Kaiser Permanente HMO

I was encouraged to get tested for sleep apnea by my son in early March. I got the test machine the same day as my appointment, returned the results the next day and got a 1 week loaner a couple of days later. At the end of the week I got my resmed cpap machine and everything I needed was included and I paid nothing for any of this. I do have senior advantage Kaiser/medicare. The only thing not covered with my Kaiser plan is prescriptions and emergencies. Using the cpap has helped me feel better during the day and sleep quietly for my son

slumberer wrote: I am Kaiser of Southern California
Todd

I have no experience with Kaiser but my advice to you would be to try and obtain their policy on sleep apnea/sleep disorders. I was able to find a document from blue cross blue shield in my state on their on line portal. It differed from other states and changed every year or so, but it was more informative than anything I got from speaking to anyone over the phone.

Once you get the policy you know exactly where you stand.

slumberer wrote:One question.....how did you convince your primary dr. that an auto cpap was necessary? were there compliance issues with the cpap?
thanks

A CPAP is billed to insurance under the same code as an APAP. Its your right to have a APAP (data compatible). An APAP can also work in CPAP mode but it slightly more expensive to the provider. Once you get your policy details you may find out that you can simply buy a machine yourself on line and submit a claim yourself.

Any nasal issues that persist then I would see an ENT doctor. There have been many people here that have had minor nasal surgery including myself, the joy of being able to use a nasal mask rather than a full face mask as a result is well worth it.

Good luck

~UB

Somewhere I posted my experience with Kaiser
and I have their Platinum level plan.

The actual service through kaiser wasn't too bad. The take home test, the overnight titration test.
had to email the DR directly to get a glimpse of the test results.

The BIGGEST ISSUE!
Kaiser uses Apria Healthcare

WHAT A FREAKING NIGHTMARE!
10 weeks to get my machine, and then I still had to drive 2 hrs to get it.
countless hours, getting a dozen people involved from my HR to insurance broker, kaiser & apria and explaining simple things over and over and over and over and over and over.
Apria telling me they have NO record of my order. 30 min later they call back and have my order along with a detailed description of the ordeal.

This fall, when open enrollment comes around, I'm switching to Blue Shield and dumping Kaiser all because of Apria

KenM wrote:This fall, when open enrollment comes around, I'm switching to Blue Shield and dumping Kaiser all because of Apria

Before you make the switch, try to find out who you will be dealing with under Blue Shield. You may find yourself in the same situation.

The problem with Kaiser + Crapria is that Kaiser is actually your DME and Crapria is merely the supplier. They have such volume with Kaiser that they don't give a darn about providing any service with Kaiser customers, and their billing is WRONG about 100% of the time.

My Kaiser ACA silver plan no longer has CPAP coverage, and I'm thrilled. I don't have to use Crapria ANY MORE!!! I have found that I can get stuff hassle free either from our hosts or from Amazon.com (I've gotten masks and supplies with no prescription--no problem from Amazon). Even if it costs more out of pocket, its a win win as far as I'm concerned. My fervent wish is that Crapria CEO's and administrators have to be their own customers some day!!!