I've started the arm-wrestling process with my doctor and the DME. My doc is pretty much on my side but feels I will get better service locally. The machine the DME offers is the:
REMstar Plus C-Flex CPAP, REMstar Heated Humidifier.
I want the 420e, from what I gather here.
I'm being told I don't need Auto, it's only for people who struggle with CPAP, it's a luxury item (along with the Switft being a luxury item), blah, blah blah. Basically, I can't have the 420e without paying $450.00 on top of the other 10% I would have to pay. The REMstar is $2,200.00 through them so I can only assume that the 420e would be a fortune.
Is the REMstar Plus ok? I need some ammo to take back to the doc. He feels I should go local for the support. I have a M.S. in computer science and do technical work all day. Surely I can run one of these machines.
I need advice ASAP.
Update - Time to pick the machine
12 posts
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Sleepless on LI
- Posts: 3997
- Joined: Mon May 30, 2005 6:46 pm
- Location: Long Island, New York
Ellie,
Why settle on the Ford Escort when you can get the Maybach Benz? If this is the machine you are going to use for awhile, get what you want, with the bells and whistles. So maybe right now your pressure is low and you don't need the Cflex or care about an auto capability, but what happens if your condition changes in the future? Is your insurance company going to buy you another machine or say, "Well, sorry. We bought you one in 2005. You're not entitled to the 420e or the Remstar Auto until 2009," or whatever it is you really want.
I have the Remstar Auto and I've been hearing nothing but negatives about it on the boards lately. I have no problems with it. If you really want the Cflex, that would be the machine. If you don't care, most people swear by the 420e. WillSucceed even says he didn't feel as rested on the Remstar Auto and he does on 420e. So what can I say? I would guess that like masks, it's an individual preference.
I would not personally settle for something less if they are buying it for you. I had my machine bought for me at the end of July and I told them what I wanted. I was prepared to chip in if necessary, but it didn't come to that. But I wanted what I wanted as this was what I was going to have for some time, unless I want to pay out-of-pocket until the next time they are ready to buy me one. Decide which one you want and go for it.
Why settle on the Ford Escort when you can get the Maybach Benz? If this is the machine you are going to use for awhile, get what you want, with the bells and whistles. So maybe right now your pressure is low and you don't need the Cflex or care about an auto capability, but what happens if your condition changes in the future? Is your insurance company going to buy you another machine or say, "Well, sorry. We bought you one in 2005. You're not entitled to the 420e or the Remstar Auto until 2009," or whatever it is you really want.
I have the Remstar Auto and I've been hearing nothing but negatives about it on the boards lately. I have no problems with it. If you really want the Cflex, that would be the machine. If you don't care, most people swear by the 420e. WillSucceed even says he didn't feel as rested on the Remstar Auto and he does on 420e. So what can I say? I would guess that like masks, it's an individual preference.
I would not personally settle for something less if they are buying it for you. I had my machine bought for me at the end of July and I told them what I wanted. I was prepared to chip in if necessary, but it didn't come to that. But I wanted what I wanted as this was what I was going to have for some time, unless I want to pay out-of-pocket until the next time they are ready to buy me one. Decide which one you want and go for it.
L o R i
$2,200????????? What a bunch of pirates!!! ellie, through cpap.com you can get a full blown 420e, heated humidifier AND the software for only $799. They want you to pay an extra $450 on top of what they pay for a 420e (that will probably come without manuals or software???)?? That's just downright nutz!
Like Sleepless says, you're probably only going to get one machine out of them to be used for the next 5 years. Go for the gold, girl!! You may be able to talk your insurance company into going for the 420e if you show them how much money you can save them at cpap.com. Alternately, try the billmyinsurance.com link at the top of the board. That may work even better. Any way you go, though, you deserve the best! This is your health you're working toward here!
This therapy WORKS!!!
Like Sleepless says, you're probably only going to get one machine out of them to be used for the next 5 years. Go for the gold, girl!! You may be able to talk your insurance company into going for the 420e if you show them how much money you can save them at cpap.com. Alternately, try the billmyinsurance.com link at the top of the board. That may work even better. Any way you go, though, you deserve the best! This is your health you're working toward here!
This therapy WORKS!!!
_________________
| Mask: Ultra Mirage™ Full Face CPAP Mask with Headgear |
| Additional Comments: APAP, 8-14 cm H2O. |
This therapy WORKS!!!
Why not try another approach? If you are already looking at $450 + $220 (10%) = $670 and a 420E will cost $698 + shipping here, why not buy it outright and submit the bill to your insurer as an out-of-network provider. Sure you'll get a lower subsidy, usually 20% copay vs. 10% for the preferred vendor, but if you get anything back then you'll do almost as well as your net cost from the preferred provider.
You might also try challanging your DME with the retail prices from the 'net sources and telling them that if they can't help you with the 420E, you'll bolt. Might work, might not but if you don't try it surely won't work. Also, depending on your insurer, you might have another preferred DME available. If so, call and see if they'll do what you want.
-Chris
You might also try challanging your DME with the retail prices from the 'net sources and telling them that if they can't help you with the 420E, you'll bolt. Might work, might not but if you don't try it surely won't work. Also, depending on your insurer, you might have another preferred DME available. If so, call and see if they'll do what you want.
-Chris
Always consider the source when accepting advice...
Assume insurance companies are lying...
Air ain't no big thing 'til you're not getting any...
Research gives power.
Assume insurance companies are lying...
Air ain't no big thing 'til you're not getting any...
Research gives power.
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
You certainly can. And you don't need any kind of degree to be able to do that. Average intelligence, common sense, and educating yourself via the message boards will do it, as long as what you have is plain old garden variety OSA.Surely I can run one of these machines.
The others are telling you right. It's YOUR health. It will be the machine YOU have to sleep with every night for a long time. Not the doctor. Not the DME. Not the insurance company bean counter. You. You and YOUR machine.
ellijacket,
I don't mean to contradict Bigboy, but if YOU purchase the equipment and submit a bill to your insurance provider, you would (or should) be considered "in-network" and would get that co-pay percentage. Check with your insurance provider before shelling out all that money. My gosh, for $2200 you could buy between 2 or 3 machines (complete with masks, heated humidifiers, software, etc.) from CPAP.COM.
And, DITTOS on what Rested Gal said.
I'll just say it again in a little different way:
It's YOUR life, YOUR therapy and YOUR money....get what YOU want!
Best wishes,
Den
I don't mean to contradict Bigboy, but if YOU purchase the equipment and submit a bill to your insurance provider, you would (or should) be considered "in-network" and would get that co-pay percentage. Check with your insurance provider before shelling out all that money. My gosh, for $2200 you could buy between 2 or 3 machines (complete with masks, heated humidifiers, software, etc.) from CPAP.COM.
And, DITTOS on what Rested Gal said.
I'll just say it again in a little different way:
It's YOUR life, YOUR therapy and YOUR money....get what YOU want!
Best wishes,
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
Wow! $450 for a stripped down 420E, just for your "share" of the cost???? Isn't that about the price of the bare machine TOTAL if bought on line?
CFLEX seems to be only for those struggling to breath against the machine, but the "auto" part is for 99.9% of ALL CPAP users, resulting in less gas, better sealing or masks, more comfort and on and on.
The DME's are clueless about setting up machines. You can definitely do BETTER than them, since you CARE, as long as you get the clinician's manual, and search through some posts and asks questions here.
Now that I have software I can see I am doing MUCH MUCH better with my 420E on my results than my old Remstar Auto. Of course that will NOT be the same for everyone.
It sure sounds like your current "insurance paid" options end up with you paying about the same as if you skipped insurance ALL TOGETHER and just paid COMPLETELY out of pocket over the internet. What a deal? Or is it "What a STEAL?" by the DME.
CFLEX seems to be only for those struggling to breath against the machine, but the "auto" part is for 99.9% of ALL CPAP users, resulting in less gas, better sealing or masks, more comfort and on and on.
The DME's are clueless about setting up machines. You can definitely do BETTER than them, since you CARE, as long as you get the clinician's manual, and search through some posts and asks questions here.
Now that I have software I can see I am doing MUCH MUCH better with my 420E on my results than my old Remstar Auto. Of course that will NOT be the same for everyone.
It sure sounds like your current "insurance paid" options end up with you paying about the same as if you skipped insurance ALL TOGETHER and just paid COMPLETELY out of pocket over the internet. What a deal? Or is it "What a STEAL?" by the DME.
Remember:
What you read above is only one data point based on one person's opinion.
I am not a doctor, nor do I even play one on TV.
Your mileage may vary.
Follow ANY advice or opinions at your own risk.
Not everything you read is true.
What you read above is only one data point based on one person's opinion.
I am not a doctor, nor do I even play one on TV.
Your mileage may vary.
Follow ANY advice or opinions at your own risk.
Not everything you read is true.
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WillSucceed
- Posts: 1031
- Joined: Sun Nov 07, 2004 7:52 am
- Location: Toronto, Ontario
LORI wrote:
If possible, trial different machines. If you can't make your decision based on features and availability. The 420E is a good choice because it is small/easy to travel with, has several adjustable triggers allowing for tweaking of treatment, allows the user to set the machine to work in 1.0 or 0.5 pressure change increments, has great software for data analysis and, has an integrated pressure sensor line that, in the opinion of some, makes for more accurate treatment.
All of the machines are good and, the likelihood that you will get good treatment from any machine that you choose is very high. The difference between a regular CPAP and an AutoPAP is huge; the auto gives you significantly more treatment options and data. It can, if you wish, function in straight CPAP mode. Overall, it makes for more gentle treatment and is clearly a good choice.
Stamp you feet and dig in. The Auto machine will give you more treatment choices and efficacy data along the way. Insist on the auto; if you don't like the auto function, you can always change it to CPAP mode.
True, I did say this. However, please keep in mind that what works for one might not work for another. Personally, I HATE C-FLEX but there are those who love it. The algorithm in the RemStar Auto did not suit me well, but it is fine for many.WillSucceed even says he didn't feel as rested on the Remstar Auto and he does on 420e. So what can I say? I would guess that like masks, it's an individual preference
If possible, trial different machines. If you can't make your decision based on features and availability. The 420E is a good choice because it is small/easy to travel with, has several adjustable triggers allowing for tweaking of treatment, allows the user to set the machine to work in 1.0 or 0.5 pressure change increments, has great software for data analysis and, has an integrated pressure sensor line that, in the opinion of some, makes for more accurate treatment.
All of the machines are good and, the likelihood that you will get good treatment from any machine that you choose is very high. The difference between a regular CPAP and an AutoPAP is huge; the auto gives you significantly more treatment options and data. It can, if you wish, function in straight CPAP mode. Overall, it makes for more gentle treatment and is clearly a good choice.
Stamp you feet and dig in. The Auto machine will give you more treatment choices and efficacy data along the way. Insist on the auto; if you don't like the auto function, you can always change it to CPAP mode.
Buy a new hat, drink a good wine, treat yourself, and someone you love, to a new bauble, live while you are alive... you never know when the mid-town bus is going to have your name written across its front bumper!
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RAMBLINMAN
- Posts: 94
- Joined: Sun Feb 13, 2005 9:12 am
- Location: Coram, Long Island
If I may say Ellie....don't feel so bad about your struggle with the DME...
I also am having a very hard time trying to find a DME that will get me what I want which is A Remstar Auto w/Cflex...and I've already been shot down by 2 DME's so far.....
I think my 3rd and Last try is going to be with billmyinsurance and see what happens......I just don't care to shell out any money when I have medical coverage...
I also am having a very hard time trying to find a DME that will get me what I want which is A Remstar Auto w/Cflex...and I've already been shot down by 2 DME's so far.....
I think my 3rd and Last try is going to be with billmyinsurance and see what happens......I just don't care to shell out any money when I have medical coverage...
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12 posts
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