CPAP for people with no insurance

KansasRT · Post by **KansasRT** » Fri Jun 13, 2008 1:26 pm

OK- I am here to vent and that should tell you how frusterated I am. (Because I am a DME RT and I know the mass feeling about us) Medicaid our state helath program does not cover sleep apnea testing or CPAP/APAP/BIPAP at all no matter what. Except that the hospital doing the sleep study gets a tax break or some sort of deal from medicaid every year for doing non covered stuff for free. Now they diagnos these people with sleep apnea and then expect the DME's in town to give them a CPAP machine mask and tubing. If you knew me in my personal life you would know I am all about charity and I give a lot of my time and my resources to charitable causes. So this is a hard thing for me. I would like to help everyone that walks through the door. But no business can give away more than they sell. We are a small local DME that I can assure you does not price gouge as horrible as most others. What I don't understand is that I am a two time Cancer survivor and the second time all of my chemo was non covered. They would not do it unless I showed up with money. I take $300 of medication a month and the pharmacy won't give it to me unless I pay for it. My son is very ill as well and if I can't afford the treatments he dosen't get them. But I am supposed to give some one a CPAP scott free and not even gripe about it. I truely feel for all of these people. It is horrible to be able to fix a problem and not be able to afford it. Medicaid's answer is a tracheostomy. Which to me is a very over the top option for sleep apnea. I am at a loss. It is a helpless cause. Because not all, but most of the time if you "give" someone a CPAP they will not use it as diligently as some one who has something at stake such as money or time. But is there anything out there for people who cannot afford treatment? We have had 6 of these in the last two weeks. I am at a loss and just needed to vent. I am sorry to take up your time.

Slinky · Post by **Slinky** » Fri Jun 13, 2008 1:47 pm

No need to apologize, KansasRT. That had to be very difficult to turn six people away. I can understand the need to vent. In a situation like that one is bound to feel helpless, frustrated, a little guilty when you shouldn't, etc., etc..

Certainly finding oneself faced w/undergoing a "free" tracheotomy or going untreated - or finding a way to come up w/some money and the ingenuity to find a used CPAP via a classified, rummage sale, etc. shuld spur some to find that way to get the CPAP. Not ideal. But .... I assume you are aware of A.W.A.K.E. and can refer these patients to them as a POSSIBLE assist.

Mr_Ed · Post by **Mr_Ed** » Fri Jun 13, 2008 2:45 pm

I know some of the drug companies have programs for people that are needs based and they determine eligibility based on income.

I don't know if any of the CPAP companies do the same though.

socknitster · Post by **socknitster** » Fri Jun 13, 2008 3:16 pm

Check with your suppliers. Maybe they would donate older models or reconditioned models for this cause.

I feel for you. Sounds like a ridiculous situation.

Jen

SleepGuy · Post by **SleepGuy** » Fri Jun 13, 2008 3:22 pm

Funny you should ask.

I met the ProBasics people at Sleep2008.

They are David vs. Goliath. They are the Model T Ford in a world where all automobiles were custom built and far too expensive for the average consumer. This is a fantastic company with a $200 cpap that is amazing in its design, innovation, performance.

Check out the ProBasics Zzz-Pap. Cpap.com advertises it as a small travel cpap (which it is and can be) but it's actually a fully versitile machine that can be used in a variety of ways, with or without a humidifier. There's a second model with good data capability.

And the base model is like $200. I am extremely impressed with this little cpap!

sleepycarol · Post by **sleepycarol** » Fri Jun 13, 2008 9:57 pm

KansasRT

In MY OPINION it is not unreasonable for those on Medicaid to have to make some tough choices!! Those of us in the working poor make those choices everyday!!! We have to pay our insurance premiums, deductibles, copays, out of pocket expenses, etc. regardless of our wages we are earning. I take 5 different medications daily. Prescriptions are expensive, even with a prescription plan I have to make sure I get medications that are covered by the plan and pay the copay. I, like you, have to do these things in order to obtain my medication -- it isn't free or low cost.

Those of us on insurance have to pay our copays and deductibles prior to owning our equipment. Why not let those on Medicaid find affordable means to obtain their equipment? It is unreasonable to expect DME's to give out equipment for no cost or to pass that cost on to the paying consumer!!!!!!!

How many times have you seen someone YOU personally KNOW on goverment assistance purchasing cigarettes, lottery tickets, beer or other alcoholic beverages, etc? My daughter used to work as a cashier in a local supermarket and would talk about how customers would come in and buy their groceries with foodstamps and then turn around and purchase cigarettes, alcohol, and lottery tickets with their cash.

Remember Kansas RT you have to do what you need to do in order to take care of YOUR family.

jules · Post by **jules** » Fri Jun 13, 2008 10:21 pm

call / contact and see if you can get a working relationship with

http://www.awakeinamerica.org/DonateRelief/

Awake In America, Inc.
P.O. Box 51601
Philadelphia, PA 19115-1601
(voice) 215-764-6568
Download Awake In America's vCard
email: Use our contact form
web: http://www.AwakeInAmerica.org

Guest · Post by **Guest** » Sat Jun 14, 2008 12:29 am

KansasRT,

You are an ethical businessman, and it is generous that you do what you can to help others. You need not feel pressured by processes others put in place (the system there) or by opinion to do that which is detrimental to your business and family. That's why you work - for your family.

Charity is a choice. Unless you feel particularly drawn to a situation, it probably isn't yours to solve.

As far as true need, going from management to being unable to work has opened my eyes to how destitute some can really be. I was fortunate enough that I had accumulated some modest possessions, and I sold them piece by piece to keep the wolves at bay, and had family and friends I knew would never let me "fall thru the cracks". I don't know what people do who truly have no alternatives - nothing of value to sell, family barely surviving themselves. Getting down to owning only my mattress and box springs and my mother's old cedar chest was scary, and I gained a new appreciation for those who have no safety net.

With your heart, KansasRT, you'll probably not be able to help yourself when you know there's a true need. Just don't let anyone make the decision for you.

Kathy

Fredman · Post by **Fredman** » Sat Jun 14, 2008 11:50 am

KansasRT thanks for your efforts. You obviously are a caring person and are trying to run a business while providing good care to your patients. Need more of you! I am not a businessman, I am not sure you if you are setup or able or want to do offer those that don't have insurance a layaway program - charge a small administrative fee on top for your trouble and costs? They don't get the machine until paid for in full.

Medical care is an issue for Americans and Canadians alike. Although in Canada we do get medical necessary medical treatment without having to pay through the nose. Having said that our system is eroding. The system is crumbling because of rising costs. Many Canadians carry additional medical insurance as an employee benefit. Premiums are rising. A number of treatments are now being de-insured like medication for anti-nausea due to Chemo therapy.

I have had some animated discussions here on this forum about medical care...and I will simply state there are no easy answers, but for me personally it is terribly wrong and sad that someone needing treatment may have to go without. I do agree in Personal responsibility and we need to be responsible for our own care - which means paying in part or in some cases in whole for our medical care. Somehow we have to make the system work for those providing a service - so that they can make a good living and yet affordable for all. I am not talking freebies...and yes perhaps some of those that can't afford treatment or equipment - need to make some decisions, like lose the cell phone, get rid of cable/satellite, don't buy the beer and cigarettes etc.

Goofproof · Post by **Goofproof** » Sat Jun 14, 2008 1:58 pm

sleepycarol wrote:KansasRT

In MY OPINION it is not unreasonable for those on Medicaid to have to make some tough choices!! Those of us in the working poor make those choices everyday!!! We have to pay our insurance premiums, deductibles, copays, out of pocket expenses, etc. regardless of our wages we are earning. I take 5 different medications daily. Prescriptions are expensive, even with a prescription plan I have to make sure I get medications that are covered by the plan and pay the copay. I, like you, have to do these things in order to obtain my medication -- it isn't free or low cost.

Those of us on insurance have to pay our copays and deductibles prior to owning our equipment. Why not let those on Medicaid find affordable means to obtain their equipment? It is unreasonable to expect DME's to give out equipment for no cost or to pass that cost on to the paying consumer!!!!!!!

How many times have you seen someone YOU personally KNOW on goverment assistance purchasing cigarettes, lottery tickets, beer or other alcoholic beverages, etc? My daughter used to work as a cashier in a local supermarket and would talk about how customers would come in and buy their groceries with foodstamps and then turn around and purchase cigarettes, alcohol, and lottery tickets with their cash.

Remember Kansas RT you have to do what you need to do in order to take care of YOUR family.

Very well put, many times the situtation we find ourselves in is a direct result of our own poor decisions. As was said, If you earn something you will have a better chance of using it. Welfare should be used to help the people that can't help themselves through no fault of their own, but most of it goes to reinforce peoples poor lifestiles and decisions. Don't feed people fish, give them a hook, line and a stick and teach them to fish for the food. Show them how to take care of opening the good doors, and closeing the bad ones. Life's about choice, make better choices. Jim

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dllfo · Post by **dllfo** » Sat Jun 14, 2008 4:29 pm

As I have said before, the DME/RT's that come here are a step above the norm for the industry. Here are some ideas, maybe one will work.

How about going to your local "Council of Churches", see if they can spare some money?

We tithe to our church to help people like you are talking about. OR if you have a large church close by, go to the Pastor, Reverend, etc. and explain the problem.

Our Deacons take up a collection when a "cause" appears. You might be very surprised.

How about the Boy Scouts doing a car wash, etc. Or having a local TV station do a report on it. Set up an account with a local bank so people can donate.

You would be amazed at how generous PEOPLE are. Our local firefighters hold up a boot at a major intersection and people stuff cash in the boot. Their cause is for burn victims.

If you set up a 501c charity, or have someone set it up, that is a tax deductible charity (if I am remembering correctly) people might be more willing do donate their old machines.

You mentioned that the hospital gets a tax write off, why doesn't your business? Of course, writing off equipment at wholesale doesn't help much, but if you could write it off at MSRP it might be of some help.

Best wishes...

mindy · Post by **mindy** » Sat Jun 14, 2008 5:17 pm

KansasRT,

My local DME lets us know that if we have a machine we are no longer using, if we donate it to them they clean them, make sure they're working and put them on a special shelf of used machines they give people who don't have insurance and/or can't afford a machine. In addition, they give them 1 or 2 new masks per year.

That way they do contribute but it is not nearly as much out of their pockets. I think it seems like a great idea.

I don't think Medicaid and charitable foundations have any idea of the significant effects of sleep apnea. And the difficulty in getting people to comply with treatment also causes a perception problem, imho.

Mindy

sleepycarol · Post by **sleepycarol** » Sat Jun 14, 2008 9:16 pm

Hmmm, just had a thought --

We have a very active Habitat for Humanity group in our area. They build on average 1 to 2 houses a year on property given to the group by the city. In order to qualify for one of their houses the receipent must be willing to put in so many hours of "sweat equity". There are additional guidelines that are followed in order to qualify as well besides the sweat equity. I do NOT know the success rate of this program as such (how long the initial owners stay in the houses, etc.)

Maybe the government ought to take a look how some of these types of organizations operate and model some of the government assistance programs in a likewise fashion.

I do feel sorry for those that need the help and are willing to sacrifice without complaint and are grateful for the help. Too often we find that those on the assistance take unfair advantage of the system and abuse it making it hard on those truly needing it.

markinOz · Post by **markinOz** » Sat Jun 14, 2008 11:11 pm

In Australia the cost of CPAP treatment is not assisted with in any way by the government. If you have private health insurance you may be eligible for some assistance, normally a limit of about $200. Health insurance here with that sort of benefit can cost thousands per year.

We are forced to purchase our machines directly from retailers. We also pay about twice as much as people in the USA. For example, a Resmed S8 II will cost about $1800. On top of this you would need to pay several hundred dollars for the humidifier. This same package could be bought from overseas for about $1150.

For some reason CPAP users in Australia are being gouged to the hilt. As these machines are tax free here, I would love to know who is making the money.

BTW, I have been meaning to ask, what is a DME? We don't have them here. Once you have been assessed by the ENT specialist and your level set, you are provided with a script and left to your own devices. They do have connections to a retailer, but that is pretty much it for suport. As a rule the retailers seem to know as much as the DMTs that I have read about.

alnhwrd · Post by **alnhwrd** » Sun Jun 15, 2008 1:20 am

Mark,

A DME is a Durable Medical Equipment provider, someone who serves as a local outlet for health care equipment, in our case Xpap machines, masks and supplies. Most patients are referred to one straight from the Drs office. In my case, and I think this is pretty standard, the doc just faxed the prescription straight to the DME closest to where I lived, and I got my stuff from them a couple of weeks later. The DME's here in the states have varying degrees of competence, empathy and avarice.

And I thought I was getting ripped off! Bloody oath! You guys are really getting shafted! Maybe that is why people on Cpap lose weight-after paying for their equipment they can't afford to buy food anymore!!

Alan

CPAP for people with no insurance

CPAP for people with no insurance

Uninsured in need of CPAP