Good bye DME!!

[Becca8104]

so basically, I have really good insurance using the Military insurance coverage, so will probably stay with paying with insurance. I will talk to my DME about the replacement schedule for supplies. I can likely get away with getting all of my supplies once a year with proper care & cleaning. I will continue to download my data in My Air because my prescription from my Military sleep clinic provider specifically requested that I register for My Air & use it. During my 90 day follow up, I did not bring my machine in because I didn't feel like lugging it. I brought my SD card instead. They didn't need my machine or ask to see my SD card, so they were able to get my data using their own method for doing so. So my DME is likely the only one checking to make sure I am compliant. That's fine. I guess I will keep using My Air (just in case it is what is needed by the military for compliance) & continue to use Oscar for my own pleasure. I would prefer not to waste my time going to doctor appointments only for them to tell me I am doing just fine.

[palerider]

Huh... you talk, and they just ignore it....


Your machine uses a cellular modem to send data to Resmed's servers.

Whether you use myair or not, *makes zero difference at all*.

You DID have to register the machine so they'd know which of the zillions of them that report back to Resmed was yours.

That's it. Use myair if you want.

[chunkyfrog]

When our rich uncle writes the checks, it is wisest to just shut up and let him.

[TropicalDiver]

so basically, I have really good insurance using the Military insurance coverage, so will probably stay with paying with insurance. I will talk to my DME about the replacement schedule for supplies. I can likely get away with getting all of my supplies once a year with proper care & cleaning. I will continue to download my data in My Air because my prescription from my Military sleep clinic provider specifically requested that I register for My Air & use it. During my 90 day follow up, I did not bring my machine in because I didn't feel like lugging it. I brought my SD card instead. They didn't need my machine or ask to see my SD card, so they were able to get my data using their own method for doing so. So my DME is likely the only one checking to make sure I am compliant. That's fine. I guess I will keep using My Air (just in case it is what is needed by the military for compliance) & continue to use Oscar for my own pleasure. I would prefer not to waste my time going to doctor appointments only for them to tell me I am doing just fine.

As others have noted, the replacement schedule used by DMEs is typically based on what insurers consider to be the maximum reasonable burn rate for supplies. It is not a true replacement schedule. There are good reasons to replace the filter on a regular basis.

For masks, I tend to use the replacement window as an opportunity to try a different mask and/or keep a spare in stock. I also like to have a spare tank and hose as well.

Compliance is important. For your health and for your insurer to pay for the machine (and, in a few cases, to pay for supplies). Your data is uploaded via a cell modem in your machine to the resmed servers (as PR and others noted). That data can be seen at a very high level via the myair app (and with some additional detail via an app used via your doc and/or DME). Or it can be done via a SD card.

I suspect the request for you to use MyAir is to get you to pay attention to your treatment compliance (and, to a much lesser extent, efficacy). Paying attention to your treatment is a very good thing -- and likely why you are here! OSCAR will tell you much much more than MyAir but MyAir is fine for what it does (tells you if are using the machine, if you are having big leaks, AHI). Not enough to evaluate the quality of treatment and/or provide information to refine the treatment but....

[Becca8104]

I agree with everything advised so far. One of the main reasons why I wanted to use the "every 3 months" for a new mask is so that I could try a new one every time. Now that I have "settled" on the N30i (no mask is completely perfect every night), I don't really NEED to have a new one every 3 months. I still have my full face Dreamwear that I rarely wear but do so on occasion. It's because it is the only Full face mask that has the hose on top of the head, but I have to wear liners with it which makes me itch & is uncomfortable for that reason. I will continue to keep it for my full face option UNTIL Resmed makes the F30i. I can't see them NOT creating one to compete with the Dreamwear FF. THAT would be my best mask for me. Would love to ditch the chin strap and go back to full face all the time. The F30 sealed for me very well, but I just couldn't stand the hose on my nose which is the only reason I gave it up. Hose nose is intolerable for me. Wish it weren't so. It would have more mask options to try if the hose nose didn't bother me so much.

[Janknitz]

I'm stuck paying through the nose for an ACA plan with such high deductibles I can't really use it. There is supposedly DME coverage but they don't cover CPAP for some unknown reason.

But the reality is that I almost had a party when I heard that. No more dealing with Crapria. I buy my supplies from Amazon at less than my co-pays were even when I had coverage, and no BS, no wrong shipments, no wrong billing (100% of the time with Crapria). I'm thrilled!

[zorki1c]

My machine cost me a one time fee of $175.00 (my 20%) and I continue to pay 20% every time I get new supplies, so I feel the cost is reasonable. I never considered trying to buy equipment out of pocket. Again, I guess I never considered NOT using insurance or following their "schedule". I use CPAP Military Medical for my DME. Tricare (Humana Military), has picky rules. I am not sure they will pay their 80% if I don't comply to what has been set up already. I was told by my sleep doctor that I must use My Air in order for Tricare to continue paying the 80% because I have to "prove" compliance before they will pay. Maybe people with Tricare coverage for CPAP all get prescribed Resmed AirSense 10 machines so that My Air can be used and they don't have any other choice? I really need to ask questions I think. I was also told that when I get on Medicare, Medicare also "requires" proof of compliance before they pay. Does Medicare really peek at your My Air results? for that matter, does Humana do the same? If what I was told is true, what do users of Dreamstation & other machines do for compliance proof? I am beginning to think that it may be a lie all around regarding "proof of compliance". Does anyone know the real answer?

When I switched Medicare plans I had to go in and get a checkup with my apnea doctor. My A10 Autoset sends in a report to the DME every night and I think they monitor usage for the first month send a report to Medicare to verify I’m really using it. I’m not totally sure of the time frame. I have to pay something like $20 a month for a year and then I own the machine. After that I don’t think Medicare cares if i’m actually using the machine every night.

[Stephaniedp3]

When I switched Medicare plans I had to go in and get a checkup with my apnea doctor. My A10 Autoset sends in a report to the DME every night and I think they monitor usage for the first month send a report to Medicare to verify I’m really using it. I’m not totally sure of the time frame. I have to pay something like $20 a month for a year and then I own the machine. After that I don’t think Medicare cares if i’m actually using the machine every night.

It’s similar for me through United healthcare through my husbands company. I think it’s around $43 a month for 10 months and after that it’s mine and I pay around half price in the end I think. Plus after the 10 months I don’t think the insurance cares about compliance because they’re already had me “rent” it for 10 months.

[tsduke]

I’d be curious how much some of the more complex machines like ST or AVS would run you guys. My insurance wasn’t terrible for a standard auto CPAP either, but for ST the were horrible.

[babydinosnoreless]

My machine cost me a one time fee of $175.00 (my 20%) and I continue to pay 20% every time I get new supplies, so I feel the cost is reasonable. I never considered trying to buy equipment out of pocket. Again, I guess I never considered NOT using insurance or following their "schedule". I use CPAP Military Medical for my DME. Tricare (Humana Military), has picky rules. I am not sure they will pay their 80% if I don't comply to what has been set up already. I was told by my sleep doctor that I must use My Air in order for Tricare to continue paying the 80% because I have to "prove" compliance before they will pay. Maybe people with Tricare coverage for CPAP all get prescribed Resmed AirSense 10 machines so that My Air can be used and they don't have any other choice? I really need to ask questions I think. I was also told that when I get on Medicare, Medicare also "requires" proof of compliance before they pay. Does Medicare really peek at your My Air results? for that matter, does Humana do the same? If what I was told is true, what do users of Dreamstation & other machines do for compliance proof? I am beginning to think that it may be a lie all around regarding "proof of compliance". Does anyone know the real answer?

I paid $500 up front and then my 20% was $79 a month for 13 months. Found out they shouldn't have collected the up front charge, my eob only had me at less than $100. The $79 a month went away when we made our out of pocket costs by the end of January. (Ugh it was a bad expensive medical year) It was mine in October. Still fighting to get the rest of my $500 back. They tell me 6 weeks. Bought my backup machine from lsat for less than my 20% total would have been. (Was actually planning on returning the machine from the DME, until we unfortunately hit the out of pocket). Now that my out of pocket reset I will be buying all my supplies from amazon. I hope we don't hit that out of pocket this year.

[chunkyfrog]

When I recently picked up supplies, I counted an extra set of p10 pillows.
Since I realized it was probably due to a human error (new help), I returned the extra pillow.
This type of honesty generally blows people away.
How I love to mess with their minds. Heh, heh . . .