ResMed cpap 10 vs the 11

[ErnieH]

I've been doing a lot of reading on the 11. The UPDATES feature sounds a lot like Microsoft. They should have the 11 completed before they sell it. The price of $1600.00 should be considered as CUSTOMER RAPE!!!! I get a new one in two years and NO it will not be the 11, it will be the 10. I know Medicare pays for most of it but why in the world should they be paying that price? I know the US Government is the dumbest thing on earth, because it's FREE money to them, but It seems today the game of BIG BUSINESS is How Much Can We Soak the Customers? It's like a nose pillow that usually costs the customers about $20.00 apiece. I'll bet China sells them for 5 or 10 cents apiece because of the volume. That is just my opinion and all other opinions to me are irrelevant.

Ernie

[Air Jordan]

Good grief. Try to be informed before going off on a rant. Medicare does not pay the MSRP. There is a Medicare-approved amount. I'm not going to look it up for you, but it is less than half of what you quoted.

[Dog Slobber]

all other opinions to me are irrelevant

What a coincident....

[LSAT]

Ernie's probably not reading this, but for anyone else interested.....Resmed requires that machines and masks get billed out at their MSRP. Medicare (And most insurance companies) have contracted rates that they have agreed to pay....For example...When I got my last AS10 it was retailing for $885. Medicare was billed $885....Medicare allowed $560. They paid $448 and I paid $112. Insurance companies are not stupid...they make lots of money. (Except for Medicare).

[Air Jordan]

all other opinions to me are irrelevant

What a coincident....

Facts also seem to be irrelevant to Ernie.

[palerider]

all other opinions to me are irrelevant

What a coincident....

well, you know what they say about ignorance being bliss...

Ernie must be astonishingly blissful.

[palerider]

all other opinions to me are irrelevant

What a coincident....

Facts also seem to be irrelevant to Ernie.

You've gotta admire someone who refuses to let their opinion be swayed by facts....

Or not.

[pgevanthor]

I just received my ResMed AirSense 11 yesterday. I have MediCare. The price on the sales slip paid by Kaiser was listed as $465.70. I did see one advertised for about $1200 on a CPAP supply site.

[chunkyfrog]

According to the statements I have received,
comparing MSRP and Medicare allowables,
nobody gets raped unless they have NO insurance--
or foolishly opted for Medicare Advantage
(They only CALL it "insurance" . . . ),
and then need surgery, or have CANCER.

[zonker]

That is just my opinion and all other opinions to me are irrelevant.

Ernie

well, thanks for that, ernie.

any other opinions?

[ErnieH]

When I went to my DME provider, the Doctor had me down for a new AirSense 10. The lady started telling me how to use it. I told her I already know how to use it because that is what I'm using now, yet she continued to explain how to use it. I stopped her and asked why do you keep explaining when I already told you I know everything about the machine? She explained that she had to do this with each client. After the explanation she filled out the paper and the total came out to $1440 dollars. I ask her where she got the $1440 dollars. I told her I could get it at cpap.com for $880, so why the extra $560 dollars??? She told me, that was for the 15 min. I had to take to explain how to use it. When I saw the payments that Medicare was paying, it was 80% of the $1440 dollars.

Ernie

[zonker]

I told her I could get it at cpap.com for $880, so why the extra $560 dollars??? She told me, that was for the 15 min. I had to take to explain how to use it.

and people wonder why we hate dmes.

[Pugsy]

I ask her where she got the $1440 dollars. I told her I could get it at cpap.com for $880, so why the extra $560 dollars??? She told me, that was for the 15 min. I had to take to explain how to use it. When I saw the payments that Medicare was paying, it was 80% of the $1440 dollars.

You don't understand how Medicare works.
The DME might bill out 1440 to Medicare but Medicare will NOT approve that amount and they only pay 80% of whatever amount they approve and then the patient (or their co insurance or supplement) is required to pay the remaining 20% of the APPROVED amount.

Medicare will NOT ever approve any cpap machine billed out as an E0601 at 1440.... which is what the AirSense 10 or 11 models are billed out as.
Now when we get to the higher end bilevel devices that are more special machines and have a different HCPCS billing code from the E0601 machines....those approved amounts are higher.
Actual amount approved for E0601 machines will vary a bit depending on where you live but its somewhere around $600.
Let's use that 600 as an example...it's close...Medicare approves 600 and they pay 80% of the 600 or 480 bucks and you or your co insurance is responsible for the 120 remaining.

The difference between the billed amount of 1440 and what Medicare actually approves gets written off if the DME is a Medicare participating provider (and if they aren't participating you don't want to use them).

[Dog Slobber]

When I went to my DME provider, the Doctor had me down for a new AirSense 10. The lady started telling me how to use it. I told her I already know how to use it because that is what I'm using now, yet she continued to explain how to use it. I stopped her and asked why do you keep explaining when I already told you I know everything about the machine? She explained that she had to do this with each client. After the explanation she filled out the paper and the total came out to $1440 dollars. I ask her where she got the $1440 dollars. I told her I could get it at cpap.com for $880, so why the extra $560 dollars??? She told me, that was for the 15 min. I had to take to explain how to use it. When I saw the payments that Medicare was paying, it was 80% of the $1440 dollars.

Ernie

Anybody who doesn't understand why Brick and Mortar DMEs are more expensive than online sites is an idiot.
Anybody who doesn't understand that just because you don't want the support, that is built in the cost, doesn't mean it gets taken off the price.

[Janknitz]

I just received my ResMed AirSense 11 yesterday. I have MediCare. The price on the sales slip paid by Kaiser was listed as $465.70. I did see one advertised for about $1200 on a CPAP supply site.

And lucky you will pay a lot MORE than Kaiser did over the lifetime of the machine in perpetual deductibles. Plus Kaiser gets a lot more Medicare dollars than $465 for Medicare's share of the reimbursement. Crapria probably has a thin as ice profit margin with the Kaiser contract but they make it up in sheer volume.