Necessary DME vs. Auto-shipped because insurance will pay?

I recommend getting replacements for everything as soon as insurance and your wallet permit. Don't throw away the old parts unless they're broken or overly gross.

Give the set you're using a really good clean once a week and set them aside while you use another set of parts. Let the clean ones sit dry for a week.

Once you have at enough spares, quit ordering them and only order when you wear out a set. I consider two sets an absolute necessity in case you break something, and I'd probably get at least 3.

If you're paranoid about germs, and the part is plastic, once you have enough spares, boil a pot of water, turn off the heat, and drop the oldest of your spares in the pot of water. Let it sit until the water cools. If it melts, no big deal, since it was your old spare part. Not necessary, but would give me good peace of mind if I were germaphobic. I wouldn't do the boiling water trick very often, even if I did it.

I didn't really answer your question, did I?

Some people get concerned and claim that germs will "take up residence" in the pores of the plastic in your mask and other parts as they get old.

Personally, I don't worry about that unless I'm using someone else's mask. Any germs in my CPAP parts either came from me or from the environment where I'm sleeping. Unless the germs are multiplying into some overwhelming number, I don't see the big problem as long as it's my own CPAP stuff.

It would be different if it was someone else's mask. I'd probably do the boiling treatment if I'd been in some dangerous germ environment like a hospital.

Silicone parts also sometimes get stiff and worn out and don't fit as well, and may leak.

Brightcrow, if you are concerned about hygeine, you can get this product from our sponsor. https://www.cpap.com/productpage/Contro ... eaner.html. My mom says it's similar to a product used in sterile processing department at the hospital, just repackaged. I bought the travel size and use that when I receive new cushions swapped with others that have been used a few times to try out. Boiling does not kill all germs, BTW. Boiling and disinfecting is more effective in the absence of commercial sterilizers.

Most of the concerns about germs and plastics involve sharing BETWEEN patients, not a single user item. Nothing about your environment is sterile, so unless you have black mold in your home (where you would then move from!) regular cleaning is sufficient. From the ENT I saw a week ago, fungus is always in your sinus's. You breathe it in. Whether it takes a toehold causing you grief depends on your immune system. I have a fungal infection now because 2 course of antibiotics killed all the germs and bacteria that would have kept the fungus in check, dang it, leaving a wide open field for the fungus to annoy me.

That said, you'd be amazed how many people never clean their mask or equipment and yes, many of them DO get ill as a result. The first question the ENT asked me after he noted I had a Cpap was how often I cleaned my mask. He had no issues with once a week.

[edited first paragraph to add more info]