Phillips / Philips Respironics recent recall notice discussion thread

[HairyReasoner]

Our Medicare Advantage Plan paid the ambulance and ER bills. When the case was settled, our Medicare plan was reimbursed by the insurance company of the driver-at-fault.

Yes, that's exactly how it works. Insurance paid, but got reimbursed by the at fault party. That's exactly how I'm suggesting insurance may want to handle it here--pay the necessary medical expenses for the patient and recover that expense from Phillips. Grandpa wasn't denied ER treatment and ambulance because he didn't have the ability to pay up front out of pocket. That's what's happening right now with xPAP patients.

As far as the company contractor, that's not medical insurance. Those policies are more likely to be limited based on fault.

[ChicagoGranny]

That's exactly how I'm suggesting insurance may want to handle it here--pay the necessary medical expenses for the patient and recover that expense from Phillips.

Have you talked to a supervisor at your insurance company? That's the way I get things done.

[Dog Slobber]

Insurance companies are not responsible for paying for Philips blunder. Read the terms of your policy.

I've read the terms of my policy. Nowhere does it say coverage is determined by whose fault it is. By that argument, if my neighbor gets careless with his rifle and shoots me, my insurance shouldn't cover my medical treatment for that if my neighbor doesn't step up. Perhaps you can show me where in the terms a typical insurance policy it in general rules out coverage for things that are somebody else's fault, but I can't find anything like that.

Are you being intentionally dishonest?

Insurance companies have amount limits and time frame limits. You even acknowledged that.

You are asking them to waive it. They should not have to, as I said "they are not responsible for Philips blunder", and they shouldn't be.

Of course, just as my insurance might recover it's expenses against my neighbor by litigation, such avenue would still be open against Phillips.

Not if they did not *have* to pay your claim.

When an insurance company has to pay a claim, they can recover damages from the party responsible under a legal doctrine called Subrogation. They are essentially stepping in your shoes because they were contractually obligated to pay you. If they were not contractually obligated to pay you, they do not have a cause against Philips.

You can be damn sure that should any insurance company go after Philips for Damages they will be scrutinizing the contract that entitled them to.

Insurance companies do have limitations on coverage, including the 5 year limitation on buying CPAP devices. But, in cases of medical necessity they can, and sometimes do waive those requirements (as according to the post here Medicare has done).

And there it is.

The terms state they are not responsible to replace your machine within 5 years.

If they volunteer to, then it's on them, not Philips. And as I originally said, "They should not have to pay for Philips blunder.

If I were to voluntarily pay for a new machine for you I would not have a cause against philips for the cost of a new machine.

I'm not saying they're operating against their policies by not waiving the 5 year requirement. I'm just stating the realistic choice they have.

Of course, maybe they'll opt out of paying for the lung cancer treatments on the grounds it's somebody else's fault.

I never said that, your strawman is both asinine and dishonest.

[HairyReasoner]

Are you being intentionally dishonest?

Obviously, nothing I've said here is dishonest.

Not if they did not *have* to pay your claim.

When an insurance company has to pay a claim, they can recover damages from the party responsible under a mechanism called Subrogation. They are essentially stepping in your shoes because they were contractually obligated to pay you. If they were not contractually obligated to pay you, they do not have a cause against Philips.

If you'd read what I've said in context, you'll see I'm not saying they "have" to (perhaps you gave a straw man argument of something I never said?). Obviously they do have policy limits as I've pointed out. My statement was that it might be in their better financial interest to choose to do so because if they don't pay for new machines now, they will likely be paying for a lot of more expensive lung cancer treatments later.

I never said that, your strawman is both asinine and dishonest.

Where did I say you did say that? So there is no strawman argument. My point is that is the logical conclusion of your argument. How can you say insurance has the right to not pay for something based upon fault, and have that not apply to other things--such as lung cancer?

However, I did realize that was an unnecessary comment about your argument that could be taken as ridicule of you, and I do apologize for that. I presume that's why you are responding with personal insults against me that are unfounded. You might notice I had removed that part of the comment before you responded (or at least before it posted, since you obviously saw it while typing your response).

[Pugsy]

Insurance companies are going to try to avoid paying for anything whenever they can legally avoid it....saves them money.
They don't care about what "might" happen later because they are banking on even if someone came up (like the lung cancer thing) that they wouldn't have as much go out for that as they would for a truck load of new cpap machines now.
They live in the now and look at the bottom line for now....and the almighty dollar is king to them...not doing what is maybe best for the patient. It's always been that way. It's a for sure pay now or a maybe pay later choice. Guess what they will choose if they can????
They get to make their own rules...is it morally right? I am thinking no...but it is their legal right.

[HairyReasoner]

Insurance companies are going to try to avoid paying for anything whenever they can legally avoid it....saves them money.
They don't care about what "might" happen later because they are banking on even if someone came up (like the lung cancer thing) that they wouldn't have as much go out for that as they would for a truck load of new cpap machines now.
They live in the now and look at the bottom line for now....and the almighty dollar is king to them...not doing what is maybe best for the patient. It's always been that way. It's a for sure pay now or a maybe pay later choice. Guess what they will choose if they can????
They get to make their own rules...is it morally right? I am thinking no...but it is their legal right.

I agree that appears to be how they work. I just happen to think it's quite short sighted. Then again, we don't have the risk quantified. If the long term lung cancer risk is really high, it's financially short sighted. If that risk is low, maybe they come out ahead this way. Of course, the patient is who loses.

The part that surprises me is the earlier posts indicating Medicare is waiving the 5 year requirement. My impression has always been that Medicare is the stingiest of them all.

[HairyReasoner]

That's exactly how I'm suggesting insurance may want to handle it here--pay the necessary medical expenses for the patient and recover that expense from Phillips.

Have you talked to a supervisor at your insurance company? That's the way I get things done.

I haven't yet. The individual I spoke with at first had no idea what I was talking about. Then she talked to her supervisor, and told me her supervisor was familiar with it and said Blue Cross isn't waiving the 5 year requirement.

[irish80122]

Hi all, new person here, though I did force myself to read through all the posts.

I see a lot of folks jumped on the Airsense 10, and I likely will as well, but is anyone still waiting on the Airsense 11? Is there much reason to? The videos I have seen don't make it look that that big of an upgrade, but I thought i would ak about it before plopping down the cash.

Also, my wife (who also has a Dreamstation, lucky us) is thinking about getting a HDM Z2 as the replacement. Anyone here have experience using it as a daily driver... at least until Phillips figures things out?

I appreciate all of you more than you know!

[kbh209]

The Airsense 10 (you want the AutoSet) is the best machine out there right now. We don't know much about the Airsense 11 series yet, since it hasn't been released.
If you want to take charge of your CPAP health, get the Airsense 10 AutoSet and you can start monitoring your own therapy with the Oscar app. I haven't heard anything about the HDM Z2

[irish80122]

The Airsense 10 (you want the AutoSet) is the best machine out there right now. We don't know much about the Airsense 11 series yet, since it hasn't been released.
If you want to take charge of your CPAP health, get the Airsense 10 AutoSet and you can start monitoring your own therapy with the Oscar app. I haven't heard anything about the HDM Z2

Thank you so much, I really appreciate the feedback! I have played some with OSCAR for a former client (I am actually a behavioral sleep medicine psychologist and do some CPAP adherence work), but I have yet to do it with my own data for some reason, so I will have to brush it off and see what I can do!

[Pugsy]

my wife (who also has a Dreamstation, lucky us) is thinking about getting a HDM Z2 as the replacement. Anyone here have experience using it as a daily driver... at least until Phillips figures things out?

If your wife decides on the Z2 make sure if she hates it she can return it and get a ResMed like yours.
While it is reportedly (from HDM) quieter than the Z1...a lot of people say it is still pretty loud in terms of noise and some people find that the tiny size isn't worth it. World of difference between it and the DreamStation she is used or the ResMed you are looking at.
If she needs much moisture to keep her nasal mucosa happy....she will probably hate it.

While some people end up really liking it...it was never designed to be a primary machine and the jury is out on how long it will last being used every night for years.

https://www.cpap.com/productpage/z2-aut ... ap-machine

So the 2 main potential negatives...noise and lack of much humidification.
This is what I have read from people here on the forum who have used the machine.

[KingSnore]

I'm curious what folks are doing about replacements in this particular window. It's a very unique situation.

We're likely a month out from the Air 11. But there could be shortages, bugs, who knows.
And the current AirCurve isn't likely to be upgraded right away.

So if you don't want to use a Philips product right now, do you bite the bullet immediately and grab a 10 series? Or hold off a month and look at the 11 (and most likely reduced pricing on the 10?)

I ask because I bought a backup machine and I'm hesitant to go to my DME so soon before a product refresh. But I second guess myself wondering if I'd even be able to get the 11, because demand will be higher because of the Philips recall.

[4betterO2]

I second guess myself wondering if I'd even be able to get the 11, because demand will be higher because of the Philips recall.

I'm pretty sure you're right...
my DME told me they are not giving out any more Respironics due to the recall

[4betterO2]

In the Dreamstation and the System One machines, is all the foam only in the main machine, or is there any at all in the humidifier? (Sorry if this is a dumb question, but I'd like to be totally sure)
Also, is the cancer risk worse when using the machine's humidifier, or only when the ambient air itself has high humidity?

[kbh209]

In the Dreamstation and the System One machines, is all the foam only in the main machine, or is there any at all in the humidifier? (Sorry if this is a dumb question, but I'd like to be totally sure)
Also, is the cancer risk worse when using the machine's humidifier, or only when the ambient air itself has high humidity?

in the Dreamstation, the foam is in the plastic housing for the turbine engine. The foam is in the airway path, from the entrance to the exit. As for the cancer risk: that is something you need to reach out to your sleep specialist or primary care doctor about.

I'm curious what folks are doing about replacements in this particular window. It's a very unique situation.

We're likely a month out from the Air 11. But there could be shortages, bugs, who knows.
And the current AirCurve isn't likely to be upgraded right away.

So if you don't want to use a Philips product right now, do you bite the bullet immediately and grab a 10 series? Or hold off a month and look at the 11 (and most likely reduced pricing on the 10?)

I ask because I bought a backup machine and I'm hesitant to go to my DME so soon before a product refresh. But I second guess myself wondering if I'd even be able to get the 11, because demand will be higher because of the Philips recall.

If you can get a Resmed Airsense 10 AutoSet now, get it now. I was reading on CPAP DOT COM's website today that it's going to be about a year before Dreamstation 2s are going to enter the market , due to foam gate, as we're calling it, along with the world wide silicon chip shortage and our shipping issues. I suspect that the ResMed 11s supply and demand will be affected by the chip shortage and shipping issues.