Experience with Cigna and Travel CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Chitlom
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Joined: Thu May 30, 2019 4:55 am

Experience with Cigna and Travel CPAP

Post by Chitlom » Tue Apr 30, 2024 6:15 am

It has been 5 years since I last got a CPAP machine reimbursed by CIGNA. I would like to get a travel machine, such as he Resmed AirMini and am wondering if anyone has experience getting CIGNA to reimburse/pay for it.

I reside outside the USA so I pay my medical bills or in the case of my CPAP supplies buy them and CIGNA reimburses. I am wondering if the AirMini would be denied for any reason.

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ChicagoGranny
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Location: USA

Re: Experience with Cigna and Travel CPAP

Post by ChicagoGranny » Tue Apr 30, 2024 11:00 am

Chitlom wrote:
Tue Apr 30, 2024 6:15 am
anyone has experience getting CIGNA to reimburse/pay for it
Even if they do, they can't answer your question because they don't know the details of your policy. CIGNA has dozens of policies and benefits vary.

You need to ask CIGNA if you are eligible for a new machine. The insurance code for a CPAP machine, home or travel, is E0601.

Janknitz
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Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: Experience with Cigna and Travel CPAP

Post by Janknitz » Fri May 03, 2024 9:15 pm

Cigna may not care which E0601 machine you get, but the DME might, as the Airsense Mini's are about 20 - 30% more expensive than the standard machine. Most insurers, by contract, pay an agreed-upon flat amount for ANY E0601 machine, and you are responsible for (usually) 20% of the agreed upon price. Although the minis cost more, by contract Cigna will only pay the standard price, you are responsible for 20% of the agreed-upon price, and the DME would have to eat the difference (most states prohibit "balance billing" which allows the DME to charge more than the agreed upon amount in the insurance contract). So it's very unlikely you will get one on your Cigna plan.
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