Insurance took my CPap machine

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Macado

Insurance took my CPap machine

Post by Macado » Mon Apr 06, 2015 6:28 pm

My insurance, Anthem took away my c pap machine after sevral months of trying to et use to the machine and finally was getting the hang of sleeping with it most nights. They say 70% use is required. I was using 67%. Have others experience this problem? What recourse is there for me?

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LSAT
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Re: Insurance took my CPap machine

Post by LSAT » Mon Apr 06, 2015 6:40 pm

I guess you could purchase your machine out of pocket...there are many available used. OR...You could also get your doctor to intercede on your behalf with the insurance company.

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chunkyfrog
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Re: Insurance took my CPap machine

Post by chunkyfrog » Mon Apr 06, 2015 6:48 pm

LSAT wrote:I guess you could purchase your machine out of pocket...there are many available used. OR...You could also get your doctor to intercede on your behalf with the insurance company.
Agreed! Do not give up! It is harder for some than others, and when you succeed, it inspires the rest of us.

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Thatgirl
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Re: Insurance took my CPap machine

Post by Thatgirl » Mon Apr 06, 2015 7:14 pm

What have you tried so far? My first step would be a detailed letter mailed certified to their medical director citing sources on the risks of untreated sleep apnea, and discussing your personal journey with CPAP and what steps you've taken to ensure success and how you've improved "compliance." CC your physician on this letter, and if you feel okay with it, the benefits director for your company (particularly powerful if it's a large company). In this letter specifically request a written response within 5 business days. I've found this approach very powerful.

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chunkyfrog
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Re: Insurance took my CPap machine

Post by chunkyfrog » Mon Apr 06, 2015 7:19 pm

A letter from the doctor, specifying the need for extended time for acclimatization is often recognized by insurers.
A doctor's order often overrides the whims of OCD bean counters.

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