Use insurance or not??

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
YoungMom00
Posts: 1
Joined: Thu Jan 23, 2020 7:33 pm

Use insurance or not??

Post by YoungMom00 » Thu Jan 23, 2020 7:43 pm

Hello. I have been using a CPAP to control apnea for over 20 years. I've had 4 sleep studies over the years to confirm that yes, I STILL have it! :o :? So a year ago my CPAP broke. I called Aetna to see about getting a new one, and I was told that I had to go to a pulmonologist for $85 then have another sleep study for $ 800. I couldn't do it so I have been using a family member's old CPAP machine. I'm still not sleeping 100% so I am guessing that the settings are incorrect. So now it's 2020 & I have put aside $ 900 into my flexible spending account, intending to go do the sleep study & buy a new machine. My deductible is $ 2,000, so I am thinking that I should just buy a APAP in cash instead of using the insurance. Does anyone have any thoughts or advice? Thank you in advance!

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zonker
Posts: 11451
Joined: Fri Jun 19, 2015 4:36 pm

Re: Use insurance or not??

Post by zonker » Thu Jan 23, 2020 8:24 pm

YoungMom00 wrote:
Thu Jan 23, 2020 7:43 pm
Hello. I have been using a CPAP to control apnea for over 20 years.
welcome to the zoo! there is absolutely no problem doing what you want to do. and you will get a LOT of support from this forum to help you. avoiding insurance will save you lots of hassles.

IF you have the money to just buy out of pocket for the machine, one option for you would be to forgo the sleep study altogether and buy a used cpap machine. forum member lsat has used machines here frequently. no, i'm not a shill for him! :lol: but users here have purchased from him (while i have not) and they seem rather pleased with the price and performance of what he sells.

he has sold before the same machine i use, the Resmed Airsense 10 for her cpap machine. This is a very good machine that i have every faith in. lsat sells these used with very low hours. you may want to pm him to see if he has anything to hand.

there are other outlets for used machines as well. the reason i'm talking used is that, unlike new machines, you can get these without a prescription. may not be true from every where, but certainly any peer to peer transaction.

good luck!
"Age is not an accomplishment and youth is not a sin"-Robert A. Heinlein
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Okie bipap
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Joined: Thu Oct 15, 2015 4:14 pm
Location: Central Oklahoma

Re: Use insurance or not??

Post by Okie bipap » Thu Jan 23, 2020 8:30 pm

Where are you located? Are you located in the US? If so, simply ask your doctor to write you a prescription for a new, auto CPAP machine. Then take the money you have set aside and purchase a new ResMed Auto For Her from cpap.com. Once you have the machine, the people here on the forum will help you get your settings adjusted. I you are here in the US, you can find lightly used machines on your local Craig's List or Facebook Marketplace. I found a ResMed Air Curve 10 VAUTO on marketplace for $220 and it had less than 110 hours on it. You can also find machines for sale here on the forum. Forum member lsat often sells lightly used machines for very reasonable prices.

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palerider
Posts: 32299
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Use insurance or not??

Post by palerider » Thu Jan 23, 2020 8:35 pm

YoungMom00 wrote:
Thu Jan 23, 2020 7:43 pm
Hello. I have been using a CPAP to control apnea for over 20 years. I've had 4 sleep studies over the years to confirm that yes, I STILL have it! :o :? So a year ago my CPAP broke. I called Aetna to see about getting a new one, and I was told that I had to go to a pulmonologist for $85 then have another sleep study for $ 800. I couldn't do it so I have been using a family member's old CPAP machine. I'm still not sleeping 100% so I am guessing that the settings are incorrect. So now it's 2020 & I have put aside $ 900 into my flexible spending account, intending to go do the sleep study & buy a new machine. My deductible is $ 2,000, so I am thinking that I should just buy a APAP in cash instead of using the insurance. Does anyone have any thoughts or advice? Thank you in advance!
Screw the sleep study, just get the apap, and learn how to read the data and set it yourself.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Miss Emerita
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Joined: Sun Nov 04, 2018 8:07 pm

Re: Use insurance or not??

Post by Miss Emerita » Thu Jan 23, 2020 9:58 pm

How do you usually get supplies (mask, filters, etc)? If you will now be getting them on line and out of pocket, it’s a lot simpler if you have a prescription for at least the supplies so you can scan and upload it to vendors like cpap.com. They will ask you for one before selling you certain items.

But why not also get a prescription that covers the machine too? As Okie bipap points out, your regular doctor can write one for you.

I got my machine used from LSAT, by the way, and everything went exactly right.
Oscar software is available at https://www.sleepfiles.com/OSCAR/