Insurance or not???

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Jcoyne97222
Posts: 14
Joined: Fri Dec 30, 2022 11:58 am
Location: Oregon

Re: Insurance or not???

Post by Jcoyne97222 » Sat Feb 04, 2023 10:30 pm

ChicagoGranny wrote:
Sat Feb 04, 2023 12:37 pm
Jcoyne97222 wrote:
Fri Feb 03, 2023 6:33 pm
Then why is my price cheaper than the insurance company price?
You are comparing apples and oranges. One is a rental that you could back away from and leave the DME with little revenue and a used machine. The other gives the DME full revenue upfront.
I am not talking about buying a used machine. I am currently renting a used machine but have made it clear I am ready to move forward with getting my own machine.
Thanks,

John

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hoserdude
Posts: 8
Joined: Tue Jun 26, 2018 6:23 pm

Re: Insurance or not???

Post by hoserdude » Sun Feb 05, 2023 1:23 pm

Kind of depends on how much your deductible is.
If it's a high deductible and the cost of the machine will only pay a small portion towards your yearly deductible, and you won't realistically reach the limit during the course of the year that might not make sense. However, if your yearly deductible comes to only the cost of the machine ($1,000+) and you are deducted monthly for your deductible instead of paying it all up front that might be another option should you need to make another claim of any kind.

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: Insurance or not???

Post by Janknitz » Sun Feb 05, 2023 3:22 pm

feel like I don't get straight answers.
BINGO!

You will never get straight answers from the DME. Never, never, never, ever, ever, ever trust what a DME says without corroborating evidence. That's why you are being urged to check with your insurer, preferably in writing in the form of the Evidence of Coverage, to understand what your benefits are, how they are applied to your deductible, etc. Then you can make an informed decision as to your out of pocket costs.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

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babydinosnoreless
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Joined: Fri Nov 02, 2018 2:53 pm

Re: Insurance or not???

Post by babydinosnoreless » Sun Feb 05, 2023 4:27 pm

Lsat sells good low hr machines here for a lot less than insurance. I'd check with him. Dme really screwed me with the rental. Wound up paying far more than it was worth.

Jcoyne97222
Posts: 14
Joined: Fri Dec 30, 2022 11:58 am
Location: Oregon

Re: Insurance or not???

Post by Jcoyne97222 » Mon Feb 06, 2023 12:02 pm

hoserdude wrote:
Sun Feb 05, 2023 1:23 pm
Kind of depends on how much your deductible is.
If it's a high deductible and the cost of the machine will only pay a small portion towards your yearly deductible, and you won't realistically reach the limit during the course of the year that might not make sense. However, if your yearly deductible comes to only the cost of the machine ($1,000+) and you are deducted monthly for your deductible instead of paying it all up front that might be another option should you need to make another claim of any kind.
Yeah, My deductible is fairly high @$ $3,200 and I am only $500 into it so far this year. I don't expect much else for this year but who knows. Most of my current $500 towards deductible is CPAP stuff and appointments through this process with DME.

I will try and talk to somebody at my insurance and see what I can find out.

Thanks for the advise!
Thanks,

John

Jcoyne97222
Posts: 14
Joined: Fri Dec 30, 2022 11:58 am
Location: Oregon

Re: Insurance or not???

Post by Jcoyne97222 » Mon Feb 06, 2023 1:39 pm

I checked with my insurance carrier and found out that after deductible they cover 90%. I rarely meet my deductible in past years so I am strongly leaning toward just buying my own machine.

I asked the insurance representative if I could buy from somewhere else than a DME for the machine and my supplies. She said I could buy through a DME and have them submit the claim. I responded with I can buy the items elsewhere for cheaper. She then said I could submit my own claims online for the machine and supplies.

My question to you all is have any of you ever submitted your own claim with any success? At least that way I could buy supplies at a reasonable price and still get them to go towards my medical deductible.

I have sent a PM to LSAT and have verified JTRAVEL price for the Autoset 10 at CPAP.com with the promo code. Next to confirm I can use my HSA account. They are picky sometimes about what we submit so I want to confirm.

Thank for all of your responses.
Thanks,

John

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ChicagoGranny
Posts: 14409
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: Insurance or not???

Post by ChicagoGranny » Mon Feb 06, 2023 2:33 pm

You learned a lot in this thread.