First 2 Weeks on APAP

My wife Barbara has just completed her first 2 Weeks on PAP therapy.
She has had only 3 days with AHI above 1.0, 1.42 was her worst score. She does complain about why it was so bad.
She keeps asking me why everyone says it is so difficult to get used to PAP.

I am curious what the typical amount DMEs bill insurance for the integrated humidifier on the Airsense 11. It seams to me $176 is i little high. Like buying a new car and being billed for the stearing wheel or the windshield. Yes, I know it is standard practice, but how much do they usually get away with billing?

bwexler wrote: ↑

Fri Jan 05, 2024 8:09 pm

It seams to me $176 is i little high.

That is in line with the Medicare guidelines for a Competitive Bidding Area. https://document.resmed.com/documents/a ... S_Card.pdf

bwexler wrote: ↑

Fri Jan 05, 2024 8:09 pm

but how much do they usually get away with billing?

They don't "get away" with anything. Your insurance will only pay the amount on the contract they both signed. You have to find out from your insurance policy what your share is.

bwexler wrote: ↑

Fri Jan 05, 2024 8:09 pm

My wife Barbara has just completed her first 2 Weeks on PAP therapy.
She has had only 3 days with AHI above 1.0, 1.42 was her worst score. She does complain about why it was so bad.
She keeps asking me why everyone says it is so difficult to get used to PAP.

I am curious what the typical amount DMEs bill insurance for the integrated humidifier on the Airsense 11. It seams to me $176 is i little high. Like buying a new car and being billed for the stearing wheel or the windshield. Yes, I know it is standard practice, but how much do they usually get away with billing?

I have been battling my CPAP/APAP for 18 months and have only recently started to gain some consistency. Most of the last 16 months has been me unconsciously yanking my mask off in the middle of the night. Since it happens while I am asleep, I am not sure exactly what is causing me to consistently yank it off, but I can only imagine it is physical discomfort of the mask itself, or maybe it's the air coming from the machine (maybe it's too humid, not humid enough?). Not sure.

In any case, I do not have to imagine why it is so difficult to get use to CPAP/APAP. I have lived it for 16 of the 18 months I have been on it. Fortunately, the last two months has been pretty good.

Regarding DME coverage: My Kaiser Permanente DME coverage is 90%. I paid about $75.00 for my AirSense 11, and pay between $20 and $30 for my quarterly supplies.

Glad to hear that your wife has taken so quickly to CPAP/APAP. Some of us, unfortunately, are not so fortunate.