Cannot sleep and 90 days

Is it true the four hours daily applies for only 90 days and then you can use anytime? I cannot sleep at all, so I use it when I am awake. Do I get a benefit from that, or is it rendered useless?

You should be using your machine any time you sleep. The "four hour rule" is in the Medicare requirements. Before Medicare will pay for more than 90 usage on a machine, you have to prove you have used the machine for at least 4 hours for 70% of the days in a 30 day period. Once your doctor or DME certifies that you have met this requirement, Medicare will then pay for 80% of the rental fee for the remainder of the 13 month period. After this, your doctor or the DME must verify you are still using the machine and it is adequately treating your sleep apnea in order for Medicare to continue to pay for your supplies. Many insurance companies follow the same guide lines as Medicare does. Medicare guide lines say this certification should be within 12 months of when you order supplies.

Are you not sleeping due to insomnia or something about using Cpap? We could help if you give us a hint (also, what model of which machine you're using, the pressure settings, what mask, etc. etc.

gailfonda wrote: ↑

Wed Aug 14, 2019 4:27 pm

Is it true the four hours daily applies for only 90 days and then you can use anytime? I cannot sleep at all, so I use it when I am awake. Do I get a benefit from that, or is it rendered useless?

*TOTALLY* useless. either start using it properly, or give it back.