5 Year Replacement & Medicare/Insurance

My initial CPAP that was provided by my DME and paid for by Medicare and supplemental insurance was on a 13 month rental after which time I owned it. My 5 year replacement CPAP is currently in process by my DME. Will this replacement also be subject to a 13 month rental period like the first one or since I've already proven usage and compliance will Medicare and insurance pay in full rather than do the rental period?

I believe you will have to meet and satisfy that 13 month rent to buy thing all over again with a new machine.

Just got off the phone with the DME confirming the order of the replacement CPAP. Yes, there is a 13 month 'rental' on the replacement, but unlike the initial CPAP I had, there is no usage compliance requirement.

Monday the RT from the DME comes to the house to deliver and go over the new machine, a Resmed AirSense 10 Autoset. The machine evidently is fitted with a cell modem which I wasn't sure if it would be. Confirmed with the DME it wasn't a refurb or used unit and presumably only has hours on it related to manufacturing testing (we shall see).

Grumpy48 wrote: ↑

Fri Sep 05, 2025 1:15 pm

Just got off the phone with the DME confirming the order of the replacement CPAP. Yes, there is a 13 month 'rental' on the replacement, but unlike the initial CPAP I had, there is no usage compliance requirement.

Monday the RT from the DME comes to the house to deliver and go over the new machine, a Resmed AirSense 10 Autoset. The machine evidently is fitted with a cell modem which I wasn't sure if it would be. Confirmed with the DME it wasn't a refurb or used unit and presumably only has hours on it related to manufacturing testing (we shall see).

Any new machines I have seen always have ZERO run hours.

LSAT wrote: ↑

Fri Sep 05, 2025 3:33 pm

Any new machines I have seen always have ZERO run hours.

For sure I am going to check the run hours when the RT sets it up for the demo and instructional session. I already have an AS10 (bought it here a few years ago) so am familiar with getting into the menus.
I did find some comments in a Reddit thread that more than a few users had found about 1.5hrs of run time on a new machine and the consensus was factory testing.

One thing that I'm wondering about is the DME stated the machine does have a cell modem. I know Resmed was producing units without cell modems for a while, but not sure if some of these later production units had been fitted with the cell modems for a certain portion of the market. From Resmed's site, "*Please note, the only model available for direct purchase is the AirSense 10 Card-to-Cloud machine.". I don't believe a patient can make a 'direct purchase' from Resmed, so I'm not sure what 'direct purchase' means
I'll be looking at the date code embedded in the serial number as well.

The DME I'm using is supposedly well regarded and was the one my PCP recommended, so hopefully all will go well.

This is a very interesting conversation, my first Resmed Autoset 10 was subject to the usual compliance minimum of 4 hours a day and was also 13 months with
Banker's Life supplement F policy. Now I have a Resmed Aircurve 11 and the insurance is with Aetna Medicare PPO. Their policy is 10 months and the unit is mine.
Every insurance company has different policies regarding when you own your device. Choose wisely regarding your DME supplier, they can be extremely helpful
or a total disaster. My biggest thing about Sleep Apnea is it is imperative you have a Doctor who listens to you and knows how to work the system. I say this because
it took several attempts to prove to my insurance company that I needed a BiPap machine. I had my Autoset 10 replaced after 5 years of use, I made sure the replacement
was going to be a BiPap machine because I have more central apneas than obstructive.