CPAPtalk.com

aStuff wrote: ↑

Tue Oct 04, 2022 1:30 pm

Ask for a home sleep study as it should be much cheaper. My insurance did deny mine stating sleep center would be appropriate as I also have a history of central apneas.

Thanks!

vze2363v wrote: ↑

Tue Oct 04, 2022 1:19 pm

I don't know what to do about mine. They only offered me $25 for my unit (System One, 50 Series). I can't get a prescription for a new machine without a new sleep test and my insurance doesn't cover everything I need for a new sleep test. My options in my area are horrific and I'd have to rent a car to get to a half decent place to get a sleep study done. In addition, I don't even know if I can get the study done at that facility any more since Florida Blue refused to renew the contract for any BayCare doctors or facilities. $25 is an insult quite frankly. I have tried very hard not to use my machine since I got the notice, but there are some nights where my breathing is so bad I have to use it anyhow. I'm on Medicare and the HMOs available under Medicare health policies have such cheap, hideous equipment providers I'm told the machines they would give me wouldn't work very well as I'm one of those people who has different pressure levels for breathing in and out.

Has anyone else faced these obstacles and figured out a way to navigate them successfully? I'm still trying to find a new health insurance provider since the only doctor that's really understood my health issues was part of the BayCare system so I need to change my health insurance ASAP. Thanks for any advice you can offer.

A year and a half ago I asked my family physician for a CPAP prescription. He asked if I wanted a referral to the sleep center. I told him I wouldn't go to the sleep center if I had a referral because they don't even look at my CPAP data if I do bring it in. I know how to set and adjust my CPAP and read my historical data so the sleep center is just a waste of time and money. So he wrote a prescription for a cpap, printed it out and handed it to me. The only thing he asked was what pressure was my current CPAP.

Might be worth a try! The worst your primary physician can say is no.

P.S. I have been using my System One Series 60 every night since the recall came out. I ordered a bunch of the inline HEPPA filters and use them to make sure no particles are making it through to my lungs. I just ordered a AirSense 10 Auto last Friday. I did not receive an email notice so I used the link I found on this board to select stay in the queue for a new CPAP for both of my System One's.

My script is 6 years old and my Insurance rules require I get a new sleep study for insurance to cover a machine & supplies. I however don't care about Insurance and pay for my own.
Last I read Cpap scripts are good for 8 years in general and your doctor can write it for 99 months or even lifetime. Has this changed? I have been able to order online with my script without issue so far.
My Primary care doctor however signed a new script for me after talking with her and explaining I currently use Apap, the Philips recall situation. I showed her my 6 year old script and asked for a updated one just in case.

Oughtsix wrote: ↑

Tue Oct 04, 2022 11:27 pm

A year and a half ago I asked my family physician for a CPAP prescription. He asked if I wanted a referral to the sleep center. I told him I wouldn't go to the sleep center if I had a referral because they don't even look at my CPAP data if I do bring it in. I know how to set and adjust my CPAP and read my historical data so the sleep center is just a waste of time and money. So he wrote a prescription for a cpap, printed it out and handed it to me. The only thing he asked was what pressure was my current CPAP.

Might be worth a try! The worst your primary physician can say is no.

Thank you for your response. I was looking at the user guide for the Resmed AirSense 10 Series and was wondering which one would apply to me as there are several models available. The pulmonary doctor I used to go to died since I've seen him last (five or so years ago). I don't like to go to that office because I have panic attack problems and the people in the reception area were not very kind then and apparently still aren't. Since my panic attacks bring on severe asthma attacks I try not to go there at all. You wouldn't think it would be so hard to find a decent pulmonary doctor, but the ratings in my area are NOT good.

P.S. I have been using my System One Series 60 every night since the recall came out. I ordered a bunch of the inline HEPPA filters and use them to make sure no particles are making it through to my lungs. I just ordered a AirSense 10 Auto last Friday. I did not receive an email notice so I used the link I found on this board to select stay in the queue for a new CPAP for both of my System One's.

I'm going to call the Phillips phone number that was in the e-mail (877-907-7508) to let them know I want to be on the replacement list. I don't know how long this trying to get a prescription is going to play out before I can get my hands on one. I had asked my primary care physician for a respiratory referral, but got the flu a few days before my appointment so I had to cancel it. I'm going to have to focus on finding the new insurance first so I COULD ask my primary doctor to just write me a script based on my current prescription. The last time I shared my SD card file with someone from this community they said it looked like the settings were still correct based on the data. I just need to find out how to adjust for a filter.

I had COVID back in March of 2020. It turned into long-haul COVID. I used my machine during that time and after I cleared the original testing positive for it part, every time I used my machine I'd have respiratory problems. I tried to put a filter on it, but then I wasn't getting enough air. I have problems with allergies and my sinuses constantly being so swollen I can barely breathe. Using my Bi-PAP machine every night used to help with that. If I knew how to adjust the air flow correctly, I suppose I could have just gone with the filter, but then I worried I'd be screwing up my lungs worse than they already were by not knowing how to adjust it. The sad truth is I get better information from this forum than the people that are actual professionals.

If I knew what model of the AirSense 10 would be best for my central sleep apnea, I could try to order it with Assure financing it. I need a new machine I can actually plug into my UPS systems as I live in Florida (was told that was a no-no for my System One). Human interaction and the constant thunderstorms in the summer (which seem to be more violent this year) tend to mess with the fact I don't have a regulated sleep time of day (i.e. the need for electrical backup).

Thank you for all of the information you've given me (as well as everyone else who shared their experiences). As soon as I get my health insurance provider figured out, I'll forge ahead with getting a prescription.

jtravel wrote: ↑

Wed Oct 05, 2022 4:41 am

My script is 6 years old and my Insurance rules require I get a new sleep study for insurance to cover a machine & supplies.

I've never seen a health insurance policy that routinely requires a new sleep study. They may require a renewed prescription and proof of compliance.

Think about it. Sleep apnea rarely goes away. Insurance companies don't want to pay for additional sleep studies and a new machine.

vze2363v wrote: ↑

Wed Oct 05, 2022 4:02 pm

If I knew what model of the AirSense 10 would be best for my central sleep apnea, I could try to order it with Assure financing it.

Start a new thread. Describe your diagnosis. State the exact model machine you are using and the pressure settings. Ask which ResMed model would give the same or better therapy. Title your thread: Need Help with Machine for Central Apnea.

vze2363v wrote: ↑

Wed Oct 05, 2022 4:02 pm

If I knew how to adjust the air flow correctly, I suppose I could have just gone with the filter, but then I worried I'd be screwing up my lungs worse than they already were by not knowing how to adjust it.

If you add an in-line bacteria filter to a Respironics machine, there are no adjustments to the machine settings necessary.

ChicagoGranny wrote: ↑

Wed Oct 05, 2022 4:57 pm

If you add an in-line bacteria filter to a Respironics machine, there are no adjustments to the machine settings necessary.

This is good to know! I bought the inline filters because I didn't have an extra grand to shell out for a new machine at the time and didn't want to inhale deteriorating foam. I only get a week out of a filter, more than that and the moisture in the CPAP air stream starts growing mold on the filter media... YUCK! I probably won't continue to use the filters when I get my AirSense 10.

ChicagoGranny wrote: ↑

Wed Oct 05, 2022 4:57 pm

vze2363v wrote: ↑Wed Oct 05, 2022 4:02 pm
If I knew what model of the AirSense 10 would be best for my central sleep apnea, I could try to order it with Assure financing it.

As a CPAP patient with ABSOLUTELY NO MEDICAL TRAINING... I would suggest looking at the AirSense 10 Auto that CPAP.com has on sale right now for $599 with a free mask if you use the BOGO2020 coupon code. Unless you currently have a BiPAP the AirSense 10 Auto should be all you need for a CPAP. If a doctor asks where you got the CPAP machine version recommendation from PLEASE tell them that you got it from the Internet... they always love to hear that!

I also just received the self-serving E from Phillips offering me a whopping $50 for my System One ASV. Or, after more than a year waiting, I NOW must provide a prescription to even stay in line??

I wish them all to try to stay alive in small-town America where the three "sleep specialists" are 1) arrogant and misogynistic, 2) arrogant and misogynistic and 3) too dumb to have a conversation with. None of them was able to set me up with a proper machine or determine effective settings.

I only have an appropriate machine and workable settings because of the super-helpful, super-knowledgeable people here on cpaptalk.

I despise these worthless, corrupt corporations.

UPDATE: I'm filing a complaint with the Arizona Attorney General's office. Yeah, I know it's a waste of time. But it will be one more annoyance for Philips R.

RubySnooze wrote: ↑

Wed Oct 05, 2022 5:29 pm

I also just received the self-serving E from Phillips offering me a whopping $50 for my System One ASV. Or, after more than a year waiting, I NOW must provide a prescription to even stay in line??

I wish them all to try to stay alive in small-town America where the three "sleep specialists" are 1) arrogant and misogynistic, 2) arrogant and misogynistic and 3) too dumb to have a conversation with. None of them was able to set me up with a proper machine or determine effective settings.

I feel your pain! I gave up on the sleep doctors 20 years ago. They don't even know how to download the data to see if your CPAP is effective or needs adjustments. The whole sleep doctor / sleep clinic is just a money making scam in my eyes.

RubySnooze wrote: ↑

Wed Oct 05, 2022 5:29 pm

I only have an appropriate machine and workable settings because of the super-helpful, super-knowledgeable people here on cpaptalk.

Same here!

RubySnooze wrote: ↑

Wed Oct 05, 2022 5:29 pm

I despise these worthless, corrupt corporations.

UPDATE: I'm filing a complaint with the Arizona Attorney General's office. Yeah, I know it's a waste of time. But it will be one more annoyance for Philips R.

LOL! I filed a complaint with the FCC about my DSL internet service that constantly went down... Guess what... the FCC pulled through for me and sent the phone company a "letter of inquiry" which moved their bottoms to actually fix the issue after several years of service problems (they replaced the line between the street and my house on their dime)! I was absolutely SHOCKED!!!!

P.S. My states Attorney General and the FCC BOTH have online forms for submitting complaints so it was actually quite easy to do so! Maybe we should start a campaign to all submit complaints about Philips! They are putting the public's health in danger.

ChicagoGranny wrote: ↑

Wed Oct 05, 2022 4:45 pm

jtravel wrote: ↑

Wed Oct 05, 2022 4:41 am

My script is 6 years old and my Insurance rules require I get a new sleep study for insurance to cover a machine & supplies.

I've never seen a health insurance policy that routinely requires a new sleep study. They may require a renewed prescription and proof of compliance.

Think about it. Sleep apnea rarely goes away. Insurance companies don't want to pay for additional sleep studies and a new machine.

Maybe it is the DME provider? The last two times (different insurance companies) I was told a sleep study was required before getting a new machine.

aStuff wrote: ↑

Wed Oct 05, 2022 6:08 pm

Maybe it is the DME provider?

Yup, DMEs are known for misinformation and flat-out lies.

ChicagoGranny wrote: ↑

Wed Oct 05, 2022 4:45 pm

jtravel wrote: ↑

Wed Oct 05, 2022 4:41 am

My script is 6 years old and my Insurance rules require I get a new sleep study for insurance to cover a machine & supplies.

I've never seen a health insurance policy that routinely requires a new sleep study. They may require a renewed prescription and proof of compliance.

Think about it. Sleep apnea rarely goes away. Insurance companies don't want to pay for additional sleep studies and a new machine.

Thanks for bringing this up. I was thinking about this as I have been reading along.

It makes no sense imo to punish someone with managed apnea by forcing them to not use their cpap for a sleep study that won’t likely show someone magically cured of sleep apnea.

just my thoughts

ChicagoGranny wrote: ↑

Wed Oct 05, 2022 4:45 pm

jtravel wrote: ↑

Wed Oct 05, 2022 4:41 am

My script is 6 years old and my Insurance rules require I get a new sleep study for insurance to cover a machine & supplies.

I've never seen a health insurance policy that routinely requires a new sleep study. They may require a renewed prescription and proof of compliance.
Think about it. Sleep apnea rarely goes away. Insurance companies don't want to pay for additional sleep studies and a new machine.

Not routine, Different Insurance providers is my issue. When I started Cpap I had Cigna and they dragged their feet with lots of hoops to jump thru. When almost completed my insurance switched to UMR and a whole new Deductible was required and following their process. I purchased the System one 60 from Cpap.com for $325 without Insurance. I have Blue cross & blue shield now and need to start from scratch with them if I want insurance to cover a new machine.

When my girlfriend went on Medicare, they insisted on a new sleep study before they would spring for a new bipap.


I got the Phillips email as well. "Therefore, we are offering financial payments to patients of $50 per System One, 60 Series device returned to us."

This sounds like very cheap product liability insurance for them, you hand over the physical evidence you would need to prove in court you got lung cancer or COPD from their machine, and you get $50 in return. Ridiculous.

My prescription was from an old primary that I stopped seeing due to the poor service at that clinic, if he's still even there. Frankly I am not sure I would even want a new Philips machine. Thought I saw a thread here that even the new ones are putting out foam particles for some people?

jtravel wrote: ↑

Thu Oct 06, 2022 6:00 am

need to start from scratch with them if I want insurance to cover a new machine.

If by "start from scratch" you mean undergo another sleep study, I'm skeptical. Even Medicare doesn't require another sleep study if you had one before enrolling in Medicare.

Are you sure you understand BCBS correctly? Have you called and spoken to a supervisor? Have you told them you can have a copy of your sleep study sent to them?