Buying first CPAP...questions

[ham7137]

Hi all....I completed my titration last evening. I was asked what DME provider I wanted. I told them I would do some more research and get back to them. So, today I called a number of DME's. I asked what machines they use....all of them are using basic entry level machines. I'd really like the S9 Elite. Is this an insane request? I called my doctors office and they said the doctor woulf write the script for a specific machine.

[ham7137]

I should also mention that I called Americare Respiratory Services (an online company that takes insurance) and they said that I could get the S9 Elite for $200 total out of pocket. Anyone know of these guys? Is this a good deal?

[Bons]

Welcome to the hose head club!
If he writes a script for a specific machine they will have to get it for you. Lucky you, to have a nice doctor.
Search through the site and you can find comments and ideas about masks.

[Janknitz]

If you have insurance, PLEASE take a look at my blog for important tips on how to deal with the DME. http://maskarrayed.wordpress.com/what-y ... me-part-i/

Scroll down to the part that reads

Most private insurers work a lot like Medicare, but there can be infinite variations. Therefore, if you are not on Medicare, it’s extremely important that you call YOUR insurer and ask the following questions:

and make sure that you ask these questions of your insurer (never trust a DME to tell you what your insurance covers!) before you talk to a DME.

It's CRUCIAL that you understand how your insurance works and what the DME will be trying to do to maximize their profit. And, BEFORE you contact any DME, you should also know exactly what machine you want (you'll find lots of info and advice here). Otherwise many DME's will try to sell you a brick. DME's can smell a sucker a mile away. If you go into this process fully informed, they can't take you for one.

[Emilia]

Are you using insurance? A lot depends on what your policy covers, deductible, copays, etc. If you have an HMO things get pretty sticky.... You need to find out all you can from your insurance company what they cover, how they pay....is the machine bought or rented, will they allow you to buy from an online vendor, can you go out of network, etc.

HMO's can be a nightmare to deal with so I hope you don't have one of those..... mine would NOT allow me to have an auto adjust machine, nor would they allow me to have a machine with flex....both were specifically Rx'd by the doctor, but they rejected his Rx based on THEIR review. I wound up buying my own machine and got what I wanted.

I can only advise you to read, read, read this forum. One of our forum members has a wonderful blog on which this post is vital for you to read: http://maskarrayed.wordpress.com/what-y ... me-part-i/

Best of luck! Keep us posted on your progress.

[ham7137]

I've been reading the forum since I was scheduled for my 1st sleep study. The information has been great. When I called Lincare at first they said "oh we can't get the S9 Elite". I continue calling DME's and all of them shudder when I say S9, except Americare Resp. (online) I call Lincare back and say are you sure you can;t get the S9? Then she says "well, we can but just have your dr write it specifically instead of the S8". I'm sick of the sharks trying to get the most money out of me without any regard to my treatment.

[msradar65]

Um, why the elite? I would ask for s9 autoset. You might as well get the cadillac if you are going to spend the money.

I happen to love mine!

[Breathe Jimbo]

The S9 Elite is a reasonable request. Say that you want the S9 Elite, and that you will use a DME that provides it. "If you want my business, you will get me the S9 Elite."

Don't be bashful; it is your health, so insist on what you want! "I won't settle for anything less than the S9 Elite."

[linagee]

S9 Autoset here too. It is silly to not spend the extra $50 on an already $800 flow generator. (Autoset is $850. Elite (crippled machine) is $800.) Of course these are online prices. Who knows what the DME gets them for.

[RDawkinsPhDMPH]

In our area the DMEs have learned that the more expensive/sophisticated machines result in better compliance and they make up the extra cost when you ultimately stay on the machine and use more masks/supplies. So we order auto set machines with modems, Respironics or ResMed only depending upon which DME, on all patients. The DMEs we work with (4 of them) have no complaints. In fact, they only stock the auto set machines and just use them in fixed mode on those people studied in other labs. Plus they know that anyone who has trouble with CPAP eventually ends up in our lab.

You should lean on the DME to provide the machine you need for the amount insurance payment and no more.

[RDawkinsPhDMPH]

PS: I have discussed many of the problems you might face in "how to tolerate cpap therapy for your sleep apnea" available at sleepingwithcpap.com

[ham7137]

More great info guys....really appreciate it. I was about to just say screw it and take whatever they gave me. You guys made me realize that they will get the same amount of money weather they give me a junk machine or the machine I want. Has anyone had any experience with Americare Resp. services?

[linagee]

http://s7.zetaboards.com/Apnea_Board/to ... st-8004980

"I am in the process of getting my first machine, a ResMed S9 Autoset with a H5i humidifier, and mask, a ResMed Mirage Liberty. My physician wrote the prescription for a CPAP machine set at 9 cm, a mask, and supplies. Period. I am buying all of it from Americare Respiratory Services (http://www.americarecpap.com) who are very helpful, friendly, and easy to deal with."

(I've never dealt with them, just thought I'd share the cross-search/quote.)

[robysue]

Hi all....I completed my titration last evening. I was asked what DME provider I wanted. I told them I would do some more research and get back to them. So, today I called a number of DME's. I asked what machines they use....all of them are using basic entry level machines. I'd really like the S9 Elite. Is this an insane request? I called my doctors office and they said the doctor woulf write the script for a specific machine.

It's not an insane request. The S9 Elite and the S9 AutoSet are both billed under the same code as all the more basic, entry level and NON-data capable machines.

Stick to your guns and good luck in either finding a DME who will let you choose an S9 Elite (or AutoSet) or in getting the doctor to write the script the way you want it written.

You might try finding a place that specializes CPAP related equipment instead of a more general DME. The DME I found that by default supplies S9 AutoSets and PR System One Autos only does CPAP-stuff and most (if not all) of the staff that works there are hose-heads.