Recommendations on Machine/Mask? Insurance Prob?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
mhe
Posts: 1
Joined: Wed Jul 06, 2005 11:31 pm

Recommendations on Machine/Mask? Insurance Prob?

Post by mhe » Wed Jul 06, 2005 11:47 pm

Any suggestions as to which machine/mask to get? I used the Remstar C-Flex with the Resmed Mirage Swift during my sleep tests; both seemed fine. Just want to see if there are better equipments out there.

Also, I am told that my SDI is too low for insurance to cover the cost of the machine but my doctor thinks I should be on CPAP. Any advice?


ahujudybear
Posts: 354
Joined: Mon May 23, 2005 10:12 am
Location: Franklin, WI

Post by ahujudybear » Thu Jul 07, 2005 7:08 am

If your O2 sat level is low but your AHI is also low, there might be other things going on. An AutoPAP can track your usage and give you and your Dr. an indication of what settings might be better for you than a straight CPAP setting. If your problem is underventilation due to weak breathing muscles, you might do better with a BiPAP which can give the most exhalation relief (lowest pressure against which you must exhale). But if you have a high AHI, a BiPAP wouldn't help unless the EPAP (exhalation pressure) were also fairly high.

Figuring all of this out is pretty much hit-or-miss unless you use a self-titrating machine like an AutoPAP, at least for awhile.

- JB
PB GK425 BiPAP 12/3
F&P HC105 heated Ambient Tracking Humdifier
F&P FlexiFit407 Nasal Mask/ Resmed Swift
"shapeable" pillow

brandy
Posts: 26
Joined: Sat Jun 04, 2005 5:10 pm

Post by brandy » Fri Jul 08, 2005 12:07 am

If your doctor thinks CPAP is necessary, you may still be able to get your insurance to cover it. According to the Medicare guidelines most insurance companies use, my sleep apnea was not severe enough (during some stages of sleep) for me to be approved for CPAP. But because my doctor felt it was medically necessary, I was eventually approved for the equipment. My doctor ended up submitting a letter of medical necessity to my insurance company, as well as more detailed copies of my reports. Myself, my doctor, and my insurance agent put quite a bit of work into getting insurance approval. It took about 2 months before I had been approved. If your insurance has good coverage, I would give it a shot. If not, I would save yourself some time and just buy online.