Venting about replacing 6YO PR machine!!

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kwikwater
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Venting about replacing 6YO PR machine!!

Post by kwikwater » Thu Oct 07, 2021 11:26 am

I live in the sticks. Most patients in my hometown are commonly forced to go 50 or 90 miles if they have troubles with their machines, regardless of their DME. I use a DME affiliated with RoTech that is 55 miles away. I have a 6 year old Phillips that has been registered with their recall. I would like to get a replacement, since the machine is 6 years old and my DME has no loaner or replacement machines, should mine die. As a Medicare patient, I can't go out and buy one on the market and be reimbursed, minus a bigger co-pay, like with my old insurance. Today I'm told they were ready to put me in their queue for a ResMed Airsense, but they can't since I'm on the PR recall list. FRUSTRATED!!! If my machine dies, I'm high & dry. Not a good feeling. Anyone have any suggestions??!! Thanks for listening to my VENTING. This is the only place that understands. The medical/DME world sure doesn't!!

Scott_G
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Re: Venting about replacing 6YO PR machine!!

Post by Scott_G » Thu Oct 07, 2021 12:12 pm

My advice would be to get an appointment with your sleep doc, and ask him/her to write a prescription for a new machine. The DME will react to that prescription by ordering you a new machine as specified by the prescription.

Beware, Medicare will then approve a "90 day trial" rental, and you'll be required to see the doc again (in person) within 90 days to "prove compliance". Assuming you're compliant, Medicare will then extend the rental another 10 months after which the machine will be "owned" by you. Also beware you will be subject to standard Medicare deductible and copays for the rental fees and the two doctor visits, and any "upfront" charge the DME makes (e.g., DMEs typically bill the "humidifier" as a purchase at beginning of rental, even when the humidifier is integrated in the machine - and Medicare allows them to do that.)

In the meantime, it is unlikely your Philips machine will "die". My Philips was 9 years old when the recall was announced -- and had over 27,000 hours on it, still working fine. I inspected it carefully for any signs of the foam disintegration problem (i.e., black specs in water reservoir, tube, or mask) and found nothing. So I kept using it -- but also scheduled an appointment, went to my sleep doc, and now have a shiny new Airsense 11. :-)
Resmed Airsense 11 Autoset
Resmed ClimatelineAir-11 Tube
Resmed P30i Mask

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ChicagoGranny
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Re: Venting about replacing 6YO PR machine!!

Post by ChicagoGranny » Thu Oct 07, 2021 1:27 pm

kwikwater wrote:
Thu Oct 07, 2021 11:26 am
Anyone have any suggestions??!!
Pray your machine doesn't die. There is a very good chance it won't.

Your replacement machine will probably come more quickly than you are thinking.

Keep your old machine as a backup.

Going forward, see if Medicare will provide a new machine every five years. You might need a statement from your doctor that your old machine no longer serves your needs.

Some people love living in the sticks, but it does have disadvantages. I would like to have a teleportation machine and move back and forth between city and sticks as my mood changes throughout the day.

kwikwater
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Location: NW Colorado 50 miles from nowhere
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Re: Venting about replacing 6YO PR machine!!

Post by kwikwater » Fri Oct 08, 2021 9:20 pm

Today, I called to ask about the status of my supplies order from Sept 21. I was told that since I had requested a replacement machine, which they can't deliver because I'm on the PR recall list, they can't fill my order for mask supplies?? WHAT???!!!! I suggested that they drop my request of any machine recalled or not, and send me my supplies!! I only change my nasal pillows every couple months and it's been 11 months since I last ordered and now, .... I'm cut off?? Monday is a holiday, so Tuesday, I'm double checking if anything is processed! Couple all this with the fact I've never been notified of anything, until I ask. Not what I call customer service!! But too, I'm yet to see customer service since the inception, in August, 2005 with 3 different DMEs Thanks again for listening to my whining!

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chunkyfrog
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Re: Venting about replacing 6YO PR machine!!

Post by chunkyfrog » Sat Oct 09, 2021 9:21 pm

Contact your insurance company.
I suspect your DME is lying, as they often do.
On a different matter, I called my insurance from the DME office,
and straightened them out.
Resmed Airsense 10 Autoset FOR HER, p10 mask

Holocron
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Re: Venting about replacing 6YO PR machine!!

Post by Holocron » Sun Oct 10, 2021 12:03 pm

I was notified about the recall by my DME on SEPTEMBER 14. I received no notification from DME or Philips prior to that date.
Evidently it was my responsibility to watch the correct news sources that announced it. Apparently, I do not.
I tried contacting my DME multiple times after that date. Eventually, after throwing the word "malpractice" into the communications, I got a call back. This was also after requesting all my records be transferred to a new DME.

Old DME said I was "one of the few" that slipped through the cracks of their system, the system that Philips said they had to use, and the Philips system which was also supposed to notify me directly by mail. Old DME said insurance will not cover a new machine, even if one was available, said current 5+ year old machine is "reparable" by Philips.

New DME said, no problem, but you won't get a new one till we have them in stock. Sorry, can't tell you when that will happen.

Insurance said a new one should be covered.

Old DME basically said, oops, sorry, we'll let you know when we can get you a new one, good luck.

Called Philips recently to check on status, said all who registered will be informed by end of September as to status of replacement/repair. Still waiting on that.

Basically, it all sounds like a giant clusterfrack. We should all be contacting our elected representatives, attorneys general, and hounding our DME's if only to hound them. IMO.
Daily Driver (normally sans recall): Phillips SystemOne w/ Humidifier / DreamWear Nasal Cushion
Travel Unit (now currently daily driver during recall): ResMed Airmini / AirFit P10

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SleepGeek
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Re: Venting about replacing 6YO PR machine!!

Post by SleepGeek » Sun Oct 10, 2021 1:07 pm

Holocron wrote:
Sun Oct 10, 2021 12:03 pm
Old DME said - New DME said
You should name new and old to save people some trouble and time.
Why folks dont like it when you treat em the way they treat you?
If you can be anything why not choose to be kind?
AC VAuto 20/14
palerider aka GrumpyHere wrote: What exactly do you think you're adding to this thread?

Holocron
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Re: Venting about replacing 6YO PR machine!!

Post by Holocron » Mon Oct 11, 2021 5:36 am

SleepGeek wrote:
Sun Oct 10, 2021 1:07 pm
Holocron wrote:
Sun Oct 10, 2021 12:03 pm
Old DME said - New DME said
You should name new and old to save people some trouble and time.
Old DME - Minnesota Sleep Institute (their medical staff is OK, the DME department is the operation to avoid)

New DME - To early to review, but my initial experience with M Health Fairview Home Medial Equipment has been positive.
Daily Driver (normally sans recall): Phillips SystemOne w/ Humidifier / DreamWear Nasal Cushion
Travel Unit (now currently daily driver during recall): ResMed Airmini / AirFit P10