CPAP & insurance change due to lay off

[newarcher]

Hello all,

I receive my new cpap a handful of months ago and my insurance company was renting it for me. I think the rental term was 12 months.

However, I was laid off from my job last Tuesday (while on vacation no less) along with 30% of the rest of my company. So now I am wondering what happens to the rest of the cost of that CPAP.

If the insurance company cancels my benefits, the CPAP owner can come pick it up. However, I would think they would have to honor the machine's purchase price.

If necessary, I can get a new machine through my new insurance company as soon as I find a new job. I'm not coming out of pocket for this since my company decided that it would lay me off.

Anyone been through this who can provide some guidance as to how it works?

thanks,
New

[cowlypso]

I went over a lot of this with my DME when I first got my machine, since I will be switching insurance companies in August. They said that, with the new insurance company, as long as it is a covered benefit, then I could keep the machine but the rental period would start over (so I'd essentially lose the 3 months that my current insurance company has paid out, along with my $30 in copays for that time). If, for some reason my new insurance company does not cover it (looks like it should be okay for me, but many times when you get new insurance they exclude pre-existing conditions for a period of time, especially if there was a gap in the insurance), then I could either return the machine or buy it outright. The DME said that if I were to buy my machine from them before the rental period was up but while I was still covered under my insurance, that I'd be able to buy the machine at the insurance-negotiated rate, rather than full retail.

If you have the money available, I would probably go with that last option, especially if the machine is nearly half paid off anyway. If you can buy it for the balance of the insurance-negotiated price, it will be cheaper than buying the same machine new online. That's one other option, by the way, is to buy your supplies from an online supplier, which are typically cheaper than brick and mortar DMEs.

[Linus]

Do you have cobra for insurance to cover yourself? Also see if you can outright buy the machine through insurance or outside of insurance if possible. Try to get your rental as a credit towards the purchase.

[ameriken]

This doesn't speak to the CPAP issue directly, however when laid off the law allows you to continue coverage through COBRA for up to 18 months, or until you are covered elsewhere, whichever is the lesser in time.

You pay the premium, however it not only continues your coverage for the CPAP, but also any other health issues, injuries, surgeries, emergencies, hospitalizations, etc that could arise in the interim.

Good luck!

[Wulfman...]

Since you don't have anything listed in your profile.......what specific make/model of machine is it?
If it's a non-data-capable piece of crap, you might be better off getting something else. The cpapauction site has many good machines listed for very reasonable prices. There's also a secondwind site that has them, too.
Just make sure you have your prescription (the physical document).

But, if it's a good data-capable machine, see if your existing insurance will do an immediate payout before you're completely done with them.


Den

[archangle]

Be very careful if you want COBRA insurance. There is a very short time period to get signed up for COBRA. If you miss the time period, you're out of luck. When you try to arrange it, they will often tell you they're working on it, but "accidentally" not get you the information and bill in time, and then deny you coverage.

Read up on COBRA and take action now.

[ameriken]

I believe the window for COBRA is 60 days from the date of termination. Here's some basic info:

Laid Off? COBRA Insurance May Be an Option for Health Care Coverage
From Michael Bihari, MD, former About.com Guide
Updated April 14, 2010

http://healthinsurance.about.com/od/hea ... basics.htm

[Janknitz]

DO NOT let your insurance lapse. Even if you get another job right away, it could take up to 3 months to get new employer provided insurance. Meanwhile you'd be uninsured. If it takes you longer than 3 months to get a job, you may NOT be able to get any insurance until you are employed again.

COBRA is expensive but it's your best bet. You may be denied individual health coverage because of the OSA otherwise.

You might look into buying your own CPAP machine online or through something like secondwind.com or cpapacution.com so that you won't be at the mercy of your employer provided health insurer--it gets crazy. For example, if your new employer offers only an HMO that does not have a contract with your current DME, you might have to start all over again with a new DME.

[Breathe Jimbo]

Tell your last employer that you want the COBRA forms immediately.

Tell your insurance company that you intend to exercise your COBRA rights and want the forms immediately.

Do EVERYTHING in writing.

The current rental arrangement should not change under COBRA.

Once you have COBRA in place, instruct the DME IN WRITING to submit the CPAP purchase to your insurance company immediately - assuming your current machine works for you.

COBRA is among you, your last employer, and your insurance company. It is none of the DME's business (although you will need to give the DME your new insurance ID number) and does not entitle the DME to screw around with rental terms or anything else to its own benefit. You simply tell the DME that the new ID number is "continuation coverage under COBRA," and you complain to your insurance company if the DME tries to take advantage of the change in any way. At every turn, repeat: "This is continuation coverage under COBRA."

You will, of course, be obliged to pay your own insurance premiums under COBRA. Your deductible aggregation for the year should continue as if nothing happened, i.e. your deductible should not be reset to zero. However, you may need to have someone in your insurance company's customer service arrange to have your deductible "rolled over" from your old ID number (i.e. the one you had while employed) to your new ID number under COBRA. I would just call and make sure they roll over your deductible because, in my experience, the insurance company will "forget" to do it until you tell them to do it. Here, too, the mantra is, "This is continuation coverage under COBRA," i.e. nothing changes to your disadvantage, except you must pay your own premiums.

Welcome to the club. I was laid off last fall a few days after returning from vacation. It seems that taking a vacation is now considered a disloyal act.

[newarcher]

Thanks all.

Sorry I misspoke and didn't put all of the information in play.

My ex-employer (from her on referred to satan inc) is going to pay the first 30 days of Cobra and after that I will go on my wife's insurance until I get a new job. I have an interview tomorrow morning and if I get that job I would be required to have a 30 day waiting period. So there will be no lapse in coverage at all.

I was just curious if there was any obligation on the part of the old insurance company to purchase it since I received the machine while covered, but it was their choice to rent it. I also have the same problem with my son's braces since the benefits were paid quarterly and he only had the braces since December of last year.

Damned satan inc.

Thanks,
New

[gasp]

COBRA is an option as mentioned in other posts. Depending on the size of the company (20 or more) the company that laid you off has to provide you with COBRA coverage, notification, and instructions on what to do (UNLESS it went bankrupt). If you decide to get it, make certain you send it with delivery confirmation. Do not just hand it to a person. Do not depend on the employer's information to be completely accurate. Read this first and make certain they are telling you the same thing and address any inconsistencies http://www.dol.gov/ebsa/publications/cobraemployee.html You will see that your ex-employer has a certain amount of time to provide you with COBRA notice. Watch these dates to make certain you get the paperwork and if you don't, contact the company to see how you can get a copy. In case the company closes down, call now to see who you can contact regarding future COBRA information. Get their name and direct number.

There are many factors on whether your COBRA payment is worthwhile. Does the company have a really good health policy in your opinion? Did it adequately cover your needs? Or was it basic with super high co-pays and deductibles and didn't cover many needs? If the company didn't shop well they may pay a lot for a bad plan in which case your COBRA payment will be a lot for little coverage.

I'd still get the COBRA versus being uninsured since an expensive health incident or accident can be infinitely more expensive. While you are on COBRA you can shop for individual/private health insurance. Also pre-existing conditions are protected under law if you choose to get an individual/private health policy. If your company had a good plan you will probably find that your COBRA is a better deal than individual/private insurance plans, especially if you have a family. Remember that COBRA does eventually end.

Depending on your financial situation, you can opt to pay for all your own incidentals and only purchase a catastrophic health policy that would as the name implies cover catastrophic events which are the most expensive.

In any case, I'd choose COBRA while you make up your mind.

[Janknitz]

Nope, the insurers don't have any obligations like that.

You should NOT let your DME start any kind of rental period over again and if your new insurer will make a purchase either your DME should pro-rate the purchase or give you a brand new machine. They don't get to make a windfall because you change jobs. Ask your new insurer how to handle this and exPect your DME to try to take advantage of the situation.