Switching DME during rental period?

I have completely had it with my current DME and want to switch. My insurance company says that I can. Has anyone tried this before? Were you successful?

You could leave the machine with the current DME and use another for supplies.

If you switch DMEs during the rental period it is possible that the rental amounts will start over with the new DME.
Check with your insurance company to see exactly what the payment terms will be before doing something permanent.
As BlackSpinner suggests, keeping with your current DME and moving to another for supplies, etc. might be the best financial alternative. That's what I did for my first machine.

You will need to get a copy of your prescriptions from your doctor so that the new DME can fill your orders.
You should also get a copy of your sleep study and titration study as they will contain very useful information as you begin to track your own therapy progress.

Sharrykb wrote:I have completely had it with my current DME and want to switch. My insurance company says that I can. Has anyone tried this before? Were you successful?

If insurance says it is doable then it should be. How many months in are you?
As mentioned you should ask how much this will cost you.

The insurance company may say it's "doable" but what exactly does that mean? If you have a capped rental (rental for a certain period of months before you own the machine) they may think "fine" but they may not plan on starting the rental period over with when you switch DME's.

Say you have a 14 month capped rental period and you're halfway through. DME #2 may have to provide you a machine and accept only 7 months of rental payments instead of 14 they usually receive for the machine. Who would want to do that???

So before you plan to switch machine rentals, you need a thorough understanding of how this works with your insurer and with EACH DME. And you need to confirm that DME will be willing to provide you with a machine under the circumstances.

If you want to simply keep your machine rental with DME #1 and get supplies from a new DME, that's easier BUT some DME's don't want your supply business without renting you a machine, because most of the profit is in the machine. So again, you need to make sure that DME#2 really wants you before dumping DME #1.

Janknitz wrote:If you want to simply keep your machine rental with DME #1 and get supplies from a new DME, that's easier BUT some DME's don't want your supply business without renting you a machine, because most of the profit is in the machine. So again, you need to make sure that DME#2 really wants you before dumping DME #1.

My DME just delivered my heated hose last week. The charge was $79, compared to the cpap.com price of $40. Looks to me like a couple of years of supplies are going to be pretty lucrative for the DME, too. And if they do a good job, you'll still be there down the road when it's time for the next machine.

My DME just delivered my heated hose last week. The charge was $79, compared to the cpap.com price of $40. Looks to me like a couple of years of supplies are going to be pretty lucrative for the DME, too. And if they do a good job, you'll still be there down the road when it's time for the next machine.

I used to think this way too, but consider . . .

The charge was $79, but if you have insurance, what will ultimately be paid between your insurer and your co-pay or deductible? (and if you don't have insurance, why would you pay $79 out of pocket if you knew you could get it for $40???). My guess is that once insurance kicks in plus your share they will get close to the $40, perhaps even less. But a whole lot of paperwork will transpire before they get paid a cent. So when you pay for their billing department and their negotiation runarounds with the insurer, their liabilities, their rent and inventory, on-staff respiratory therapist, they probably make $5 or $10 profit on the hose, while cpap.com with its cash basis is probably making $20. So just how lucrative is it for the DME to sell supplies???

The behavior of the DME's tells the story. Some DME's flat outright refuse to order things like a single replacement cushion, because they are in the red by the time they do all the documentation, ordering, delivery, etc. So they probably are much happier when we DON'T order supplies from them, unless it's a bigger order of multiple items (hose, humidifier chamber, filters, and a new mask that can be parted out).

And will THEY be around by the time it's time for us to order a new machine. In the current climate--thanks to Medicare competitive billing--possibly not. So they could care less about making us happy, and it shows in the lousy way most DME's treat us "valued customers".

Janknitz wrote:The insurance company may say it's "doable" but what exactly does that mean? If you have a capped rental (rental for a certain period of months before you own the machine) they may think "fine" but they may not plan on starting the rental period over with when you switch DME's.

Say you have a 14 month capped rental period and you're halfway through. DME #2 may have to provide you a machine and accept only 7 months of rental payments instead of 14 they usually receive for the machine. Who would want to do that???

So before you plan to switch machine rentals, you need a thorough understanding of how this works with your insurer and with EACH DME. And you need to confirm that DME will be willing to provide you with a machine under the circumstances.

If you want to simply keep your machine rental with DME #1 and get supplies from a new DME, that's easier BUT some DME's don't want your supply business without renting you a machine, because most of the profit is in the machine. So again, you need to make sure that DME#2 really wants you before dumping DME #1.

Thank you everyone for your responses. What Janknitz has said here is exactly what I believe is going to be the issue. I am about 6 months through what I believe to be a 10 month rental. I have reached the point where I absolutely do not want my current DME to get one more penny of my money or my insurance company's money. However, one prospective DME has told me that it is there understanding that the insurance would only give them the balance of my original rental period (4 months) and I completely understand why this is not acceptable to them. My insurance company insists that this isn't true and that they would start over again with a brand new rental period with the new DME.

At this point I'm not sure which one of them to believe. I was hoping someone on here has been through this before and could tell me how it worked for them. I think I need to determine how much extra $$ switching is going to cost me and my insurance company and how much I hate my current DME and decide whether a change is worth the extra $$.

On a positive note, this other DME I talked to has offered to sell me supplies even if I keep my machine contract with the old DME.

Keep the machine with the current DME and let the contract run its course unless you want to get a totally new machine and start over with new everything and that includes co pays and make sure that the insurance also is willing to go another 10 months.

If the new DME is willing to sell you supplies without first providing a machine...go for it. There's law (except in some DMEs rather small mind) that you have to get other cpap supplies from the person who sold you the machine.

My DME has never sold me a machine and they are quite happy to be selling me piddly little masks twice a year and maybe an occasional nasal pillow. Once when I lived in town they even delivered a replacement nasal pillow...totally blew me away and it was after hours at that. Now to be fair he was on an oxygen call a few streets over but it was 7 PM at night and his comment was..."just takes a few seconds to drive up and give it to you and I was in the area anyway".

What you do is just quietly go over to the new DME to get any further supplies and you simply don't order anything else from the old DME.....or at least that is what I would do unless I had a hankering for the latest ResMed machine. Then I might consider starting totally new with the new DME only if my insurance would also start over with 10 month rental thing.

Thank you for sharing your opinion Pugsy! The current DME is DEFINITELY not going to be getting any more supply orders from me. I just haven't decided yet what to do about the machine rental.

This started out completely about not being happy with current DME's customer service, or lack thereof, and not wanting to give them my business. But the idea of possibly getting the new Resmed machine is somewhat intriguing...

I figured the thought of the "latest and greatest" might be tempting. That would be the only way I would want to change machine contracts and have to start my copay over again.

If you do it you do it though....make sure it is AirSense 10 AutoSet for Her model though...the for Her model has a special apap mode that might come in handy.

Make sure you know exactly what to expect from your insurance company.

Pugsy wrote:If you do it you do it though....make sure it is AirSense 10 AutoSet for Her model though...the for Her model has a special apap mode that might come in handy.

Make sure the new DME is willing to get this machine. Else there will be even more frustration.

Guest wrote:

Pugsy wrote:If you do it you do it though....make sure it is AirSense 10 AutoSet for Her model though...the for Her model has a special apap mode that might come in handy.

Make sure the new DME is willing to get this machine. Else there will be even more frustration.

That's a good point! For me this is more about making sure the DME didn't get any more of my $$. Getting the new machine would just be a bonus.

On a slightly different tack, I am on Medicare and 3 weeks into my capped rental of my new machine.
Competitive bidding is coming up, effective next year. Will my lovely new machine and awesome DME
be grandfathered, if the bid goes to some clip joint? I would hate to be cut down to some POS brick.

chunkyfrog wrote:On a slightly different tack, I am on Medicare and 3 weeks into my capped rental of my new machine.
Competitive bidding is coming up, effective next year. Will my lovely new machine and awesome DME
be grandfathered, if the bid goes to some clip joint? I would hate to be cut down to some POS brick.

Oh chunkfrog!!! I sure hope that doesn't happen to you!!!