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I have read conflicting information regarding Medicare payments for a new APAP. My machine is less than 5 years old, but was bought buy my older insurance, not Medicare. I was told that Medicare will pay for the machine if I have notes and prescription from sleep doctor within the past year (which I do have). I am on my DME’s wait list for a new machine.

Another question - If can’t get it through Medicare and buy “out of pocket” online, how (who) will set up the Bluetooth for compliance monitoring ?

zaban3 wrote: ↑

Fri Aug 20, 2021 8:23 am

If can’t get it through Medicare and buy “out of pocket” online, how (who) will set up the Bluetooth for compliance monitoring ?

Compliance monitoring is via cellular data transmission not BlueTooth for one thing.
If you buy your own machine with your own dollars then there really isn't going to be needed any cellular transmission compliance watching.
Compliance hours of use monitoring is mainly so that Medicare knows you are using the machine they are paying for. If they didn't pay for it...doesn't matter...they don't care because their dollars aren't wasted.

Now there may be some additional requirements to get masks and other supplies paid by Medicare but there are ways to take care of that need as well....
Example: If you buy a ResMed machine yourself with your own money but do wish to now have Medicare pay for masks, etc since this is first time you are using Medicare. You may need to still provide evidence of usage or other documents needed to satisfy Medicare's requirements so that they pay for masks.
That can be done the old fashioned way with just the SD card...or you could set up a MyAir website account yourself with the serial number off your machine and then YOU give the serial number to the DME/doctor so they can then access the AirView website portal and monitor your usage. It's all done with serial number registration. You can start it yourself if you wish.
Or you can take a copy of your SD card to the DME/doctor and tell them to get the data the old fashioned way.

Thanks for the response. I have been getting masks and supplies through Medicare so I should be okay with that.

zaban3 wrote: ↑

Fri Aug 20, 2021 9:30 am

I have been getting masks and supplies through Medicare

Then you should get a new machine through Medicare. A good DME can file the proper paperwork for you. You paid taxes, use the benefits.

zaban3 wrote: ↑

Fri Aug 20, 2021 9:30 am

Thanks for the response. I have been getting masks and supplies through Medicare so I should be okay with that.

In that case nothing will really change if you elect to purchase a machine out of pocket on your own.
I have Medicare and in my 12 plus years on cpap Medicare has never purchased a machine for me...but I still use Medicare for mask purchases if I see something I want to try and don't want to pay for it myself in terms of masks.
I have also let Medicare buy me a new water chamber and heated hose. So you can still get other supplies as well if needed.

If you want to set up your own MyAir (assuming you buy a ResMed) account and then allow the DME/doctor access to that account by providing the machine's serial number then that is up to you...but it isn't a requirement for Medicare compliance in terms of proving use of the machine so that medicare will pay for the machine because medicare isn't paying for the machine in the first place...you are.

Now you can also buy your own machine right now if you wish and also go through the steps needed for Medicare to buy you a machine and then you can delegate the machine you purchased to back up machine status.
If you do that then the DME will take care of registering the machine with AirView and setting up for remote compliance monitoring...or the SD card could be used if you are in an area without good cellular service.
Whether you do that or not depends on you and what your co pay might be for the machine. If you have a medicare supplement...it will pay your 20 % copay for you and ultimate cost to you might be just the annual part B deductible.

Word of warning ....if you happen to have a Medicare advantage plan of some sort you need to review the policy closely as to how they handle cpap machines. A lot of advantage plans have gone to a perpetual rental of cpap machines...the 13 month capped rental doesn't apply and you would have to pay the 20% co pay essentially forever unless they change how they pay for cpap machines. So make sure you understand how the advantage plan pays for cpap machines if that is what you have for medicare.

kbh209 wrote: ↑

Sat Aug 14, 2021 11:33 pm

https://www.philips.com/c-dam/b2bhc/mas ... QwOC42MA..

An update from Philips in regards to the Bacteria Filter usage for CPAP and BiPap machines

Thank you for the updated information.

Given the recent update from Philips and the inaction we have seen since the initial recall notification in June, here is what I think:

If you have Medicare, then you likely have some options to get a new machine.

If you are not on Medicare, then you are essentially out of luck. No one who needs cpap therapy will wait 2 months, let alone 12 months. It's everyone for themselves.

In early July, I gave up waiting and purchased the ResMed Airsense 10 and have moved on. Will never deal with Philips again... except to perhaps to join in the upcoming class action lawsuit (because you know that is bound to happen).

I talked to my doctor and told him I purchased a new CPAP machine - and his reply was "good". He knew waiting around wasn't going to solve things.

I have similar circumstances. Medicare did not pay for my 3.5 y/o machine, and they are paying for my supplies.

I provided the info you mentioned to my DME and picked up my new Resmed Airsense yesterday.

I suspect you will be picking up your new machine as soon as your DME gets it in. Based on my experience, you should have no problem with Medicare.

zaban3 wrote: ↑

Fri Aug 20, 2021 8:23 am

I have read conflicting information regarding Medicare payments for a new APAP. My machine is less than 5 years old, but was bought buy my older insurance, not Medicare. I was told that Medicare will pay for the machine if I have notes and prescription from sleep doctor within the past year (which I do have). I am on my DME’s wait list for a new machine.

Another question - If can’t get it through Medicare and buy “out of pocket” online, how (who) will set up the Bluetooth for compliance monitoring ?

I have been shopping online for a backup device due to the Phillips Respironic recall. I see that several online dealers are advertising the DreamStation 2 for sale. I haven’t seen, however, where any of these dealers have the new machine available for immediate delivery.

I am going to be totally out raged if I find that Phillips is putting the new devices out for sale before those devices are provided as replacements for the recalled machines. Has anyone heard whether the new machines are going to be on the market for sale before all recalled machines are repaired or replaced?

Steptoe wrote: ↑

Sat Aug 21, 2021 2:27 pm

I have been shopping online for a backup device due to the Phillips Respironic recall. I see that several online dealers are advertising the DreamStation 2 for sale. I haven’t seen, however, where any of these dealers have the new machine available for immediate delivery.

I am going to be totally out raged if I find that Phillips is putting the new devices out for sale before those devices are provided as replacements for the recalled machines. Has anyone heard whether the new machines are going to be on the market for sale before all recalled machines are repaired or replaced?

You don't want a DS2 anyway, they're all bricks, no data.

Steptoe wrote: ↑

Sat Aug 21, 2021 2:27 pm

I have been shopping online for a backup device due to the Phillips Respironic recall. I see that several online dealers are advertising the DreamStation 2 for sale. I haven’t seen, however, where any of these dealers have the new machine available for immediate delivery.

I am going to be totally out raged if I find that Phillips is putting the new devices out for sale before those devices are provided as replacements for the recalled machines. Has anyone heard whether the new machines are going to be on the market for sale before all recalled machines are repaired or replaced?

I would not be waiting on Philips to make you whole again. You mentioned a "backup" machine, but by all appearances, everyone should be looking for a new primary machine. If the reports of over 4 million+ machines being part of this recall... does anyone really expect to receive a replacement machine from Philips. Pull out your calculator and you will see that is a billion dollar+ cost to do that. You may instead receive some kind of repair option from Philips - but I can't trust them and have moved on.

A replacement DS2 would be ok with me, data or no data.

Don't care that the DS2 doesn't have data available as I seldom have the need to use OSCAR with my DS1. The real non-starter for me with the DS2 is the design with the hose that comes out front, the access to the pull off water tank in the rear, and info screen on top. All this would make it difficult to setup on my already crowded small nightstand. Make it sleek and pretty, but forget about the ergonomics for the user.

boudin99 wrote: ↑

Sat Aug 21, 2021 9:26 pm

If the reports of over 4 million+ machines being part of this recall... does anyone really expect to receive a replacement machine from Philips.

You might be surprised. Early reports said not many are registering for the recall.

Grumpy48 wrote: ↑

Sun Aug 22, 2021 8:27 am

but forget about the ergonomics for the user.

They've never cared about the end user, obviously.