Price of Hybrid through a DME?

Has anyone purchased a Hybrid mask via their DME? I'm just wondering how much of price difference there is. My ComfortFull 2 was $275 at the sleep center yet I can get the full set here for $89. (Although I suppose my 20% cuts my price down to $55 at the center.)

I'm just curious.

Thanks!

Kimberly

So the people who pay your health insurace premiums pay the other $220.00?

You can usually expect most of the xPAP items to run anywhere from 50% - 100% more at the when billing insurance (Either through a DME or a website such as billmyinsurance) vs paying cash online.
Add in that Medicare and Insurance companies do not allow a DME to charge less for cash customers (Hence having setup multiple companies such as cpap, billmyinsurance and cpapforseniors).
For most DME companies the xPAP units and supplies are currently being used as the profit center to offset lossleaders such as patient aids and oxygen. This hurts the cash customer in the short term but helps the insured customer as it keeps companies willing to take on different insurances.
So yeah, short answer is if insurance is involved expect prices to run about double what you can pay cash for either online or through a cash only equipment provider.

oldgearhead wrote:So the people who pay your health insurace premiums pay the other $220.00?

Pretty much so. I'm not sure what the total "allowable" amount is that is written off.

Kimberly

oldgearhead wrote:So the people who pay your health insurace premiums pay the other $220.00?

Not Exactly. Generally, Insurance companies will have a certain amount/percentage they automatically knock off the top.

Lets say a certain procedure/item is billed at 100 Dollars.

THe Insurance company has a contract with the doctor's office or DME that says "We will pay 40% of the amount you charge a cash/no insurance customer."

Thus, Its already down to $40 bucks. Then, you end up paying 20% of the original cost, meaning the Insurance company is out 20%.

And Insurances are nothing compared to medicare/medicaid. It isn't uncommon for their percentages to be mandated at 10% or lower of the cash price.

Mind you, these percentages or amounts will vary based on the insurance company, the insurance plan, the contract that plan has with the doctor/DME, or the particular item/procedure being covered.

But Basically, Insurance companies virtually never pay as much as it looks like they pay. Doctors Offices are forced to bump up their prices to obscene levels to still bring in enough to cover their costs.

Its like the Tax code. Its too complicated for anyone to understand, so nobody really knows what needs to be changed.

I have a $500.00 a year allowance for maintenance or equipment so the dme charged it against that......it was $236.00 alot higher than cpap.com

Around here, the DME's are balking at carrying Hybrid, they say, for financial reasons. I assume that means the Hybrid price is too high for their usual mark-up with the insurance companies. I mentioned this to the marketing director at the hybrid company in the only conversation i had with him, and he said that's a lot of baloney--the Hybrid price for dme's is cheaper than some Resmed masks. so BCBS said i should buy over the internet and they would reimburse me.

oldgearhead, i imagine that Kimberly's premiums are making up part of the difference for what she's not paying out of pocket for her mask. Is there something wrong with the fact that other people's premiums are paying for a good part of her mask when her premium is helping to pay for the inflated cost of someone else's cancer screening or kleenex tissue in a hospital or what have you? really, looking at the inflated cost of cpap equipment through a microscope is distorted--try looking at the inflated cost of the entire health care system. Not that health care premiums are any bargain either...what good does a lot of bitching and moaning do in a group of believers? Try taking your cause to someone who can do something about your gripe. Maybe you should mobilize your energy to try to solve the problem.

Caroline

whatrdreamsmadeof wrote:I have a $500.00 a year allowance for maintenance or equipment so the dme charged it against that......it was $236.00 alot higher than cpap.com

If you are unhappy with the cost - contact your insurance company.
A provider does NOT decide on the price to charge for an item. To state that any provider (Whether it is an internet provider or a dme company) "charged" is really inaccurate.
The insurance companies determine what the price is for any product, service or procedure billed to them. If costs are ever going to be brought down it's going to have to be done by applying the pressure to the insurance companies. Everything starts and ends with them.

I disagree with the marketing director of the hybrid company. I was quoted a price for the hybrid mask that was more than 3 times as much as I pay for any Resmed mask. I would like to know the costs of manufacturing the masks.

I was told today at the sleep center place that when I get my new mask at the end of October, that they charge the same price for the Hybrid as what I am paying for the ComfortFull 2 mask. (Well, they charge $275 but I think that I only pay 20% of that.)

I had gone in to be refitted for my current mask, the ComfortFull 2. I started out with the small size and left today with a medium mask/headgear. I also get to keep my small one and headgear at no "extra" charge.

Kimberly