CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Different?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Lane101
Posts: 66
Joined: Sat Jul 07, 2018 12:03 pm

CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Different?

Post by Lane101 » Tue Jan 10, 2023 11:09 pm

Found this on ResMed's Australian web site (link and copy pasted below). Would love to hear their explanation as to why the same items should last from 2x to 4x as long in Australia versus what they recommend in the U.S. (pasted a link and copy from ResMed's U.S. site below the Australian ResMed recommendations for comparison purposes. A few examples:

1) CPAP Tubing: 3 month recommended replacement in the U.S. versus 12 months in Australia

2) Humidifier Water Tub: 6 months in the U.S. versus 12 months in Australia

3) Air Filters: Monthly in the U.S. versus every two months in Australia

4) Mask Cushions: Monthly in the U.S. versus every six months in Australia

This supports the posts from many here that the typical U.S. recommended CPAP supply replacement cycles are only based on what insurance companies will pay for versus what makes sense if you regularly clean your equipment. Additionally given what are often up to 30% insurance copays on heavily marked up DME supplies it could be less costly for someone to skip insurance and by direct from an online supplier per a replacement schedule that reflects the true life or your equipment and supplies.

The Australian replacement recommendations are similar to what I've realized, over 20 years of CPAP use, for my masks (6 months when made of silicone, roughly 3-4 months for other materials) and filters ( I clean/replace every 2 months). My water tubs last for years (I dump the water and let them dry every day and clean gently with hand dishwashing liquid every few weeks. My hoses also last for years and I clean them once every 2 - 3 months with soap and water using a hose brush.

What has your experience with CPAP Supplies been? How does medical insurance work for CPAP equipment in Australia and/or are more users self-funding their CPAP usage versus the U.S.?


From the Resmed Austrialian Website (link included below):

https://www.resmed.com.au/blog/heres-ho ... -cpap-gear

Sleep Apnea Here's how often you should be replacing your CPAP gear

Mask Cushions - Every 6 Months

Mask cushions, for instance, rest against your face every night and can build up quickly with dirt, oil, and bacteria. Without proper care, they can deteriorate leading to leaks and discomfort – even skin irritation. 

How often you replace your mask cushion depends on the kind you have. Silicone cushions are designed to be replaced every 6 months, whereas memory foam cushions are designed to be replaced monthly. 

Mask Frame - Every 6 to 12 Months

Newer frames are made out of medical grade silicone that can harden over time so we recommend replacing these every 6 months. For our older models' mask frames are made of strong plastic and are more durable than mask cushions. Their lifespan will depend on well you look after them. If they ever get damaged, cracked, or discoloured, you should replace them immediately.

Mask Headgear - Every 6 Months

Mask headgear will lose elasticity and become stretched out over time, leading to a bad mask fit. One sure sign is when you’re starting to overtighten your headgear to achieve a secure seal.

We suggest you replace headgear every 6 months or so to ensure your mask is always sealed as secure as possible.

CPAP Machine Air Filters - Every 2 months

Air filters  will collect dirt and dust with regular use, which can lead to blockages, and poor hygiene and even contribute to allergies if not changed out as needed. While we recommend they are replaced every 2 months, users in dusty environments should inspect them often to determine their cleanliness. 

CPAP Tubing - Every 12 months

We recommend CPAP tubing be replaced every 12 months as air tubing can sometimes get damaged with small holes or tears, leading to air leaks and less effective therapy. Any tubing that is leaking air should be replaced immediately. 

CPAP Humidification Tubs - Every 12 Months

Humidification tubs or water chambers can become damaged over time or build up with bacteria if not cleaned regularly. You can improve the longevity of the tubs by using distilled or filtered water to avoid the mineral deposits that tap water leaves behind. You should inspect your humidification tub for wear and deterioration once a month and we recommend replacing them every 12 months.

From the U.S. ResMed Web Site (link and copy pasted below):

https://www.resmed.com/en-us/sleep-apne ... -supplies/

Based on general wear and tear, we suggest that you use the following as a guideline to replace your CPAP parts:

Every month

Mask cushions and/or nasal pillows
CPAP machine filters

Every 3 months

Mask frame (not including the headgear)
CPAP tubing

Every 6 months

Mask headgear
Chin strap (if applicable)
Humidifier water tub

User avatar
Respirator99
Posts: 228
Joined: Mon Jul 05, 2021 12:39 am
Location: Australia

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by Respirator99 » Wed Jan 11, 2023 12:49 am

As a general rule (there are exceptions) medical insurance in Australia only pays AU$500 - 750 against the cost of a machine and nothing towards supplies. Consequently, items like tubs, hoses and cushions are all out-of-pocket. People here tend to look at the value and cost of replacements, rather than just getting them on a schedule. People also know that even with the reduced replacement recommendations here, that Resmed are still trying it on. (Not just Resmed, of course). Some examples from my own experience: F20 mask cushion lasts over a year. S9 humidifier tub lasted 8 years (it's still like new, in what is now my backup machine). Heated hose (S9) lasted about 5 years till the rubber sockets started wearing. And so on...
* Download Oscar
* Oscar help
* Organise your Oscar charts
* An alternative to Oscar - try SleepHQ

I have no medical training or qualifications. I'm just a bloke on the internet - take my advice for what it's worth.

User avatar
LSAT
Posts: 13007
Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by LSAT » Wed Jan 11, 2023 8:38 am

I'm with Respirator on this. I am on my 3rd machine and I have never replaced a water tub. I do replace my standard hose at about a year, not because its worn out, but because I have uses for the used tubes. My masks and head gear last well over a year usually with 1 cushion replacement. I check my filters every month and replace them when they show discolor....usually 5-6 months.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

User avatar
nelamvr6
Posts: 67
Joined: Thu Mar 07, 2013 11:29 am
Location: New London, CT, USA

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by nelamvr6 » Wed Jan 11, 2023 11:58 am

In my opinion the periodicity of replacement in the US is indefensible! There is no way hoses, reservoirs, even masks need to be replaced as often as these insurers allow.

It's no wonder we pay such high premiums for insurance! How did insurance providers in Australia get so much smarter that those in the US? And how do insurers justify replacing CPAP supplies like they're free and then fight tooth and nail to deny other more necessary needs?

And ResMed and Philips are not without blame! They "recommend" replacement exactly as often as insurance will allow. How coincidental. No consideration at all as to how often these things actually need to be replaced.

The whole situation disgusts me.

_________________
MachineMask
Additional Comments: Oscar Software. Pressure: 12 - 16 cmH2O

User avatar
ChicagoGranny
Posts: 13230
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by ChicagoGranny » Wed Jan 11, 2023 12:30 pm

nelamvr6 wrote:
Wed Jan 11, 2023 11:58 am
They "recommend" replacement exactly as often as insurance will allow. How coincidental. No consideration at all as to how often these things actually need to be replaced.
Think Medicare. Medicare sets the replacement schedule. Most insurance companies follow the Medicare schedule.

As far as the CPAP equipment suppliers, they follow the same schedule to avoid lawsuits. Your disgust is misdirected.

User avatar
chunkyfrog
Posts: 33224
Joined: Mon Jul 12, 2010 5:10 pm
Location: in a nice, moist, Nebraska bog

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by chunkyfrog » Wed Jan 11, 2023 2:47 pm

I am thinking that Medicare accepts that maintenance of equipment
can get difficult as one gets older, and sets replacement period for worst case scenario.
Don't be ashamed of getting spares, because nobody is open at night,
when breakdowns ALWAYS happen.
If you are "on the dole", please don't be greedy--because others are needy.
If you pay, get what you need--now and in the near future.
Storing stuff you don't need is hoarding--it's a bad habit.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: second Airsense 10 Autoset for Her --sticking with a good thing.

User avatar
palerider
Posts: 31606
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by palerider » Wed Jan 11, 2023 4:29 pm

chunkyfrog wrote:
Wed Jan 11, 2023 2:47 pm
Don't be ashamed of getting spares, because nobody is open at night,
Be ashamed of getting unnecessary spares.

You should *always* have a spare or two of everything, but don't throw away perfectly good cushions, hoses, tanks, etc just because medicare will buy another one.

I'm sure there are minimum replacement times for everything medicare (and insurance) pays for, that doesn't mean you should throw away your walker, or cane, or wheelchair because Medicare will buy you another one after 2 years (or whatever).

There have to be limits on how often replacements will be paid for, or there would be idiots out there wanting a new x every day.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

Lane101
Posts: 66
Joined: Sat Jul 07, 2018 12:03 pm

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by Lane101 » Wed Jan 11, 2023 4:31 pm

chunkyfrog wrote:
Wed Jan 11, 2023 2:47 pm
I am thinking that Medicare accepts that maintenance of equipment
can get difficult as one gets older, and sets replacement period for worst case scenario.
Don't be ashamed of getting spares, because nobody is open at night,
when breakdowns ALWAYS happen.
If you are "on the dole", please don't be greedy--because others are needy.
If you pay, get what you need--now and in the near future.
Storing stuff you don't need is hoarding--it's a bad habit.
Given the age cohorts covered by Medicare you likely hit the nail on the head regarding their recommended intervals for many of the items. Also for the oldest cohorts many may not remember exactly when to replace/clean certain items. That said there is still no reason for ResMed, and most of the U.S. apnea device industry and delivery network, to just parrot back the Medicare intervals with no additional clarifications as the "standard" replacement interval. DMEs, on-line retailers and manufacturers could recommend an inspection schedule aligned with the Medicare Intervals recommending replacement of anything that has deteriorated while noting that the various supplies have a typical usable life range that goes from the Medicare figure to something more realistic if proper cleaning/maintenance is carried out without likely exposing themselves legal liability. They don't because the likely just want to maximize revenue at the users expense.

Storing a reasonable level of back-ups is prudent these days. Given current supply chain variability, due to the recall and pandemic, it is actually a good practice for those that can afford it. A spare machine (could be an older retired unit that still works), an extra water chamber for each (per you post no one is open in the middle of the night if you drop one and break it), and a years supply of masks, tubing and filters (not as much as you would think, 3-4 masks, 2-3 tubes, two reusable filters and 6 disposable filters) is not unreasonable.

Note that for any orphaned machines (discontinued models) that one uses regularly an extra 2 -3 water chambers could make sense as those rapidly become scarce and jump in price once a machine is discontinued. I picked up an extra for my Devilbiss Intellipap when they announced their departure from the CPAP market for $28 as well as some extra silicone gaskets. Cheap insurance against premature obsolescence of what was my main unit while waiting for DS1 replacements for the past year and a half. Those chambers are now going for roughly $55 and most retailers are out-of-stock. Have seen many posts from fellow CPAP users where they had to get a new machine because they could not find a replacement water chamber.

Lane101
Posts: 66
Joined: Sat Jul 07, 2018 12:03 pm

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by Lane101 » Wed Jan 11, 2023 4:47 pm

Respirator99 wrote:
Wed Jan 11, 2023 12:49 am
As a general rule (there are exceptions) medical insurance in Australia only pays AU$500 - 750 against the cost of a machine and nothing towards supplies. Consequently, items like tubs, hoses and cushions are all out-of-pocket. People here tend to look at the value and cost of replacements, rather than just getting them on a schedule. People also know that even with the reduced replacement recommendations here, that Resmed are still trying it on. (Not just Resmed, of course). Some examples from my own experience: F20 mask cushion lasts over a year. S9 humidifier tub lasted 8 years (it's still like new, in what is now my backup machine). Heated hose (S9) lasted about 5 years till the rubber sockets started wearing. And so on...
Thank you for sharing how medical insurance works in Australia and why ResMed posts more realistic, if still aggressive, CPAP supply replacement schedules there versus the U.S.

What made it important to post the Australian ResMed recommendations is that in the U.S. almost every entity in the CPAP manufacturing and delivery business tows the line in recommending the Medicare based replacement intervals. Posting a more realistic set of replacement intervals from one of the top two global CPAP manufacturers give the ad hoc experiences posted by individual users like us much more credibility. Will note that everyone should regularly inspect and clean their equipment and replace anything that is damaged or can't be adequately cleaned or sanitizes when needed versus any recommended schedule as I'm sure that the Your Mileage May Vary (YMMV) applies to every CPAP user.

Like you my humidifier chambers last for years. Never replaced one due to the plastic deteriorating, any replacement was due to deterioration of the silicone rubber seals. Had an old ZZZPap where after 4 years the silicone on the base leaked requiring use of my back up chamber. My Devilbiss Intellipap still has its first chamber with over 5,000 hours of use. A year ago it also began to leak due to a thin silicone seal (like a tubular rubber band) that deteriorated. Fortunately those are sold separately so I did not need to go to my back-up chamber.

User avatar
CPAP-A-MUST
Posts: 10
Joined: Tue Dec 13, 2022 11:35 am

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by CPAP-A-MUST » Wed Jan 11, 2023 4:56 pm

Every 3 months I receive a phone call from my CPAP supplier asking what I need and what insurance will allow. If I don’t need anything they will call again in 3 months. I keep 2 spares of everything and use my nasal cushions until they start leaking. I’m not one to be wasteful and truly appreciate this locally owned CPAP supplier. The water chamber I have looks like the day I picked up my machine but have had to change out the ClimateLine hose once when it quit communicating with the machine.

My neighbor on the other hand was using a big multi-national supplier that never asked what he needed which resulted in 3 storage tubs filled with stuff. Thankfully he recently switched to my supplier and likes receiving the phone call.

I recall reading a while back about the Aussie replacement schedule vs the US and was left scratching my head.
Machine: ResMed AS10 for Her w/Humdifier & ClimateLine Hose
Settings: Fixed at 10 cm H2O, EPR 3
Masks: Bleep & N30i
Other: Griff Grips Sports Tape

“What a long, strange trip it’s been”

User avatar
billbolton
Posts: 2257
Joined: Wed Jun 07, 2006 7:46 pm
Location: Sydney, Australia

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by billbolton » Wed Jan 11, 2023 6:19 pm

Lane101 wrote:
Tue Jan 10, 2023 11:09 pm
Would love to hear their explanation as to why the same items should last from 2x to 4x as long in Australia versus what they recommend in the U.S.
This is not news..... it been known for a long time and discussed here previously on numerous occasions. :idea:

_________________
MachineMask
Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6

Lane101
Posts: 66
Joined: Sat Jul 07, 2018 12:03 pm

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by Lane101 » Wed Jan 11, 2023 11:11 pm

billbolton wrote:
Wed Jan 11, 2023 6:19 pm
Lane101 wrote:
Tue Jan 10, 2023 11:09 pm
Would love to hear their explanation as to why the same items should last from 2x to 4x as long in Australia versus what they recommend in the U.S.
This is not news..... it been known for a long time and discussed here previously on numerous occasions. :idea:
Glad to hear that. Did a quick search before posting on "Australia Replacement Frequency" and didn't come up with anything. Personally had not seen the Australian replenishment frequencies before. Also from many threads here where recommended replacement frequencies are discussed we don't typically see mention of how different the recommendations are in Australia. A fact set that adds lots of credibility to the views of many of us that CPAP supplies should last a lot longer than what is typically recommended by our providers if they are correctly cleaned and maintained.

Please add a link to the prior discussions on this as there are likely a number of folks like myself who are not familiar with prior posts on the topic.

User avatar
Respirator99
Posts: 228
Joined: Mon Jul 05, 2021 12:39 am
Location: Australia

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by Respirator99 » Wed Jan 11, 2023 11:44 pm

ChicagoGranny wrote:
Wed Jan 11, 2023 12:30 pm
Think Medicare. Medicare sets the replacement schedule. Most insurance companies follow the Medicare schedule.

As far as the CPAP equipment suppliers, they follow the same schedule to avoid lawsuits.
Not being in the States I'm only surmising, but do Medicare set the schedules for Resmed (etc) to follow? Or do the manufacturers set a schedule and then Medicare and the insurance companies follow that schedule to be in accordance with "manufacturer instructions"? Thereby covering their backside.
* Download Oscar
* Oscar help
* Organise your Oscar charts
* An alternative to Oscar - try SleepHQ

I have no medical training or qualifications. I'm just a bloke on the internet - take my advice for what it's worth.

User avatar
palerider
Posts: 31606
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by palerider » Wed Jan 11, 2023 11:51 pm

Respirator99 wrote:
Wed Jan 11, 2023 11:44 pm
ChicagoGranny wrote:
Wed Jan 11, 2023 12:30 pm
Think Medicare. Medicare sets the replacement schedule. Most insurance companies follow the Medicare schedule.

As far as the CPAP equipment suppliers, they follow the same schedule to avoid lawsuits.
Not being in the States I'm only surmising, but do Medicare set the schedules for Resmed (etc) to follow? Or do the manufacturers set a schedule and then Medicare and the insurance companies follow that schedule to be in accordance with "manufacturer instructions"? Thereby covering their backside.
Medicare set a minimum replacement frequency, ie, "we won't buy x any more often than y days/weeks/months", then the greedy DMEs in the US seized on that idea and said "if we tell people to throw away perfectly good stuff as often as we can bill medicare/insurance, WE'LL MAKE MORE MONEY.

And that's how we got where we are today.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

-tim
Posts: 710
Joined: Sat Dec 03, 2011 7:46 pm
Location: Melbourne Australia

Re: CPAP Supplies Last Up To 4x Longer in Austrlia per ResMed - Or Is It That Allowed Insurance Replacement Rules Differ

Post by -tim » Thu Jan 12, 2023 11:07 am

The Aussie parts cost 4x more. Yea monopolies!

_________________
Mask: AirFit™ N20 Nasal CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Resmeds overpriced SpO2