Dreamstation and Medicare replacement Schedule

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
doubletee2cm
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Joined: Fri Dec 10, 2010 5:40 pm

Dreamstation and Medicare replacement Schedule

Post by doubletee2cm » Tue Jul 26, 2022 12:58 pm

Still haven't received my Dreamstation replacement. My affected machine will be 5 years old in May 2023 which is time for replacement under Medicare rules. Question is, if I receive my replacement machine before that date, does it start the Medicare replacement period 5 year clock again? i guess what I am asking is, is the replacement considered a new machine by Medicare? I really don't much want another Phillips product, obviously. I have been using my old Fisher & Paykel Icon in the interim which I kept as a backup luckily.

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Pugsy
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Location: Missouri, USA

Re: Dreamstation and Medicare replacement Schedule

Post by Pugsy » Tue Jul 26, 2022 1:09 pm

My understanding of the replacement machine and Medicare is that unless Medicare starts a new payment schedule then it won't even know you got a new machine if the machine you get is a replacement for the recalled machine.
Medicare isn't a party to all of this recall stuff....Respironics won't send a notice to Medicare that it sent you a new or refurbished machine. Medicare simply has no way of knowing about any machine unless it is paying for it.

Now another potential sticky wicket. Medicare no longer will just automatically pay for a new machine after 5 years...they add on another requirement being that the unit must be broken beyond repair.
Typically all that is required is the DME/supplier to just say it's broken and will cost more to repair than it is worth and that's sufficient. I would think that the foam issue and recall should qualify and make the original device no longer usable.

Regardless of the status of your replacement machine....it's worth at least trying to get another new machine right now and let Medicare pay for it....and you can request the brand and model. You aren't forced to accept another Respironics machine if you don't want one but you may have to look for a DME who will supply you with what you want.

If you don't ask the answer is always no.

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SleepGeek
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Re: Dreamstation and Medicare replacement Schedule

Post by SleepGeek » Tue Jul 26, 2022 1:20 pm

I like that approach. You should start looking for a DME who will work with you now.

You do have a copy of your sleep study and the equipment order, right?
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