to send me bills as recently as last year) If I go to a DME I'll find someone else. But I have no idea who to trust online to shop around, and I'm about 98% sure that my insurance would call that out-of-network, and thus out-of-pocket. If I use a DME, it'd at least hit my deductible.

As you can see, I can write a heck of a lot more about cons than about pros, but I also deal with anxiety and depression and I overthink everything so that's not exactly a galloping shock. Any help I can get to help untangle this would be much appreciated!!!

[ragtopcircus]

The "discounted" price for buying stuff from an in-network DME was about double to triple the market price for me. Since I have a high deductible, insurance "coverage" really just meant they felt like they had a say in what I could or could not overpay for out of my own pocket. I'd suggest looking at sistemmacpap.com, secondwindcpap.com, and our host, cpap.com (my primary source). The latter offers "free" trials on a lot of stuff, but some return rate is priced on. However, they have frequent sales and discount codes that often put them in the lead on price if you are patient. The first two offer used equipment, and some members here have connections for lightly-used equipment.

I've taken a PRS1 Auto for a test run, used a Dreamstation Pro for about a month, and still have a Dreamstation Go Auto for travel and power failures. Personally, Resmed works better for me, and it does for many here, but it's hard to argue with your success.

A new Dreamstation Auto will be a little more friendly to operate, but functionally very similar to what you have. If you decide to go that route, I'd give serious thought to buying used or waiting for a fire sale price.

[Cruiser1234]

13k hours is certainly getting up there, but then again, I have heard of members with over 35k hours (12 years!!!). My advice would be to make sure that whatever you get has advanced data so you can use Oscar. It helps give you access to a ton of information which you wouldn't otherwise have access to.

Let me know if you need a good used machine and I can at least let you know what I have - no pressure. You may as well at least explore your options.

[bwexler]

I wrestled a bit with Crapria last year, but couldn't get them to even quote a cash price for a new ASV machine.
They said I had to place an order and get insurance approval before they could quote any price.
So I bought a slightly used machine from a member here.
In less than 3 years I will break even based on my best guess as to what my copays might be.
I would love to have insurance again that actually pays for stuff. But, that seems to have gone away since Obamacare.

[TropicalDiver]

I would strongly encourage a spare. Full stop.

A very viable option is buying used. There are plenty of low hour machines around. I personally purchased my spare used from LSAT on this site -- great product, exactly as described, very good communication. Second wind also has a good reputation. Lower prices can sometimes be found on Facebook, Craigslist, etc.

You can also buy new...CPAP.com is the forum sponsor and has treated me very well in my transactions for various items. And you have traditional DME; some are very good while others are less so.

Now, insurance. It really just depends on your insurance whether self pay is worth it or not. As context, my machine new was over $1700. Used it was around $500.

Now, which machine. Full data and auto adjust. Beyond that depends on your needs. For me, ResMed breathing just feels more natural. If you use ResMed and are happy, I would stay with them. The same with respironics.

[JeffV]

I would strongly encourage a spare. Full stop.

Yeah, you're not wrong. What I'm thinking though is buying a new (or very gently used from a reliable seller) machine that'll become my primary machine, and keeping my current one as a spare since it's still in good shape.

Now, which machine. Full data and auto adjust. Beyond that depends on your needs. For me, ResMed breathing just feels more natural. If you use ResMed and are happy, I would stay with them. The same with respironics.

I'm happy with my PR machine. I've never even tried a ResMed. I've seen good things about the ResMed For Her, but from what I'm reading the extra modes won't help me since my minimum pressure starts at 13. I'm thinking trying to find a good price on a Dreamstation Auto and just doing it out of pocket.

[Cruiser1234]

If PR works for you, then absolutely, you should stick with it. No point in trying to fix something which isn't broken. Some of the online stores have great deals on them.

[ragtopcircus]

You probably won't benefit from the For Her mode. That doesn't mean you won't benefit from the regular Autoset mode of an Airsense 10 Autoset or a For Her (whichever you find cheaper - both support the regular mode). Of course, if you are satisfied with what you have, there may be little reason to change.

I can get AHI a little below 1.0 on my best day with a Dreamstation, but it typically varies from somewhere between 1.0 and 2.0 or even higher. With Resmed, 0.1 to 0.5 is easily attainable. I can feel that difference in the morning. Of course, Resmed has its warts too, like the humidifier tank design.

As the saying goes, if it ain't broke .... Of course, there's always room for improvement too ....

[Pugsy]

Some people adjust easily to change in anything and some people don't.
Going to a totally different brand machine means you go to something totally different and new....a person may like it or they may hate it. Unfortunately it's kind of a pricey experiment for most of us unless we get some sort of screaming hot deal on a new/different machine to play with.
Each brand does things a little different in terms of any exhale relief and any auto adjusting algorithms.
When the body/brain has been used to one way of doing something for years it might not always be happy with the new way of doing things. It might love the new way or it might hate the new way.

Most people like the way ResMed does its job but not everyone will....and we don't have a crystal ball to know what will happen in the future (unless you get one like a doc did who can see 56 apnea events per hour from a brick cpap machine another story )
So when in doubt and a person doesn't like to experiment and risk things or just try new stuff for the sake of trying new stuff....stick with tried and true.