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So it's been 2-3 months since I got my CPAP machine and I'm due for a follow-up visit with the sleep doc. I've never actually seen the doc, only an NP, who has been excellent to work with. I'm just not really convinced I want to give the half-day of time away from my work (which is keeping me plenty busy) and the copay to be told what I already know—I rigorously check my SleepyHead data, I know my AHI is close to 0 and my compliance is > 98%. My symptoms (that got me to go get tested in the first place) are gone. I paid out of pocket for my machine so there isn't any insurance requirements there.

Is it worth it to still go? My prescription is good for a year; if I need more supplies after that time can I get them from my PCP? What about getting a second machine? I travel a lot and have been thinking about getting a second machine (maybe a smaller one) to travel with since I want my expensive large one to last as long as it can.

HoustonMedic08 wrote:I rigorously check my SleepyHead data, I know my AHI is close to 0 and my compliance is > 98%. My symptoms (that got me to go get tested in the first place) are gone. ...

Is it worth it to still go? My prescription is good for a year; if I need more supplies after that time can I get them from my PCP? What about getting a second machine? I travel a lot and have been thinking about getting a second machine (maybe a smaller one) to travel with since I want my expensive large one to last as long as it can.

if it were me, I wouldn't go. sounds like you're on top of your own treatment more than any doctor ever will be.

you've got one of the cheaper machines already. but a second machine is always a good idea, since when your machine breaks, you won't have to figure out what to do while waiting for it to get fixed, if you can't find a loaner.

there are a number of good machines on sale here on the forum, likely for a lot less than you paid for yours, there's also secondwindcpap.com

BCBS requires that I see a doctor every 6 months as part of their requirements to continue coverage of CPAP supplies, machines, etc..

So for a $25 co-pay & 30 minutes of my time, my sleep doctor takes care of documenting my usage with BCBS.

I have no issue with that...

Denial Dave wrote:BCBS requires that I see a doctor every 6 months as part of their requirements to continue coverage of CPAP supplies, machines, etc..

So for a $25 co-pay & 30 minutes of my time, my sleep doctor takes care of documenting my usage with BCBS.

I have no issue with that...

Someone is ripping you off.

I saw the sleep Dr once after I got my new machine and don't see him for another year. RX is for 99 years and I have no problem getting supplies I need without baby sitting from him.

I have BCBS.

Not even sure I will see him in a year.

Denial Dave wrote:BCBS requires that I see a doctor every 6 months as part of their requirements to continue coverage of CPAP supplies, machines, etc..

So for a $25 co-pay & 30 minutes of my time, my sleep doctor takes care of documenting my usage with BCBS.

I have no issue with that...

I know that there are different requirements because BCBS administers many different kinds of plans, but I would call them again and verify this requirement. I think you were given wrong information unless you are getting oxygen.

BCBS used to be a single company, accountable to stockholders and clients.
Now it is a brand name, for sale to the highest bidder, and accountable to no one.
Hundreds of different plans are available.
What you get depends on your employer's contract and whatever small influence your union may have on that.
It is what it is. Out of pocket makes sense more and more as time goes on.

chunkyfrog wrote:BCBS used to be a single company, accountable to stockholders and clients.
Now it is a brand name, for sale to the highest bidder, and accountable to no one.
Hundreds of different plans are available.
What you get depends on your employer's contract and whatever small influence your union may have on that.
It is what it is. Out of pocket makes sense more and more as time goes on.

My wife's employer offers BCBS and my employer does as well..... unfortunately, both versions of BCBS coverage for us now require periodic visits to a doctor to maintain coverage for CPAP supplies, etc...

I do out of pocket purchases when my pocket allows.... such as purchasing replacement parts via good deals off of e-bay..

But I have to rely on my BCBS coverage for major items like masks or machines.

If you are asking if they have any type of plan for you, the answer is no. There is no "every 2 years we do x, and after 5 years we check y". They just want to "monitor" you, and do a sleep test when they need to verify something. I need mine to approve mask and equipment orders. For me, its all been on my end. Nothing proactive would happen if I didn't call and set an appointment.

I diagnosed myself and went for an intitial visit, then a sleep study mainly for confirmation I had this condition.

My sleep doctor highlights:
- After my sleep study was kept waiting over a month for a followup appointment where I was told I had a really severe case of OSA (AHI > 100).
- Another week of waiting for Doctor's chosen DME to contact me - I finally called them and told them to get going or they would be replaced.
- Battling the office staff about piddling amounts of money.
- Failure to bill me in a timely fashion.
- Failure to take my BP during a routine office visit.
- Disavowing machine data altogether excepting compliance.

I cancelled my last appointment and never heard back. New insurance too, took a minor hit there but nothing crazy. I have a handle on this and you can too. Unless you have complicating factors you may be wasting your time and money, especially if your doctor is a quack.