Co pay?

[CpapDude2012]

What is the typical procedure as far as copays? Do DME's usually charge set up fee's and/or co pays before or at time of set up? Or is it billed after set up?

[jlmoorekcmo]

Co-pays are all over the map. In our house it ranges from %50-20%. It could be 0- a few $100. It also may depend on deductible & other matters. I would call insurance company phone # on the back of your card. Or if you don't do business calls well ask DME to call.

You usually would pay the co-pay after getting the equipment.

[JamesAllen828]

We would have to collect the Co-Pay at the time of set-up with the company I worked for.

[sawinglogz]

It entirely depends on your insurance carrier.

Most don't allow balance billing or so-called "set-up fees". There's a negotiated rate for everything, they pay some percentage of it, and you pay the rest. The DME isn't supposed to charge you more than that.

If you think your DME is making up some bogus charges, call your insurer and ask.

[CpapDude2012]

Im just curious what the norm is. I didn't get any bills or have to pay anything until about 6 months after receiving the machine.

[robysue]

Im just curious what the norm is.

That's the problem: There is no norm.

Many, but not all insurance companies follow Medicare's copay and replacement schedules. But many don't.

Some insurance companies don't cover CPAP at all. Some insurance companies pay 100% for CPAP machines and supplies. Most are somewhere in the middle. Most people posting here seem to have insurance companies that requires a copay of 20-50% for the machine and the supplies.

[jlmoorekcmo]

Im just curious what the norm is. I didn't get any bills or have to pay anything until about 6 months after receiving the machine.

My Copay has changed this year to zero(Medicare PPO). My wife's copay is 20% (Ins Through emp) but because she had 2 surgeries in Feb & March between now and the end of the year it is paid at $100.