Prescription not renewed

[JJR]

Last time I went to the sleep “doctor,” they said everything was good, here’s your next appointment, waaaaay out in the future.

So it was a surprise and disappointment to find out today that I can’t get new masks or filters through insurance because my prescription had expired.

So I immediately called the “doctor,” but they’re closed on Fridays!

I’m not in immediate need of supplies, so it’s no emergency, but it’s very frustrating.

[LSAT]

It's amazing the difference in DME procedures. When I get a new machine with a prescription, no additional prescription is needed until the next time i get a new machine. I can get supplies for 5 + years. (Medicare Complete).

[chunkyfrog]

My rx at cpap.com was printed at 99 months, which is over 8 years.
Insurance companies often require frequent updates;
--possibly to confirm that the patient is still alive, or to give docs/labs a shot at some easy $$$,
because we cannot prove that kickbacks do not exist.

[D.H.]

They did require a new sleep study when I wanted a new machine. The old machine was a box, so admittedly they didn't have good stats that were recent. What was really annoying is that they wanted a new "baseline" test (i.e. I had to sleep without CPAP to "prove" that I still had sleep apnea). Considering that I had an AHI of 52 seventeen years earlier and did nothing about the condition besides CPAP, that was ridiculous. I am also very uncomfortable about sleeping without CPAP. However, after about 90 minutes, they said I can use CPAP the rest of the night. They titrated me at 13, which was what I had the old machine set at anyhow.

BTW, based on feedback from SleepyHead (now OSCAR), I raised it to 13.5 with a max of 20.

In short, the test was a waste of time and money, and cost the insurance more than the new machine!

[chunkyfrog]

The system is so broken . . .
We just have to do whatever we need to in order to survive.
And bitch very loudly about it.
Especially to those responsible--or whoever is watching them.

[Pugsy]

I am wondering who said the RX had expired. The DME or the insurance company. I would want to see the RX and also ask the insurance company directly if they really needed a new RX. I don't trust DMEs.

[JJR]

I am wondering who said the RX had expired. The DME or the insurance company. I would want to see the RX and also ask the insurance company directly if they really needed a new RX. I don't trust DMEs.

Good question, it could have all been an error, too.

[Goofproof]

Or another DME Lie! Jim Check you can see their lips move!

[Pugsy]

Some DMEs have decided to adopted their own in house rules about anything and put the blame everywhere but on themselves.
Some DMEs want to have a RX dated within one year on file due to their own in house rules but they want to blame it on the insurance company having new or different requirements.

That's why I would ask my insurance company directly (never trust what a DME says your insurance will or will not do) and if it is indeed a stupid in house rule and they lied to me....I would be finding a new DME.

[chunkyfrog]

Or just some untrained first line customer "assistance" person,
using BS to cover their glutes.
I called my insurance to determine benefits.
The first operator was very ignorant, giving me an answer that no way could be right.
I asked to speak to a supervisor, who helped me get the correct snswer.
Always go up the food chain.
"Mushrooms" are fed crap, and they think it's good enough for anybody.

[jsmit86]

edited to delete wrong thread.

[Pugsy]

There are several threads on this with good advice, but keep in mind that needs vary with each user.

I purchased a HDM Z2 Auto, and I'm pretty happy with it for travel. If you need portability, it's a very good choice.
If you decide on a Z1 or Z2, I strongly suggest the Z2 Auto. It has lower noise levels than the Z1 series, and it also added auto start/stop which I really like.
I had to use it for a couple of month when my Resmed unit was in the process of being replaced, and the therapy was very good, if not quite to the level of my Resmed unit.
It's very small and easy to pack in my carry on bag. If you are dragging things through the airport, you may appreciate that. It's the main reason I sprung for the unit.

The downside is that there is a bit more noise than the full size units. For me, it's not that big a deal, especially since most of my use was during times when the room A/C was on, which masks the noise. I have read that the noise at the mask can be greatly reduced by using a special travel hose. I'll probably get one before my next trip.
Also I don't don't seem to miss the humidification much, and only tried the HME unit one time, and decided against bothering with that since I was fine without it even during trips to Las Vegas and Phoenix.

Cpap.com allows you to try the machine for 30 days at no risk should you decide to get a unit.

He's just wanting masks and maybe some incidentals like filters. I don't see where he said he wanted a new machine much less a travel machine.
But what you said is good information if someone is wanting a travel machine.

So it was a surprise and disappointment to find out today that I can’t get new masks or filters through insurance because my prescription had expired.

[jsmit86]

Somehow I posted this in the wrong thread.. I'll see if I can fix it!

(I had multiple tabs opened, and somehow I messed up! At least I know it's not from lack of sleep! )

[chunkyfrog]

Somehow I posted this in the wrong thread.. I'll see if I can fix it!

(I had multiple tabs opened, and somehow I messed up! At least I know it's not from lack of sleep! )

It happens to me, too.
I tend to blame it on my hand tremors, sometimes Pugsy's aliens.
Embarrassing, isn't it?

[Pugsy]

Somehow I posted this in the wrong thread.. I'll see if I can fix it!

You can't remove anything since CF has posted.
You can still edit your posts though or if you wish me to just remove them then I can easily do that for you and can remove mine and CF's at the same time and just pretend like it never happened.