Page 2 of 3
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 6:14 am
by Sheriff Buford
SAG wrote: ↑Sat Jul 03, 2021 6:17 pm
Sheriff Buford wrote: ↑Sat Jul 03, 2021 1:17 pm
I shouldn’t have to switch masks just to satisfy Medicare.
Agreed.
Do you have a Medicare Advantage plan? Those things give Medicare a bad name as they do have way too many limitations.
No I decided to go with the Original Medicare. I've had some serious health issues lately, so I'm grateful I did. I've been going to MD Anderson in Houston, and they don't take most Advantage plans.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 7:04 am
by SAG
Sheriff Buford wrote: ↑Sun Jul 04, 2021 6:14 am
No I decided to go with the Original Medicare
Excellent choice. So Pugsy is right - Crapia is the problem. I left them for similar reasons.
Original Medicare doesn't care which mask you use or who you buy it from as long as they accept Medicare.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 9:21 am
by chunkyfrog
But, different masks have different wholesale prices.
Fitlife is more costly to stock than most.
Greed is definitely part of the equation.
A preferred provider is required to
accept Medicare allowable as full payment.
A non-preferred provider can charge extra to the patient,
but that is limited to a percentage of the Medicare allowable.
My DME is no longer "preferred", and they seem to be led by human beings.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 9:33 am
by Pugsy
As ChunkyFrog has stated....some masks cost more wholesale than others and especially true with full face masks but Medicare doesn't care.
Medicare allows X amount of dollars for all full face masks no matter what the wholesale cost.
What I suspect with DMEs who tell people that that can't or won't get so and so mask is because they aren't happy with their profit margins between what Medicare says they are allowed to receive vs what it costs wholesale.
The DME is either lazy (not wanting to special order something) or greedy (not happy with profit margin) or both.
Well all know that Crapria has earned their nickname for being both.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 11:04 am
by SAG
And if it hasn't been mentioned Never Ever give them or any DME your credit card number. Find another way to pay if there is a balance.
A Pre-Paid Debit/Credit card comes to mind. I know Walmart has one called Bluebird that has no fees. Let's face it there is a Walmart almost every where so you can deposit money on it when/if needed. Also good for internet shopping.
Last go around w Crapria I refused to give them one letting them know if they billed it correctly my co-pay would pick up any remainder.
Just DON'T Do It!
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 11:35 am
by zonker
Sheriff Buford wrote: ↑Sun Jul 04, 2021 6:09 am
It's a special trick getting the handcuffs off by yourself! The wife will leave them on....
don't you have a safe word?
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 2:24 pm
by Okie bipap
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 4:37 pm
by chunkyfrog
"You're right, dear." would be enough for me.
Sadly, I have yet to hear it.
The bullfrog is one ornery, stubborn hopper.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 6:40 pm
by Okie bipap
I can be very stubborn at times, but it didn't take me very long to learn that my life runs much smoother when the wife is happy.
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 10:19 pm
by Popozeto
Are they reliable? My current Dme only resupplies every 3 months wtf?
Re: Need DME Recommendation
Posted: Sun Jul 04, 2021 11:30 pm
by chunkyfrog
Popozeto wrote: ↑Sun Jul 04, 2021 10:19 pm
. . .
My current Dme only resupplies every 3 months wtf?
Monthly supply vs 90 day interval.
Way more paperwork for the same money.
Can't blame them. Not a big fan of paperwork.
Re: Need DME Recommendation
Posted: Mon Jul 05, 2021 5:48 am
by Pugsy
Popozeto wrote: ↑Sun Jul 04, 2021 10:19 pm
My current Dme only resupplies every 3 months
Some supplies are only allowed a 3 month replacement schedule.
So exactly what supplies are you getting every 3 months you want at a different schedule?
Does your insurance even allow a different schedule for what you are wanting?
What schedule are you wanting?
What insurance do you have?
Re: Need DME Recommendation
Posted: Mon Jul 05, 2021 8:56 pm
by Popozeto
Pugsy wrote: ↑Mon Jul 05, 2021 5:48 am
Popozeto wrote: ↑Sun Jul 04, 2021 10:19 pm
My current Dme only resupplies every 3 months
Some supplies are only allowed a 3 month replacement schedule.
So exactly what supplies are you getting every 3 months you want at a different schedule?
Does your insurance even allow a different schedule for what you are wanting?
What schedule are you wanting?
What insurance do you have?
Actually is every 6 month and they do not mail anything anymore. So the 3 months resupply I get every 6 months like the cushion and filters for the machine.
Re: Need DME Recommendation
Posted: Mon Jul 05, 2021 9:34 pm
by Pugsy
Popozeto wrote: ↑Mon Jul 05, 2021 8:56 pm
Pugsy wrote: ↑Mon Jul 05, 2021 5:48 am
Popozeto wrote: ↑Sun Jul 04, 2021 10:19 pm
My current Dme only resupplies every 3 months
Some supplies are only allowed a 3 month replacement schedule.
So exactly what supplies are you getting every 3 months you want at a different schedule?
Does your insurance even allow a different schedule for what you are wanting?
What schedule are you wanting?
What insurance do you have?
Actually is every 6 month and they do not mail anything anymore. So the 3 months resupply I get every 6 months like the cushion and filters for the machine.
So have you checked directly with your insurance as to exactly what their replacement schedule is and what they allow???
While most insurance companies will follow Medicare replacement allowance schedules...not all do.
I knew a person whose insurance only allowed 2 nasal pillows per year...one every 6 months.
Not all insurance plans are equal even among the same insurance company.
If you aren't happy with your DME....you can change. Just contact your insurance company to get a list of any DMEs in your area that they have in the insurance network for optimal reimbursement and start calling them up and decide who seems best to work with and you feel good about.
If you find out it doesn't work out so great...guess what...you can always change again.
The online suppliers mentioned here in this thread as people having a good experience with may or may not be in network with your insurance company and even if they supply the best service in the world it doesn't help if they are not in your network.
I ran into that problem with my wanting the Bleep and finding an online supplier who would do it and file my insurance...which happens to be out of network so does me no good that they are good since I can't use them if I want insurance (that I pay for) to pick up their share. My local DME who used to have all my replacement business until I switched to the Bleep...I haven't ordered so much as a filter from them in nearly 3 years because they didn't want to supply the Bleep to me and told me a whole bunch of lies as to why they couldn't.
Don't miss the filters much anyway....my co pay for one filter was around 2 bucks and I can buy in bulk and get 40 filters for 12 bucks...or my cost for 6 filters if I went through the DME. I save money buying my own filters and I don't have to deal with people who don't want my mask business.
Re: Need DME Recommendation
Posted: Mon Jul 05, 2021 9:43 pm
by Popozeto
Pugsy wrote: ↑Mon Jul 05, 2021 9:34 pm
Popozeto wrote: ↑Mon Jul 05, 2021 8:56 pm
Pugsy wrote: ↑Mon Jul 05, 2021 5:48 am
Popozeto wrote: ↑Sun Jul 04, 2021 10:19 pm
My current Dme only resupplies every 3 months
Some supplies are only allowed a 3 month replacement schedule.
So exactly what supplies are you getting every 3 months you want at a different schedule?
Does your insurance even allow a different schedule for what you are wanting?
What schedule are you wanting?
What insurance do you have?
Actually is every 6 month and they do not mail anything anymore. So the 3 months resupply I get every 6 months like the cushion and filters for the machine.
So have you checked directly with your insurance as to exactly what their replacement schedule is and what they allow???
While most insurance companies will follow Medicare replacement allowance schedules...not all do.
I knew a person whose insurance only allowed 2 nasal pillows per year...one every 6 months.
Not all insurance plans are equal even among the same insurance company.
If you aren't happy with your DME....you can change. Just contact your insurance company to get a list of any DMEs in your area that they have in the insurance network for optimal reimbursement and start calling them up and decide who seems best to work with and you feel good about.
If you find out it doesn't work out so great...guess what...you can always change again.
The online suppliers mentioned here in this thread as people having a good experience with may or may not be in network with your insurance company and even if they supply the best service in the world it doesn't help if they are not in your network.
I ran into that problem with my wanting the Bleep and finding an online supplier who would do it and file my insurance...which happens to be out of network so does me no good that they are good since I can't use them if I want insurance (that I pay for) to pick up their share. My local DME who used to have all my replacement business until I switched to the Bleep...I haven't ordered so much as a filter from them in nearly 3 years because they didn't want to supply the Bleep to me and told me a whole bunch of lies as to why they couldn't.
Don't miss the filters much anyway....my co pay for one filter was around 2 bucks and I can buy in bulk and get 40 filters for 12 bucks...or my cost for 6 filters if I went through the DME. I save money buying my own filters and I don't have to deal with people who don't want my mask business.
I forgot to add I have United Health thru medicare.