If you can buy your machine outright, do it!

[MichelleFL]

This certainly has been a learning experience for me and I want to thank everyone so much for all of the helpful information!

As you know I have been looking at used machines. Since I called BCBS they said since I met my deductible for this year to see if we could do it for purchase through the DME. I am looking to spend about $100.00 on a used machine but figured if my deductible was around $220.00 for a new machine I would take the money from the bills and do it even though I really did not have the money just to get a new machine.

So I call the DME today and told her the story. I heard tapping on the keyboard and without even asking what type of machine I wanted she said a cpap was $1,200.00. I said WHAT! Does that even include a heater humidifier!?!?!?! She said no. I then said how come your so expensive when cpap.com only charges $600.00, half of the price. She stumbled and said they do not have overhead like they do and they don't have to fill out all the paperwork.. *rolls eyes*

So if you can buy your machine either new if you can afford it, or used like I have to do because as it's been said.. The DME's will rip you off and charge you 3 times the amount you could of paid for it yourself. I think of it as like one of those, "Rent A Center" places. You rent cheap furniture which breaks down in a year and takes 5 to pay off at 3-4 times the amount if you would of bought it yourself.. Ridiculous.

[skittles]

I totally agree with you -- my insurance denied my machine until January - I did not want to wait that long -- when I returned the machine, the RT said they would sell me it for $500.00--cpap.com had them new for $600.00. I told her I would have to think about it.

I went to Cpapauction and found the exact same machine, used 29 hours for $107.00 with integrated humidifier. It is not data capable, but right now I am not in a position to go that route. I also bought my comfortlite2 and extras for half the cost.

Insurance sucks here in the US unless you are on medicare (I understand they will pay for CPAP equipment) or fortunate enough to have an employer who only wants the best for their employees.

Ok - getting off my soap box

Take Care

Skittles

[DreamStalker]

Yep, we try to warn them before it is too late but a lot slip through the cracks into the bowls of the DME.

Unless you insurance pays 100%, it is almost always better to bypass your insurance and buy out-of-pocket, get the machine with the most options, and focus on getting your health back rather than fighting DME/insurance machine.

[Guest]

That's what I did after reading about some of the experiences here.
I called my DME provider about the equipment and went through a lengthly
conversation with them. Even though I have decent insurance they still wanted
my credit card number if I went to get equipment from them (which I didnt).
I don't need the added stress of all that plus my provider said if I lost my insurance
coverage (through loss of my job which is a possibility) I would be liable to pay
the cost at THEIR charges which is ridiculous. On top of all that they said it was
a rental for 13 months to get ownership of it.

No way would I do that

Luke

[luke]

forgot to log in.....sorry

Luke

[izzyb]

Unless you insurance pays 100%, it is almost always better to bypass your insurance and buy out-of-pocket, get the machine with the most options, and focus on getting your health back rather than fighting DME/insurance machine.

I don't understand how this could be less expensive. At 15% of my machine, I paid around $400 (I can't remember exactly) for my machine with a humidifier. This would have cost $1700 at cpap.com (not sure if it includes the humidifier either). How could it be better to buy this outright. Am I missing something.

[skittles]

I think we are talking about if the ins does not cover the machine.

To rent my machine for the 3 months until my insurance kicked in would be $184.00 per month - that is $552.00 to just rent it -- I bought one for $107.00 -- do the math -- comes out much better for me to by-pass the whole rent thing.

Skittles

[GumbyCT]

Even though I have decent insurance they still wanted
my credit card number if I went to get equipment from them (which I didnt).
I don't need the added stress of all that plus my provider said if I lost my insurance
coverage (through loss of my job which is a possibility) I would be liable to pay
the cost at THEIR charges which is ridiculous. On top of all that they said it was
a rental for 13 months to get ownership of it.
No way would I do that
Luke

Sounds like a High Maintenance DME (HMDME) care to share what they call themselves?

[luke]

Apria was the one that wanted a credit card number

Luke

[Arthurs]

This is particularly true in Ontario, Canada, where local providers charge 3 times or more what I can get the same machine on cpap.com, and despite what the government's ADP program provides ($780 for a CPAP), I'm only only ahead a hundred dollars and 1 more year of warranty ahead in getting it locally. What a money grab!

[jules]

So I call the DME today and told her the story. I heard tapping on the keyboard and without even asking what type of machine I wanted she said a cpap was $1,200.00. I said WHAT! Does that even include a heater humidifier!?!?!?! She said no. I then said how come your so expensive when cpap.com only charges $600.00, half of the price. She stumbled and said they do not have overhead like they do and they don't have to fill out all the paperwork.. *rolls eyes*

Only twice the price - you must have found a cheap DME -- or --- remember the cpap they are going to give you probably isn't the machine you want ----- I would say 4 or 5 times the cpap.com price.

They will also bill for the filters and hose separately too not just the humidifier.

Lots of people tell this story on the forum.

[yorkiemum01]

I purchased my machine outright, from a forum member after I determined which
would suit me best.
My deductible with my group health plan is $2500 a yr, and ALL DME charges apply,
therefore, although I received an 'insurance discount' .....it still amounted to nearly
$200 a month to 'rent' my equiptment. Total BS! I still owe the DME some rental
charges, but have bought my humidifier, masks ...and machine, and thus far
very pleased with my purchase. Glad that costly journey is behind me.

[sleepycarol]

It is tricky to know when you are better off using insurance and when to pay out of pocket. You must do your homework AND ask the RIGHT questions - both of the insurance company and the DME. Good luck getting a straight answer as they usually wiggle around alot!!

I had my sleep studies in August of 2007. At the very end of August I recieved my cpap and found this forum the same evening. I read and read and became convinced that I had the wrong machine from what was prescribed. I did some asking of questions on here and became even more convinced that the prescribed "smart cpap" was indeed a cheap M series Plus machine. When questioning the DME they tried to convince me that I WAS wrong and they were right. With the help of my doctor and MY insurance company I fired them and returned their unit 2 weeks after I got it. Luckily the humidifier was on the rental plan as well. In the middle of September I went to another DME recommended by my doctor (which happens to be Lincare and I realize that they can be trouble as well in certain areas) and was given my M series apap. The insurance was paying rental on my machine and by the time the insurance paid the allowable amount (not what the DME actually was charging it was reasonable.)

In December I learned I was losing my coverage and was up a creek. I called the insurance and asked them if there was anything I could do. They said sure we will convert the rental into a purchase and will go back and pick up the cost from the day you received your unit. Lincare said fine with them. My machine ended up costing me $15.00 total!!! Where else could I have gotten a brand new machine for -- an M series APAP with cflex for $15.00.

I suggest if you have insurance call and ask plenty of questions -- rent or purchase, deductible amount, copays, maximum coverage amount, how long the rental is -- if they rent, which DME's are in network, what happens if you have to change DME's once the machine is in your hands -- will they allow you to return the first machine and go to a different DME?

[alnhwrd]

Izzyb,

Part of the problem arises in how the DME bills the patient. Most of the DMEs don't just charge a flat fee for the CPAP machine. Instead, they use a "rent to own" plan that winds up costing the patient and the insurance company lots more money. Using myself as an example, they charged me $200 per month for 6 months for the cpap machine alone. Since I got my machine in November, and my new deductable kicked in in January, I was on the hook for the full amount of that month's rent, and which I would not have been had they just billed even the full $1200 when I got the machine. Plus, they charged me separately for the humidifier, the hose, the case, and even the %^&*$#@ filters, all of which were included in the price of the CPAP machine when I looked it on CPAP.com. Did I mention that they sort of "forgot" to quit billing me after it was paid off? So, when you factor the price of the Tums, Rolaids, Xanax and highblood pressure meds, I would have been much better off going straight to CPAP.com. Even if they had billed it correctly, it still seems they are overcarging my insurance, which I pay the premiums on so it comes back to me anyway.

In the immortal words of Ricky Nelson, "But its all right now, I learned my lesson well". New masks, filters hoses etc are purchased online and reimbursed through my insurance company. Yes I have to do the paperwork myself, but it much less hassle and in the end cheaper.

[tomjax]

I looked a craigslt in Jacksonville and found a Remstar plus with HH that had been used only one time.
She wanted 200.00

This pix showed a manual for an apap and I thought it was an APAP.
But it was plain cpap.

Still an awesome bargain'

go to craigslist, Jacksonville fl.