Newly diagnosed geting a machine soon

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
sarkel

Newly diagnosed geting a machine soon

Post by sarkel » Thu Jun 09, 2005 12:42 pm

OK, so i did a two nite sleep study and have been told i have sleep apnea and need a CPAP maching. It's supposed to take two weeks and be covered by my insurance. A home health care co. is supposed to contact me . The question is what should i be looking for as a first timer. Will they be trying to foist something cheap on me that insurance will cover and line their pockets the most? Do I have any say so in what I am given.

I have read so many people with so much difficulties with equipment and wonder that perhaps if i am very careful upfront i can avoid this.

IN other words, are the insurance and home health care companies acting in my best interests or do i need further education here.


Guest

Post by Guest » Thu Jun 09, 2005 3:03 pm

In no way are insurance companies or the companies they work with looking out for you. You stand just about 0 chance of getting good equipment out of them.

If you want to know whats good, click the link above and look on the cpap.com main page. Compare it to what your dealer will try to push on you.

Ask a lot of product questions on this board. Use the search feature and read the threads from older newbies who asked the same thing.


chrisp
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Location: somewhere in Texas

Post by chrisp » Thu Jun 09, 2005 3:17 pm

Ditto guest advice. Read and ask lots of questions........ Avoid the temptation to go the insurance route. First they will want to rent it to you for hundreds of $ a month then they will sell it to you for another crazy amount. The whole process is at least insulting if not criminal. Get your Rx from your doc and order online. It will probably cost less than your copay. You might get lucky and your insurance might still pay. Its worked for others. Just get it in writting .

Check it out for yourself as your situation may be different.

Beware of the Evil DME

Cheers,

Chris

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Last edited by chrisp on Thu Jun 09, 2005 4:31 pm, edited 1 time in total.

ahujudybear
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Location: Franklin, WI

Post by ahujudybear » Thu Jun 09, 2005 3:30 pm

Guest,

It all depends on your DME and how reputable they and their agents are. The one I have is apparently golden from what I've read here. The RT they have sent is very helpful and very honest about what she knows and what will or will not help me. She said that she wants to join this forum to learn more about what works and what doesn't, because that is how she learns - from her clients.

Oh... One thing nobody here has mentioned... they charge the SAME PRICE for their devices (one price for masks, one price for BiPAPs, etc.) no matter what brand or style or market price it is.
- JB


chrisp
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Joined: Wed Nov 10, 2004 3:51 pm
Location: somewhere in Texas

Post by chrisp » Thu Jun 09, 2005 3:37 pm

Oh Yea. I've heard that most (not all, remember Christine's a good one ) DMEs are in the Federal Witness Protection Program. And you thought Jimmy Hoffa was burried in the Meadowlands. LOL. He's now an Evil DME in Texas

:twis ted:


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Teej813
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Post by Teej813 » Thu Jun 09, 2005 4:23 pm

I'll second Judy's comments. Altho' expensive, my DME was very helpful in explaining the differences in machines they carry. It was them, after much discussion and questions, that suggested they call my Dr. to ask about a change in my prescription. They got me upgraded from a RemStar Pro to a RemStar Auto because the Auto would help us settle on a final pressure setting without an additional sleep study.

They've also been very good about answering questions and such. As for delays in getting equipment, any delays i've experienced haven't been their fault. I got my CPAP the same day they received my prescription from my Dr. I also got a heated humidifier the same day that prescription was submitted.

So my experience with Apria has been a positive one.

Having said that, they're expensive as heck! I could have saved 50% by purchasing online. I plan to do just that now that i'm in maintenance mode (filters & replacement equipment as needed).


teej


Sleepless on LI
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Post by Sleepless on LI » Thu Jun 09, 2005 5:31 pm

Teej, I dealt with Apria, too. They got my prescription faxed to them on Day One. On Day Two, I had the appointment to see them and walked out with the machine. But I did have to wait for the mask to be shipped to me since they were out of stock of the one that I chose, although they had one waiting for me that the doctor had written a RX for. But when we talked and they heard what I really wanted, they said they would order it the next day and have it shipped and call my doctor and have her fax another RX to them for the one I preferred. They worked with me to make sure I had what I wanted and what would be best for me and were absolutely wonderful to deal with. Since I have Empire BCBS, they rent the machine for the first 30 days and then buy a machine for me after that. I do not pay a penny. My DME said to call him in 30 days and he will give me the names of a few great machines to tell my doctor to write a RX for, if she's open to suggestion, which I'm sure she will be. So my experience with the DME and my insurance company has been a sheer delight. Guess I'm one of the lucky ones.

L o R i
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chrisp
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Post by chrisp » Thu Jun 09, 2005 5:37 pm

Just wait till you see what they charge your insurance for this stuff. Then check out cpap.com prices. You could have taken a vacation with the difference.

:twis ted:


Sleepless on LI
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Post by Sleepless on LI » Thu Jun 09, 2005 5:56 pm

Hey, with what I pay per month with my premiums (I'm self-employed, so I pay for my own health insurance), they should send me on a vacation as a "thank you" for keeping my insurance with them!!!
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ahujudybear
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Post by ahujudybear » Thu Jun 09, 2005 6:11 pm

Anyone can take a scrip and go to a store and buy something off the shelf. And then have to go back and buy something else or try to figure out a better way to make the thing work, or just give up on the whole process.

I think any added expense for the services the good -- GOOD -- DME's provide is worth every penny we might have to pay - and then some. Their reassurance that SOMETHING out there will eventually work for us, their research into various mask styles and machines, humidifiers, gels, cushions, headgear, chinstraps, etc., etc. saves us a lot of hassle, money and time.

IMHO

- JB


chrisp
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Joined: Wed Nov 10, 2004 3:51 pm
Location: somewhere in Texas

Post by chrisp » Thu Jun 09, 2005 6:14 pm

No arguements here. Just look out for the incidentals and copays. The add up fast. Don't let them disassemble the cpap and sell it by the piece. Like this. The cpap comes with the hose in the box. They remove it and sell it to you for $60. Same with the humidifier and the tank. Mask and headgear. Or rent it to you for a month or 3 then sell the same machine to you for $2000.

Be careful of their tactics.

Here is an example http://cpaptalk.com/viewtopic.php?t=3094

When we can no longer afford insurance then what do we do when we really need something like heart surgery. ...........Roll over and DIE

:twis ted:

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