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wondering if you have figured this out, yet? Did you get a replacement?

Cpappappy wrote:Medicare will not pay as it was negligence. There is not a police report. This one is on your own dime. If you have a secondary insurance, they may cover with a Medicare denial, although unlikely.

A Medicare medagap, or secondary policy as you called it, will only cover the 20% that Medicare doesn't cover.

Since the OP only posted once, and never looked again who knows??

Joined: Mon Aug 10, 2015 8:47 am
Last visited: Mon Aug 10, 2015 9:21 am

Never really looked at any responses...

Hopefully he contacted his auto/home insurance to see if he had coverage but most likely the deductible would not allow much covered without coughing out $$$ out of pocket.

And if he did get it replaced, hope he hasn't lost it yet! Jim

Thanks to all who have tried to help. Wife tried to take all responsibility and felt bad. Told her I was the one who didn't pack it and accidents sometimes just happen. Have NOT further mentioned the incident to her. I haven't been married to her for 47 years only to be stupid.

Tried home insurance but my deductible is more than the cost of a new machine. Tried to work through my supplier (Lincare). Folks there were initially VERY reluctant to even TRY to help. But after a few words and several phone calls, they agreed to try to assist me. I still had to do all the legwork and even had to find out everything from Medicare since the Lincare folks claimed total ignorance of how to proceed. They even claimed Medicare would not replace a machine that was simply lost in the way I related. So, I called Medicare myself and found the same thing that Baja said. Medicare WILL pay the cost to replace a lost machine if the appropriate information is communicated. At least that's what "Rachel" from Medicare told me when I called the Medicare phone number. Appropriate information apparently is: (1) New prescription from doctor; (2) Statement from doctor that I continue to need the machine and will continue to benefit from using it; (3) Statement from doctor relating that I lost the equipment and explaining how it was lost. Doctor has sent that information to supplier. Folks there have agreed to supply replacement equipment and apply to Medicare and supplemental insurance for payment. Interestingly enough, the supplier folks tell me that they can't know whether Medicare and the supplemental insurance company will actually pay until after I have begun to use the replacement and they bill Medicare. (Just as an aside, why does it make sense that the supplier cannot find out if Medicare will indeed pay for a replacement until AFTER I am already committed to the new equipment. Will Medicare not say whether the cost will be covered until after they receive a bill from the supplier? Why?)

Anyway, at this time I have been assured by a Medicare phone rep that Medicare will indeed pay the cost for replacement of a lost CPAP and accessories if the right procedure is followed and the right information is submitted by the supplier when billing. Will have the new equipment in 3 days. Will actually find out if Medicare will pay after supplier submits the first bill. BUT...all indications are that the cost will be covered. We'll see.

Again, thanks to all who actually tried to help. And special thanks to Baja!

No doubt the new will come with the free phone, so the next one will be easier to report it's loss. Jim

I'm thinking the new one will probably have a GPS tracker...or should have for folks like me who have "Duh" moments.

Excellent, I'm glad I could help. And thank you for the follow up!

Please let us know how it goes after claims have been processed.

Update:

Today I received my replacement CPAP machine and accessories: (AirSense™ 10 AutoSet CPAP Machine with HumidAir™ Heated Humidifier and Swift™ FX Nasal Pillow CPAP Mask with Headgear ). My supplier (Lincare) agent had questions about exactly what type of documentation is required by Medicare when replacing lost equipment. Apparently a police report is not appropriate since the equipment was not stolen. And an insurance statement is not appropriate since the equipment was not damaged irreparably, destroyed by fire, etc. Though my doctor wrote a statement explaining that the equipment was lost, my supplier was not confident the doctor's chosen wordage was adequate. So, I wrote a narrative explaining in detail how the equipment was lost. I had my statement notarized, signed, dated, etc. This narrative will be submitted with the other required information when the supplier submits the bill to Medicare. The supplier agent said all information is in order and should be sufficient with the added notarized narrative.

Along with the normal billing forms to be submitted to Medicare by the supplier, the following documentation will also be submitted :
1) New prescription from the doctor;
2) Statement from the doctor affirming that I have been benefitting from using the equipment and further stating that I need to continue the sleep therapy using the CPAP equipment;
3) Statement from the doctor acknowledging that I had related to him that the original equipment was lost;
4) Notarized narrative stating the conditions under which the original equipment was lost.

At this point, all indications are that Medicare should issue payment for the replacement equipment. However, the reality is that I won't actually know for sure until the supplier submits a bill and Medicare approves payment. We'll see.

Many thanks again to all who tried to help me by sharing their knowledge.

Hope that works for you. I know what it is like to be without a machine.

SewTired wrote: For what it's worth, this is why a lot of folks on here and elsewhere buy a backup machine and take the backup when they travel. If it's lost/stolen/broken, your primary machine is still safe at home.

Excellent advice...take heed everyone Good advice for broken equipment too.

You are probably going to have to prove compliance again. That means a face to face meeting with your doctor somewhere between days 30 and 90. That key be one of your DMEs concerns.

I'm curious how this played out. Did medicare approve the replacement device?

Baja wrote:I'm curious how this played out. Did medicare approve the replacement device?

I am gonna guess that as long as the provider submitted the correct (requested/required) paperwork along with the bill that Medicare would pay. The most denials come from Medicare when the does NOT submit the required paperwork.

But yes it would be good to hear directly from the OP.

My suggestion to anyone who is denied by Medicare is to call Medicare, they are a 24/7 operation, and ask the reason for the denial, then follow their advice to correct it. And above all refuse to sign an ABN before receiving your equipment. Simply advise the provider if they submit all the require documents that Medicare will pay.

If you sign the ABN and the provider does not submit the required documents then you legally own that bill. Apria is a BIG offender in this regard.

Also as mentioned many times on this forum do NOT under any circumstances give Apria your credit card or if you must provide only a Pre-paid credit card so when things go back you can limit your losses. This may be good advice with other providers also.