Nano Users Cushion Replacement Question

[Lukie]

I am curious as to how often Nano Nasal Mask users are getting their cushion replaced. I am not talking about pillows but cushions. My DME will only replace
the Nano cushion once every three months saying Medicare has determined that the Nano cushion is part of the Frame. This is wrong but I contacted RESMED and they
told me the same thing. What is your experience? How often do you get your CUSHIONS replaced?

[chunkyfrog]

Medicare will replace my Wisp cushions 2 per month (Similar to Nano, but a different company)
Your Nano cushions are sold separately here:
https://www.cpap.com/productpage/cushio ... -nano.html
Do NOT depend on the DME or Re$Med to tell you the truth--talk to MEDICARE.
You are being LIED to.

[chunkyfrog]

If you are not on Medicare, talk to your insurer, or your benefits supervisor at work
if your insurance is through your employer.
Most insurance follows medicare guidelines.
Resmed silicone is unlikely to last longer than 30 days for me.

[StuUnderPressure]

I am curious as to how often Nano Nasal Mask users are getting their cushion replaced. I am not talking about pillows but cushions. My DME will only replace
the Nano cushion once every three months saying Medicare has determined that the Nano cushion is part of the Frame. This is wrong but I contacted RESMED and they
told me the same thing. What is your experience? How often do you get your CUSHIONS replaced?

The Nano IS a NASAL mask.

Medicare will pay for replacment cushions at the rate of 2 per month.

[Lukie]

Try to tell them that. I have called Medicare, Blue Cross, ResMed etc. Even Resmed says the replacement schedule for the Nano cushion is once every three months. I can't make them give it to me.

[chunkyfrog]

The cushion IS indeed a separate part. (see my link above)
You may not even need a prescription to get it from our sponsors. (out of pocket)
I would file a grievance with your insurance and your state insurance commission.
Edit: If you have Medicare, start raising HELL!
I had a DME who would only replace a Quattro cushion if they could write it down as an entire mask.
Guess who got fired?

[StuUnderPressure]

Try to tell them that. I have called Medicare, Blue Cross, ResMed etc. Even Resmed says the replacement schedule for the Nano cushion is once every three months. I can't make them give it to me.

Not trying to be difficult about this, but THEY ARE WRONG.

I bought my Nano (entire mask) with 1 size of the cushion.
Could never get that cushion to not leak.

1 Month later I purchased a different sized cushion for that Nano mask.

Since I was only trying out to see whether that other sized Nano cushion would work, I did NOT order 2 of the Nano cushions. But, I DID order another cushion for another mask I have (in the same order) since Medicare allows 2 NASAL cushions per month.

The 3 month period is to order an ENTIRE Nasal mask.

Medicare AND my secondary have both reimbursed the DME for that entire order (INCLUDING the Nano cushion).

[chunkyfrog]

Bump for Lukie.