Help, especially from Veterans with same problem

I had my heart set on getting the ResMed S9 Autoset w/H5i Humidifier w/climateline tube.

I'll give you a little backround.

I was under the impression that the VA was paying the whole cost of the CPAP machine, only to find out that my insurance covers 85% of the cost. When I got the machine I have now, the VA submitted a charge of $941.73 and my insurance paid $800.48. That leaves $141.25 that the VA picks up. I was stupid and didn't check my statements a little closer as they aren't very explicit when the insurance company puts down the type of service. I told them that there's no way I can know what the service was for if it's not specific. It's difficult to determine if there are duplicate charges.

So, after about two weeks, of daily calling the VA and the DME to get the ResMed S9, I finally got a call from the VA doctor consenting to the machine. I didn't hear anymore from the DME, so I called them, after the storm, to see if they ordered the machine. I was under the impression that the DME ordered it. Not so. I called the VA prosthetics department and was told that the VA gives you the machine that they have. He said they don't order any other ones and that if I wanted the ResMed S9, I should go to a private doctor to get one. I think I should have a say as my insurance covers 85%. No one got back to me to tell me that I can't it get through the VA. I had to gouge it out of them. I'm totally pissed at the situation. I appreciate them picking up the co-pay, but if I didn't have good insurance, they would have to pick up the whole tab on their machine. I pay a high premium, that keeps going up.

Hopefully some Veterans can tell me if I can get the machine I want or not. All comments are welcome. Thank you for your service to our country.
Thanks in advance.

I don't know but I'll bump your thread.
I seemed to recall a recent post about the VA giving out S9 Autosets. It appears though that you did get the other top of the line machine.

Here in San Antonio you get the Resmed S9 Autoset. They use another brand, But they only have data capable Apap/Cpap units.
I hope that you find this to be true for you also.

I'm faithfully using my machine every night; and plan to outlive it.
I have been making arrangements so I will not have to rely on Uncle Skinflint
to get whatever piece of @#$% recyclable will be the flavor of the day when my Precious finally dies
--or appears to be less shiny. . .

The VA is one of those "strange animals" when it comes to insurance. This is the way you have to look at it:

You may already have experienced this with your drug coverage--there's a limited formulary of drugs that the VA will provide. It provides drugs in every class, but it may not be the particular brand name drug you or your doctor wants. Example, your doctor may want you to be on the statin Lipitor, but the only statin on the VA formulary is Zocor. (I'm just using this as an example and not as a statement of fact).

Likewise with XPAP machines. Your local VA prosthetics department may have a limited formulary of XPAP machines, in this case, all you can get is the PR S1's they carry. Resmed S9's are not on the formulary of your particular VA. Sorry. End of story. If you want an S9, you'll have to but it yourself. I'm in the same boat--the Kaiser formulary carries only PR S1 machines. I'm envious of the S9's, but I don't have money to purchase my own, so I have the PR S1.

Now, that said, the PR S1 auto is a fine machine, and recent iterations make it fairly close to the S9 in some (not all) of the bells and whistles (e.g. back lighted screen, ability to turn off that annoying beep). Software is readily available, and the machine does an excellent job treating apnea. So you're not suffering because of the limited choice. You got a Lincoln Continental instead of a Cadillac. Still a very good piece of equipment. You're still going to arrive at the same destination (good treatment of your condition), but the car is not quite so fancy dancy. That's all.

Count your blessings that you have this coverage and that you got a machine that WILL do everything you NEED, though perhaps not everything you WANT.