I'm mad as heck and I'm not gonna take it any more!

[Mikebov]

I found out this weekend that my insurance will not pay for my cpap until the deductible is met. My DME sent me a letter in the beginning saying my insurance will pay 80%. Now, six weeks in, I want to return my machine and cut my losses and buy what I want . I thought that I would get all kinds of support from the DME. He has only called me once to schedule my first appointment. He makes me feel like I am bothering him when I call or ask for something. There has never been a follow up or a call from them asking if I need anything. Can I return this machine to them without any penalty? I have learned more here about caring for myself and I'd bet somebody here has done the same thing.

[bearded_two]

You are probably renting it -- and you just have to take it back. As you have had it for six weeks, you have a week or two before you start your third month and another rental charge. There are several places online that sell CPAPs and you should have plenty of time to get one delivered before your third month starts.

[GumbyCT]

You need to read the agreement you signed. Then contact your insurance to find out how they work and if you can deal with any other DME's.

If they still won't cover anything - then you need to get a copy of your script AND PSG in your hand - before you can deal with anyone or pay OOP (Out-Of-Pocket).

Good Luck

[kteague]

Just be sure to check every angle first. I recently went thru something similar on gettting a new mask. Could have gotten it last year but procrastinated. Fortunately my provider notified me before ordering it that it wasn't approved by my insurance for coverage due to a new year and the deductible. Seems it's usually up to the insured to know the eligibility for coverage is subject to meeting the deductible. With my compromised thinking, I just gave up because I don't even know the criteria for what applies to my deductible. Check if the rental fees due thusfar on your machine will be applied to your deductible, and if it matters whether they were just charged or if they have to have been paid to be applied to your deductible. Factor that into the math as you make your decision.

[Komodo]

Just be sure to check every angle first. .

You need to talk to your insurance company and find out what their stand is on returning your cpap. They might require a letter from your doctor saying you no longer NEED cpap. (happened with my MIL with O2 rental) But...that could to lead to serious problems down the road. If you ever need to use your insurance for an OSA problem in the future, they might deny you because the doc said you no longer NEEDED your cpap.

I know you're fustrated (been there, done that ) but do the math. Figure out what your total copay through the insurance will be, ~vs~ what your out-of-pocket cost will be without the insurance. It may not be as bad as you first thought.

[Mikebov]

Insurance said it was fine. They even said send in the bill for reimbursement, or in my case application to deductible. The doctor was fine with it. In fact his office was mad when they found out about the lack of service I was getting. I purchased a ReMed S8 Elite II from Secondwindcpap.com. It had 76 hours on it. Cost $299, shipping included. I took my other one back to the DME, no sweat! Can anyone get me a clinician's guide for my machine?

[wjp]

I'm glad that worked out for you on the insurance.

My insurance company actually hit me with the deductible twice.

They required a 10 month rental to own the machine.

Since I started in June, I had to pay that years deductible, then when the 10 months carried it into the new year I got to pay the deductible again. I contested it with the insurance company since it was their requirement, but they would not budge.

Insurance company ended up not paying very much for the machine, and I paid far more out of pocket than if I had just gone out and bought it on CPAP.com

Glad you learned that lesson up front.

[Komodo]

Can anyone get me a clinician's guide for my machine?

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