Is this Normal? - DME Related

The other thing that you can take part in is SleepGuy's aromatherapy samples... they're good at dealing with the smells.

cflame1 wrote:The other thing that you can take part in is SleepGuy's aromatherapy samples... they're good at dealing with the smells.

The link to the site is: http://www.pur-sleep.com

I am sensitive to chemicals and only use the pure essential oils versus the synthetics. There are many to choose from. Ask to try some samples so you can identify which are your favorites. When I first smelled Deep I wasn't fond of it - then I used it since I was out of Peace. It turned out that I slept, well, so deeply that it became my favorite and I didn't mind the smell.

BeanMeScot wrote: I called the DME Homelink last Thurs and my case worker said she had just gotten approval. I haven't heard anything from anyone since then. I just called my insurance to verify what I have to pay and if I go in network (which is Homelink) then I have a $750 deductible and then everything is covered at 100%. That's a yearly deductible but the lady said that if I meet it on or after Oct 1st, it will count through the next year. We are already over a week into Sept so I think I will wait until Oct 1st to get my machine. Going out of network is $2250 deductible and 70% out of pocket with a max of $5k. They said I would only have to rent the machine for a few months (to check compliance, I'm sure) before they would buy it for me rather than paying rental over the long term. So it sounds like in network would work out better (unless someone is seeing something I'm not). I know sometimes it is better to go out of network, moneywise.

The DME they have apparently assigned me to is Hi-Tech Healthcare. Anyone ever heard of or dealth with them?

I am SOOOOOOO pissed. I called a couple of days ago to see what I needed to do to get my CPAP paid in full since I had been 100% compliant for almost 2 months and was given a different answer. I was told that I would have to rent the CPAP until it was paid in full. Since my insurance will change Jan 1st, I won't even have this insurance anymore. Looks like I just got screwed out of 3 months of rental. I told the person when I called I wanted to find out if it would be cheaper to buy it myself or go through a DME. I did the DME since I was told it would be purchased for me after a couple of months. I would have paid my deductible by then so it wouldn't cost me anything extra. If we hadn't changed insurance, it wouldn't matter since I would have paid my deductible for next year already and wouldn't have to pay more either way. But of course after 8 years with the same company, my company decided to change to suckier insurance.

When I called on Monday, the person immediately said I would have to rent until it was paid for. Why couldn't the first idiot I talked to say that????? I said what I had been told so she said a supervisor would review the call. The supervisor called me today and said the operator hadn't "guaranteed" that it would be purchased after a couple of months. She had just said that was the way it was "typically" done. I can file an appeal but who knows how long that will take. They are not likely to want to help me when I won't be paying them any more premiums. I guess I can also file a complaint with the Insurance Commissioner, but again, not sure what that will accomplish.

So now I don't even know what is supposed to happen on Jan 1st. If I am renting and change insurance, anyone have any idea what will happen?

As an update, my new insurance company FINALLY had enough information to tell me what to do. Luckily, my local DME is in their network (even though Homelink isn't) so the rent to own will continue. Since it will be going against my deductible, no reason to pay it off early even though I will wind up paying almost all the payments on the machine (except for a couple of payments from the end of the year this year with my old insurance company). I asked them what the actual price of the machine was and they said $620 was what BCBS will pay for it. Which isn't a bad price. Only about $40 more than I could buy it online. It seems the only charge they really raped on was the humidifier.

I also told them I had met my deductible for this year and I wanted the to order EVERYTHING my insurance company would pay for before the end of the year. My insurance apparently allows 2 reorders per year for a CPAP user and they were able to order everything. I should be getting a nice box in the next few days with a mask, tubing, fine and foam filters and a humidifier tank.

when the costs go against the deductible, and we have other medical issues - even routine ones, it isn't a big hit as we would have spent the money on other medical stuff

I know - it's just that we have to pay $$$$ earlier in the year than we had planned -

actually my year starts July 1 which confuses everyone