CPAP Tricare

[kurbennett64]

Hi all,

Looked for info on this but cant quite find an answer. I received a CPAP machine back in 2009 using Tricare. I buy all my replacement supplies. I am trying to figure out the exact steps to replace the machine. I am still covered by Tricare and do have the original rx for the machine. Resmed says the machines should be replaced every 5 or 6 years. My current Tricare coverage is at a military hospital, and I do not have any VA coverage. What are the exact steps to get a replacement and follow on supplies?

Any assistance would be greatly appreciated.

Kurt

[greatunclebill]

Go to your doctor and see what he can do. there is no more automatic new machine after 5 years. A good doctor that knows the ropes can usually get it done though. i've been retired 30 years and have never used military facilities or the va. i have no feel for how they handle it. thank you for your service.

[SleepGeek]

Hi all,

Looked for info on this but cant quite find an answer. I received a CPAP machine back in 2009 using Tricare. I buy all my replacement supplies. I am trying to figure out the exact steps to replace the machine. I am still covered by Tricare and do have the original rx for the machine. Resmed says the machines should be replaced every 5 or 6 years. My current Tricare coverage is at a military hospital, and I do not have any VA coverage. What are the exact steps to get a replacement and follow on supplies?

Any assistance would be greatly appreciated.

Kurt

I think you will get your best answer from Tricare or TFL.
Are you still AD? If retired it will be TFL and they are not the same and do not / will not talk to each other - different billing, policy, etc.

[SleepGeek]

In fact, if it's TFL you need to call Medicare or your DME.
Hopefully, you already have a copy of your sleep study report and will save time there.

If you don't need any special attention - for a Medicare provider I have successfully used https://verushealthcare.com/contact/

[Okie bipap]

Like greatunclebill, I also use Medicare and Tricare For Life. The best place to start is with your primary care provider. Since your prescription is over ten years old, you will probably need a new prescription, and Tricare will most like want some proof you have been using the machine since you have been purchasing your supplies out of pocket and they have no record of you ever getting any CPAP supplies.

[SleepGeek]

OP hasn't clarified if Tricare or TFL?
If you are no longer AD and it truly is TFL you should also have Medicare and will have go by their guidelines. TFL will only care IF Medicare pays. IF Medicare doesn't pay for any reason TFL don't care and won't pay.

The good news is if you are VA eligible and have your PSG report that the VA of all hospitals in the US does NOT take Medicare. They will bill any other health insurance just not Medicare. Go figure.

So the point is you can get your equipment from them - if they aren't overwhelmed with this recall thing. All I did was to hand a copy of my PSG to my Primary doc and he took it from there. Tho it is Pulmonary who takes it after that you just have to be referred by your primary to any of the specialties. Isn't that how an HMO works?

The point is the VA and Medicare don't & won't talk.

HTH

[greatunclebill]

to clarify a couple things. when you retire you can go to the va or tricare. in tricare you can chose a civilian doctor as you pcp or you can chose a military treatment facility as your tricare pcp. you do not jump to medicare and tfl until age 65, actually it's the first of the month your 65th birtday falls in. . so i guess the question is how old is he and which system he is in.

[SleepGeek]

to clarify a couple things. when you retire you can go to the va or tricare. in tricare you can chose a civilian doctor as you pcp or you can chose a military treatment facility as your tricare pcp. you do not jump to medicare and tfl until age 65, actually it's the first of the month your 65th birtday falls in. . so i guess the question is how old is he and which system he is in.

BINGO

And even more depends on your location cuz some bases will treat AD Only
- then when Covid came around they didn't want anyone on base who didn't belong on base.
The Mission always comes first, period

[greatunclebill]

I spent 20 years working in usaf hospitals and 2 years in a civilian hospital. using a military treatment facility as tricare pcp has its advantages for sure. the disadvantages of base accessibility and continuity of care outweigh any advantages. you can go to an appointment and find that the base is locked down for so many different reasons. in the hospital you are assigned to a primary care team. you will see any of the doctors in the team and they rotate in and out frequently. in theory you may not see the same doctor twice. that's the way i remember it.

[kurbennett64]

Thanks to everyone for the information. I am 63 so my Tricare is Tricare Prime - Retired. Tricare Prime retirees in the Fort Gordon Georgia area have to use the local Army Hospital. When I originally got the CPAP machine in 2011 I was also in the Fort Gordon area but using Tricare Select, so I did not have to use the Army Hospital here unless I wanted too. I did call the local CPAP company that supplied the first machine, they said I needed a new Rx. So am trying to contact the original Dr. to see if he will do me a new one.

Also from above it doesn't appear that machines are replace every 5 or 6 years by Tricare?

I have no connection with the VA here. I received no disabilities when I retired so other than having an account on their site I have nothing else.

[SleepGeek]

Tricare Prime retirees in the Fort Gordon Georgia area have to use the local Army Hospital.

So contact Tricare Prime.

I have no connection with the VA here. I received no disabilities when I retired so other than having an account on their site I have nothing else.

You don't need a disability to be seen at the VA and they may even bill Tricare Prime. I know they billed TFL for me once but then I had to pay 80% which is more than they would charge a non-service connected vet who has no insurance.

Who knows what position (or training) at the MFG the person that told you that has - likely just admin - to be safe everything needs a test, ha.

IMO you need to get a copy of your last sleep study (PSG), I believe with that the VA can help you and that most any sleep doc can use that to write an equipment order (often called a script) for you. That is unless you feel you need another PSG? If you do be sure to get a copy of the results.

Then when 65 you can get a cpap from Medicare.