New around here

Hi, My name is Rich. I was just diagnosed with sleep apnea last week, I will be getting a cpap on Dec 23. I've been told the doctor ordered a Respironics system 1 pro. Can anyone tell me if this is a good machine also if you have any other advice as to what I need to get started. Thanks

Hi - Can you get more specific info about the machine (like a model #)? For more info, see this - and come back here with questions. Also start reading the links of the lightbulb at the top of the page.

http://maskarrayed.wordpress.com/

Julie wrote:Hi - Can you get more specific info about the machine (like a model #)? For more info, see this - and come back here with questions. Also start reading the links of the lightbulb at the top of the page.

http://maskarrayed.wordpress.com/

He does not have the machine yet

Ra101075 wrote:I've been told the doctor ordered a Respironics system 1 pro.

This be what we call the PR System One Pro and most likely it will be a 60 series...so the PR System One 60 Series Pro CPAP.
If so....that would be model 460 and that's a full data machine and you can use either SleepyHead or Respironics Encore software..or use both if you wish. SleepyHead has a Mac and Windows version available and links are in my signature line.
Encore is strictly Windows only though...send me a private message if you want additional information on Encore.
Sleepyhead will do all you need and then some so no real need for Encore unless you just want to try it.

The model 460 is a fixed cpap machine with some limited APAP capabilities. Nice machine...the next step up is the 560 model which has full time apap mode capabilities.

To verify model number look on the bottom of the blower unit for a little sticker with a 3 digit model number on it...may have DS, REF or P in front or behind the 3 digits. Respironics machines can be a bit difficult to discern model by the wording on the machine itself unless you really know what to look for...so I usually suggest that people just check out the model number on the bottom of the blower as it's easier and faster.
The 60 part of 460 means it's a 60 series machine (older units had a 50 in the model number) and the 60 series machines have an optional heated hose....I would suggest that you push to get the heated hose if it doesn't come with it. You may or may not need a heated hose but it might come in handy and it's better to have something and not need it than need it and not have it.
Besides...to upgrade to heated hose later costs more money that your insurance may or may not be too keen on paying for but if included at the beginning it will.

Sad to say my insurance isn't paying for much of it, My deductable is $3000.00 for the family and we've only paid about $1500 so I'm looking at about $1200.00 out of pocket on the 23rd. They said I can pay what I can when I can...but it's really a big hit. I'm just hoping I'm getting what I'm paying for. Mentally I know I need it and my health is important. I have a new baby at home and want to be able to run around with. Emotionally I'm having a hard time wrapping my head around all this and the expense that I'm not really prepared to absorb. From what the rep told me it sounds like it has all the bells and whisltes

Ra101075 wrote:Sad to say my insurance isn't paying for much of it, My deductable is $3000.00 for the family and we've only paid about $1500 so I'm looking at about $1200.00 out of pocket on the 23rd. They said I can pay what I can when I can...but it's really a big hit. I'm just hoping I'm getting what I'm paying for. Mentally I know I need it and my health is important. I have a new baby at home and want to be able to run around with. Emotionally I'm having a hard time wrapping my head around all this and the expense that I'm not really prepared to absorb. From what the rep told me it sounds like it has all the bells and whisltes

be a hell of a lot better, price wise, to tell them to piss off, and buy yourself a machine from secondwindcpap.com

just talked to the insurance company, with the cost of the sleep studies my $1000.00 deductible will be met easily just by those. So it looks like the machine will be paid for at 75% , then I may hit my $2000.00 max out of pocket at which any additional would be picked up at 100%. So if the machine don't get me the actual sleep studies will. Guess it's better than having no insurance at all

It doesn't have all the bells and whistles but it has most of them.
Really the only down side to the Pro is the limited APAP capabilities. Some people might do better with having APAP mode available all the time. I am one of those people so I have first hand experience in that regard. You may or may not end up in the same situation.

What you need to understand is that insurance pays the same for any cpap/apap machine...from the basic no frills brick to the top of the line full time apap. And what you end up paying is based on what your insurance allows for these machines and they go by HCPCS code and NOT by brand or model number.
See this blog.
http://maskarrayed.wordpress.com/what-y ... me-part-i/

You do have some options though.
You could wait until after the first of the year and get your machine then....that way the cost will go towards next year's deductible.

You can buy your machine out of pocket and probably get one cheaper than what your DME is going to have to pay.
Were you quoted $1200 for the Pro? We can get you a 560 for just a little more than half that price...brand new from cpap.com
or I also know where you can get a brand new 560 (without the heated hose stuff) for $400 from a private party that I trust.
It's a step above the Pro in terms of functional capabilities and less money.

You could still use the DME for masks...make sure you know what mask swapping policy they might have....mask manufacturers pretty much all have a 30 day trial thing and that's per mask as in each mask...but DMEs often make their own in house rules that are much more restrictive because they don't want to do the paperwork for swapping out multiple masks.

they said it's a 460 model, no heated hose, would need a separate script for that. this is my first real experience dealing with insurance, never had more than regular Dr visits up til now. But it sounds like since the sleep studies eating up my deductible the cpap machine will be covered 75% . If I look at it that way it's only gonna be a couple hundred dollars. Or is that backwards thinking. I must admit I'm feeling overwhelmed with all this

If the sleep studies are eating up the deductible then of course use the insurance to get the machine.. Do whichever saves you money out of pocket.

Find out for sure though if your insurance is doing the monthly rent to own thing or if they purchase the entire package up front.
A good many insurance plans do the monthly rent to own capped rental thing...you pay so much per month and then you own it and often it is tied to your proving you used the machine for so many hours during a 30 day period.

I mention this because next month...your deductible will start all over again and if it is a monthly "rent to own" thing...then you are going to have to foot the bill for the entire contract. Now of course it will go towards next year's deductible but if you don't normally meet your deductible...it might not be what you want to do. Unfortunately we don't have a crystal ball to tell us that yeah...on May 1st you have something big happen and have the deductible satisfied.

You need to call your insurance company to find out what they do...don't rely on the DME to do this.
They will either purchase out right or do the rent to own thing.

Oh...the heated hose does not really require a separate RX despite what your DME might say. It doesn't. If it did I wouldn't be able to buy one on the internet without a RX.
With the 60 series machines there is an upgrade kit available should you decide you want or need a heated hose.
https://www.cpap.com/productpage/pr-hea ... e-kit.html
or just get your doctor to write a RX for it and keep the DME happy and get insurance to cover it.
Again..it can be added later but then there's the Jan new deductible thing.

You may not need or want the heated hose...it all depends on how much humidity your nose prefers and your bedroom temps and your own personal preference on the temperature of the air.

I just wanted to point out your options...if your insurance is a straight up purchase...by all means use it and only pay a couple of hundred....if it is a rent to own capped rental and thus charges are going to travel over to next year....decide if you want to go ahead an pay those amounts and have it go towards your deductible or just go with an overall less out of pocket option of buying it yourself.

you could also ask the DR. to rewrite the script for a auto ... 560 with heated hose and the DME will have to provide that .
Good luck.

thank you for the info, I will have to do some more research. I'm sure I' will have plenty of questions once I get the machine.