Don't need to be in compliance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
Posts: 65128
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Don't need to be in compliance

Post by Pugsy » Thu Jul 26, 2018 9:52 am

DME prices are almost always going to be higher than online prices and your insurance will allow it.
Remember you are also getting a "service" and more hands on (hopefully) help from a brick and mortar DME than you get from an online retailer.

And that was Medicare which is usually the cheapest for what they allow...most insurance will allow more but it can and will vary with various insurance plans. So best thing is to call up your insurance and ask them what they allow.
You will likely need to be able to tell them the HCPCS billing code though. Most insurance don't care about brand and model...just the HCPCS billing code.

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Bigtonguehypopnea
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Re: Don't need to be in compliance

Post by Bigtonguehypopnea » Sun Jul 29, 2018 4:05 am

I think my rent-to-own price was over $100 per month.

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LSAT
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Location: SE Wisconsin

Re: Don't need to be in compliance

Post by LSAT » Sun Jul 29, 2018 10:23 am

My last machine in 2014 cost me 12.57 per month from Medicare advantage plan. That's $150.84 for 12 months @ 20% co-pay. That means the DME got paid $754.20 for my S9 Autoset.

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Pugsy
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Location: Missouri, USA

Re: Don't need to be in compliance

Post by Pugsy » Sun Jul 29, 2018 1:56 pm

LSAT wrote:
Sun Jul 29, 2018 10:23 am
My last machine in 2014 cost me 12.57 per month from Medicare advantage plan. That's $150.84 for 12 months @ 20% co-pay. That means the DME got paid $754.20 for my S9 Autoset.
Was the humidifier a separate purchase? It usually is with Medicare and billed out the first month as it is/was considered non returnable. People who lost machines due to non compliance were stuck with the separate humidifier. I picked up 2 off of craigslist that way for dirt cheap money.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

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LSAT
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Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: Don't need to be in compliance

Post by LSAT » Sun Jul 29, 2018 2:06 pm

Pugsy wrote:
Sun Jul 29, 2018 1:56 pm
LSAT wrote:
Sun Jul 29, 2018 10:23 am
My last machine in 2014 cost me 12.57 per month from Medicare advantage plan. That's $150.84 for 12 months @ 20% co-pay. That means the DME got paid $754.20 for my S9 Autoset.
Was the humidifier a separate purchase? It usually is with Medicare and billed out the first month as it is/was considered non returnable. People who lost machines due to non compliance were stuck with the separate humidifier. I picked up 2 off of craigslist that way for dirt cheap money.
Yes...Humidifier was paid up front. I think my 20% was about $18. I also paid the $150.84 up front so I didn't have to worry about it.

trekwars2000
Posts: 45
Joined: Fri Jul 13, 2018 9:13 pm

Re: Don't need to be in compliance

Post by trekwars2000 » Sun Jul 29, 2018 4:15 pm

LSAT wrote:
Sun Jul 29, 2018 10:23 am
My last machine in 2014 cost me 12.57 per month from Medicare advantage plan. That's $150.84 for 12 months @ 20% co-pay. That means the DME got paid $754.20 for my S9 Autoset.
Thanks, we will see if this DME ever calls me and I'll see the prices.

Glad I just bought my machine online so I could have it on Thursday. These last three nights have been awesome! I'd hate to still be waiting

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