my insurance sucks.

[tony72]

1 mask every 6 months!!what if it breaks?

[danimal71]

Mine's the same way. I think it's reasonable. The two I have used so far seem like they are quite durable. Of the many reviews I have read on multiple masks so far I only read of 1 where the headgear clips broke quite easily and often and that mask was redeisgned to fix that.

[ched03]

I have to meet a $350 deductible every year on both machines and masks before they pay 80% of the cost. Looks like I will be paying out lots again when I have to replace my mask. My doctor told me that they should cover a replacement mask every 3-6 months. Sure doesn't look like it.

[LoQ]

I have to meet a $2500 deductible before my insurance will pay 70%. Therefore, I end up paying for most stuff myself.

I would prefer that this stuff go off of Rx, because then insurance would not be involved and the prices would plummet. Probably insurance premiums would not rise as fast, either. As more and more people are acquainted with this expensive treatment, insurance premiums will have to go up to cover the cost of those additional expenses.

[elena88]

IWe have an eight thousand dollar deductable, but it will drop to 4500 next year when hubby gets on medicare.

Everything is out of pocket.

I dumped my slimey dme and searched for a new one.. who is fabulous and matches internet prices, so that is great.

[Roman Hokie]

6 months? Wow. Even Medicare puts it at a 3mo replacement cycle. For the mask (without hg) anyway.

My deduct is $2500. My employer pays $1k, then I have $1.5k (through FSA - we treat it like a budget plan), and then I've got 90/10, even for DME. I made out well.

Of course, I got the initial stuff at the end of my last plan year, so the rent on the machine is not at 90/10 yet.

[jmelby]

6 months is very standard for mask replacement... if you have a special need due to a broken mask, the DME can submit a medical-necessity exception with the claim. They did that for me when I switched from a full face to a nasal mask after the 30-day trade-in period, and the insurance covered it no problem--and I got to keep the full face mask too.

[tony72]

i work for the school system @ night.southern health is my provider.

[nanwilson]

Your insurance is WWWAAAAYYY better than mine.......mine doesn't cover cpap equipment at all. There are lots of us that have to pay out of pocket, count youself lucky you have insurance....or better still do you want some cheese with than wine?
N

[LSAT]

Most masks do not have to be replaced that often. The silicone/foam cushions DO need replacement. My Quattro is 14 months old...there is nothing wrong with it. I am on my 3rd cushion...(I will need a 4th soon). The head straps are original.
Prior to the Quattro I had a Comfort Gel nasal mask...that one I did replace at 6 months to get a back-up mask....not because there was anything wrong with the mask.

[Kevin G.]

My masks last years.

Proposed strategy: Get a replacement mask and then continue using your primary mask until it fails. Then and only then buy a new mask. not only is this strategy cheaper but it also reduces the amount of gargage due to old masks.