Rent to buy?

I did a search for this but didn't find anything useful in the sea of posts named otherwise. Maybe one of you can direct me to it.

I went into the DME after 1 month. I was supposed to see the DME to decide whether or not to buy or rent. In fact, I got seen by the sleep doc and he showed me a printed graph of my sleep study. They even tried a bi-level on me mid-morning because my oxygen levels were dropping during rem sleep. And they determined I didn't need one.

Anyway, the only reason I did see the DME was because I needed a new mask. I feel like I'm playing the shell game! LOL! During my visit with the doc I mentioned I was supposed to see the DME about whether or not to rent or buy (as she said last visit) and he said "All our machines are rent to buy." And seemed a bit confused by my question. He also didn't know that I had a APAP now instead of a CPAP even though he ok'd it for me. But when I pointed this out he quickly recovered and pulled out paperwork farther down and said 'oh yeah, alcohol occasionally could be a very good reason for an APAP because you need more pressure on those nights."

I like to paint a picture. Can't you tell? So, what is the rent to buy animal anyway?

I ended up doing a rent to buy. With my DME the way things worked out was they were charging me $1300 for a GoodKnight 420G ($255 at cpap.com grr). My insurance has a benifit of 750 for durable medical goods...which doesn't cover the cost of the machine. They also gave me a comfortgel mask for around $200 bucks.

That is when they pulled out the rent to buy option. They rented me the machine. The way things worked out my benifit ran out in September. I paid like 80 bucks for Sept, Oct, Nov, and Dec. I was covered again when my benifit reset in Jan, so my Jan, Feb, and Mar payements were covered. This "saved" me 80x3 which is $240...my out of pocket for it was $320. I "owned" the machine in March.

Technically I ended up paying more more because I needed a new mask before the new year, but that is the trick they play with the rent to own. It is a good option, that I would not have needed had I realized how much they were soaking me on the machine.

So this might not be as easy as it seems........

I found out my insurance has already paid my sleep doc/dme $1650! And that's not even what they were billed for. My insurance has a website where you can access information like what has been billed.

Rent to buy isn't always what they say. I was told that I was in the "rent to buy scheme", but then the charges kept coming after a year. I called my insurer and was told that they no longer buy the unit "as a benefit to me." This alleged benefit is that they will continue to make payments on a semi-annual basis to the DME so that the machine is covered in case it requires maintenance. Of course, that means that if I change insurers, I have to start the process over (co-pays and all) because the machine may have to be returned to the DME. So, how is this a "benefit to me?"

Since so many patients fail to stick with cpap therapy, most insurance requires some kind of trial period for compliance. You may even see it on your PSG or titration study where the doctor recommends "trial on cpap" is recommended. If you tolerate the trial period satisfactory (usually 90-days), then your trial turns into a 10-month rental where after 10 months the insurance buys the machine outright as they don't like to pay the DME those high rates.

so if you have any kind of co-pay or have to pay a higher portion you may want to consider purchasing your machine outright.

Ask the DME for a copy being billed to insurance, you'll get a chuckle out of that.

That's just it, I can see it online I can see what they billed for and what my insurance paid for. I have acordia national. And yes, I was very amused. Not only have they already charged me full price for the humidifier but they also billed a pretty penny for the machine itself and supplies. And the sleep study itself. And the initial counciltation. For example, they billed $1,900 for the sleep study alone. My insurance paid $692. I was billed for filters and hoses. And my mask. And even the nasal pillows on my previous mask.

(I did start out with one machine and after 2 weeks went to the machine I have now. I also started out with one mask and after 1 month switched to the mask I have right now.)

I too am on the rent to own plot. My DME will do either rent to own or outright purchase but my insurance as stupid as they are will not purchase. I told my insurance, Humana which only manages my employers insurance , that it would save me money to purchase outright but they said no. I must rent to be sure I am compliant. Makes sense I thought, why should they pay if I will not use it. I went three months 100% compliant and called the insurance told them to purchase the equipment and they said that they would not. They determined it was better to pay per month and no longer buy outright. After the cost of the machine was reached I would own it. Next machine will be purchased online even though it will be out of network it will save me money.

Dale

I plan on buying my 2nd machine online. And time will tell on what that machine will be. I see everyone's point about Resmed and their 40% increase. But then again, I haven't seen a change in online prices yet or no set date for that so, for now, it's a moot point.

I can't figure out for the life of me why the insurance company would want to rent to buy. Why not after 3 months just buy? Why pay more? Do they HAVE to spend that money or they won't get as much next year? Or what?

I looked at how much my insurance paid for the machine rental and it was UP THERE like they billed $300 and my insurance paid $225 with their IN NETWORK discount. That seems like alot to me for just 1 month. But they're probably used to paying more in certain areas of the country and it's no big deal to them. I don't know their reasoning on this. So, far my insurance has paid out $1,650 including the sleep study and initial sleep doc visit. That's alot of cash! And I still don't own the thing! Why be so stupid about it? And why not just buy it online for me from cpap.com? Friggin Idiots! Makes you wanna pull your hair out to remind yourself that this isn't just a dream.

The bright side is that I can get a copy of my cpap prescription at the drop of a hat legally. So, once I have that, which I don't yet, and haven't asked for yet, I will be able to purchase online at my leisure.

Oh yeah, let me add to this, I have a great job with reasonable pay but the real benefits come in with the insurance. If I had to pay out of pocket I would just go untreated more than likely. In other words, if I didn't have insurance I couldn't even afford to go to the doctor at all. The amount they bill out and the amount my insurance pays for each visit is crazy!

Gee, I thought only Medicare gave the option to rent or buy. Since the DME gave me the cheapest cpap around (was ignorant at that time about choices and this forum didn't exist) I opted to continue rental, which Medicare pays on a six month basis, and pays for any repairs that may be required.

I had the opportunity to go in at the same time as someone else who had apparently very different insurance than what I have.

Since he had a time constrant, I let them deal with him first, so I just sat back and watched and listened (and recorded)

His insurance had a co-pay. This co-pay for the session (what we went to) was $100. They said it covered the cost of the Hoses, Mask (he had little choice on that), Humidifier, filters, and the service. It also included the first months "rent" on the machine.

He asked and was told that his co-pay would be around $29 per month for the rental of the machine.

So all the consumables were paid for upfront. In my opinion, that makes sense. The humidifier is considered a consumable.

When they got to me, I had 100% coverage. What they have billed, I'm not sure as I've not seen it yet. but I would assume the same, that they billed for all the consumables up front.

My machine was used (as was his) but is stated to be a 1 Month Rental.

I"ve already confirmed that within a week or two it will be deterimined if the machine is helping and if so, will trigger a purchase by the Insurance company. A new machine will be ordered and the used one will go back to them. My insurance does not buy used machines for purchase.

Wow, the tales of insurance. It's interesting how each company works. You might find that they charged you alot more than this guy because you had 100% coverage. I could be wrong too. My DME lit up when she found out that my insurance pays 100% and has no limit on DME equipment.

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I'm not so sure about that...

Didn't realize it until now, but the paperwork that I got with the stuff has the prices that they are billing on it. $362.42

That includes a one month rental of the machine $119.96 so the purchased items were $ 242.46

If I had PPO coverage like I used to(now have HMO) they would have paid 60%, so I would have had to pay 40% of that which would come out to be about $73 for the first trip and if the rental continued about $24 a month. Which is in the same ballpark as the other guys apparent co-pay.

So I would guess that the pricing was similar if not the same.

I don't know about the sleep study itself because that was done elsewhere and I have not seen anything about that yet. I will get a accounting though, since I always do from the Insurance co.

Good deal. Sounds like you have all your ducks in a row.