New machine setup

The people who gets me supplies called to work on my insurance approval, I Have Medicare.

Being informed they will be rules on compliance, I have to make monthly payments as well, at least 13 months worth, and they have the option of taking my machine away,

Thing is I have Fibro and arthritis and diabetes, night sweats, and other conditions, So sometimes I dont sleep at night, Or if raining the fibro is very painful and cant handle anything touching me,

So I wonder if it would be better to use a cc and buy my own machine and not worry about them taking it away from me after making the payments? and if I buy my own how would I find out the setting I should set it at? I want a auto one with data and humidifier, so nothing real expensive,

What would u do? understanding my health is so bad I dont leave my house except dr apps, I dont even get dressed cause clothes hurt my skin, This has taken months so far

I do have a drs script on cpap.com

Thank you for any help or advice

Darla

In the nights when you cannot sleep, just let the machine run for 4+ hours. I would not normally recommend this, because some people would intentionally not use the machine when they should, but with your situation, I think it would be appropriate . (Occasionally).

This is the Medicare compliance rule...

Objective evidence of adherence to use
(defined as use of PAP devices for 4 or more
hours per night on 70% of nights during a
consecutive 30-day period anytime during
the first 3 months of initial use) of the PAP
device, reviewed by the treating physician.

The requirement for insurance is, for me, 4 hours a night for 70% of the time. I'm not sure if that's feasible for you to do, since you said you sometimes can't have clothes touch you because of the pain. Can you use a bandage or some kind of padding where the straps would go to minimize the issue?

When it comes to setting it up, there are a lot of knowledgeable people on this forum you can ask. They've helped many people in the past set everything up.

I wonder if your doctor could refer you to a prosthetics specialist.
They have access and knowledge of products that might be more comfortable to your skin,
and a custom liner might be made for your cpap mask.
The catch-22 is that cpap could help with your fibro--if only you could use it.
The most comfortable mask I have ever used is the Sleepweaver Elan--a soft fabric mask.
If you have never tried one, I suggest you do.

Thanks to all of you maybe I can manage it 70% of the time and explaining it ahead of time is a good idea although my dr knows I struggle so much or she wouldn't be giving me pain meds trying to control pain.

I'll make sure and ask to make sure it's a new machine and inform them about my issues and see what happens

I read medicare charges ins a flat fee no matter what machine they give you, But to be careful it isn't a used one, they consider it a rental the lady explained to me anyways

again thx so much

The Medicare requirement is this
70% of the nights within a 30 day consecutive period at sometimes withing the first 90 days of getting the machine that you use the machine for at least 4 hours a night...so 21 out of 30 consecutive nights.
And at some point after the 30th day of your getting the machine and before the 91st day that you have a face to face appt with your doctor to document that things are working out.

After you meet that first 30 day compliant thing it is extremely unlikely that you would have to document the same again. Medicare usually just does the first compliance check.

If you are getting close on the 4 hours thing and the 21 day thing...use the machine while masked up with machine on and watching TV or reading.
Turning the machine on and letting it blow without your being attached won't count. The machine's today know if a human is on the other end because they can sense the resistance from our breathing.

You could of course buy your own machine but it's going to cost you more that way...but you avoid big brother looking over your shoulder.
You have Medicare...so your portion is the 20% of the allowable amount and if you have a Medicare supplement then you probably have insurance to pay the 20 %.
If you have one of those Medicare Advantage type of plans you need to check with the particular plan to see what they do in terms of your copay and/or requirements. While most will mimic Medicare itself...not all do.

LSAT wrote:In the nights when you cannot sleep, just let the machine run for 4+ hours. I would not normally recommend this, because some people would intentionally not use the machine when they should, but with your situation, I think it would be appropriate .

that won't work, the machine won't record usage hours if it doesn't detect breathing.

MssDarla wrote:So I wonder if it would be better to use a cc and buy my own machine and not worry about them taking it away from me after making the payments? and if I buy my own how would I find out the setting I should set it at? I want a auto one with data and humidifier, so nothing real expensive,

nobody has really addressed this, I think.

"going it on your own" is *certainly* an option, there are many people that have quite successfully done so.

send a PM to grayghost4, he may be able to set you up with a nice used machine for much less than buying one new. and he's completely trustworthy.

LSAT wrote:In the nights when you cannot sleep, just let the machine run for 4+ hours. ...

These machines can detect if you are breathing through a mask, or not. So, for those 4+ hours, someone has to be masked up. The machines are not smart enough to know if you are asleep, or not. Good luck. Earl

Update,,, the first supplier called and gotten my info and said i would hear back in a week,, never heard anything

Dr called nother one (I think) They called me a month or more ago and said they would call back in a week and a machine with in 2 and last I heard from them,,, Sooo I may have to buy my own but how would I know the settings to use? I have never set one up?

I have read and learned what I would want in a machine thou, but not where I find my personal settings,, I will ask my dr when I see her thou

This just shouldn't be so hard wow

Ps my dr did send a script to cpap.com to buy supplies when I wanted too,,, not sure if it covers a machine, anyone know?

Darla

MssDarla wrote:Ps my dr did send a script to cpap.com to buy supplies when I wanted too,,, not sure if it covers a machine, anyone know?

It may depend on how he worded it for the supplies...you probably would be better off to call them and ask them to make sure.

MssDarla wrote: Sooo I may have to buy my own but how would I know the settings to use? I have never set one up?

It's not hard at all. We can help you even if you don't know the settings that you need (but they should give you a copy of the report advising the settings because it's part of your medical record...so ask) we can help find appropriate settings as long as you get a full data machine.
Besides...sometimes the titration study doesn't always get it right anyway. Mine didn't.

I know that all this seems a bit overwhelming but you can learn it. Just try absorbing small bits at a time and you can get there.

We can help and are ready, willing and able to do it.

Thank you so much,, I did ask for a copy,, so I will reread it and see if I find the info there,

I will start shopping for machines if dr doesn't get this figured out,, I guess medicare is fighting it somehow, Then I will come here for help once I pick a machine, I did already buy a mask, the F20 with no headband, I like it, but even with my old 12 yr old machine which I didn't use till now,, I wake up sweating every night and have to sit up turn air up high to cool down, before trying to go back to sleep and without mask. I know I need this and I am trying, I know the settings are wrong or this night sweats should ease up,,

This so hard for me like some others go thru ugg but I know if I dont I will never feel better, I dont leave my house but every 6 months for dr apps,, I have other medical issues too Diabetic, Fibro, Hashimotos, blood pressure etc

Ill go look at paperwork now
again thank you so much

I found my paperwork first for home study its for 2 nights because 1st night was only 2 hr 42 mins so did a 2nd night and its for 5 hrs 28 mins

Lots of grafts but what do I need to look at?? event summary? oxygen saturation information?

Can you tell me what is important on paperwork please? oops in my paperwork its only the home sleep study NOT the titration test where I had to go in and sleep with a machine, I need to ask the dr for it.. need that right?

For settings look for something that says "recommendations" or "diagnosis" or "summary".
They will usually make some sort of brief statement about what was done and recommendations.
The one recommendation that always got me "avoid driving while sleepy"

For settings look for something that says "recommendations" or "diagnosis" or "summary".
They will usually make some sort of brief statement about what was done and recommendations.
The one recommendation that always got me "avoid driving while sleepy"


I think she only gave me the home study test,,,, not the one I had to go in and use a mask,,, I need that one?

whats better Auto pap or Bipap?