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Thanks so much Slinky for all the advice.. I can justify an auto for 2 reasons.. One is because of weight loss. If they do not consider that an important issue then I don't know. Two is because I have anxiety which my doctor is fully aware of. An auto is going to take it easy on me and a gentle pressure instead of constant force. I had a hard enough time breathing with being on a level 4 as my face was all red with the extra effort of deep breathing, I can only imagine how a 6 is. As they say in life is that you can only try and get a no...

I am rethinking this whole thing now. I am extremely tired during the day no doubt. But it seems from these results of 4.9 and such a low pressure setting that I hardly have sleep apnea. When I sleep on my side propped up with my comforter I am quite rested. No, I am not going to make excuses again I will use the machine as it did make me feel great!

As for my insurance providers I did call my insurance and she gave me 3 names of local DME's in my area. I then called one to get a price quote for a rental to see if I could afford this machine or not. The provider from BCBS told me the rental for a machine was about $135.00 and the mask was about the same.. I said your kidding me, over 2 hundred a month to RENT? She said that she was giving me Medicare's figures. I then called my sleep study center and told her that I could not come in for the titration because I cannot afford over 2 hundred a month to rent this machine. She said that did not sound right and she would find out from her DME supplier how much it would cost. Her DME supplier said it would be $35.00 a month to rent and the mask is included. So then I set up for the titration and called her back to let them know what I wanted on the script. Even if I had to go straight cpap as this sleep study doctor recommends he did not put a humidifier on it. Can you imagine using this machine without one?? Talk about sore throat! And your right, my insurance said that I have to rent out the machine for 10 months and then they will purchase it for me.

Hi MichelleFL ,

I don't think the severity of your apnea can be measured by your titration presure alone. I would post my studies to get more opinions on that.

I think the way insurance usually works is, they pay rental cost for a certain number of months, then the machine is considered purchased and you would own it.

It's my understanding that if you get a prescrip for the auto machine you want....you should be able to get your insurance to pay for it.

Stay with the program, you're almost there.

Georgio

Meanwhile - back to the original post....

Michelle, are you self-pay (no CPAP insurance coverage)? I am, and my sleep center is stringing me along as well. They offered me a "deal" which included a mask, supplies, and the cheapest CPAP available. It works - but being new to OSA, I didn't know at the time that I should consider other options. This open, public forum has helped me educate myself so that I can communicate more effectively with my doctor. The sleep center has no reason to help self-pay people because they can't inflate their charges they send to the insurance company. If we don't like their price - we go elsewhere. And any problems better occur quick (within 30 days) - or you have to pay for the "consultations," or exchanges. This is what they're hoping - that they can make up some money in the long-term care and supplies.

Remember folks, Michelle was lamenting over her medical provider NOT her healthcare provider. She must be proactive in ensuring the sleep center is doing what its supposed to be doing. Her relationship with her doctor is her business - not ours..

cb28210 wrote:Michelle, are you self-pay (no CPAP insurance coverage)?

No I do have insurance with Blue Cross and Blue Shield and I called them to see what they would cover. The could not give me specifics but gave me 3 names of suppliers who said my rental would be over 2 hundred dollars per month. That is crazy! So that is why my sleep center got involved because I told her I could not afford that and she said it did not sound right and would talk to "her" supplier. I am so sorry that your going through these same issues but hang in there and keep fighting. So far in all of my 42 years I have had to do just that to get proper medical care. Only now with my new doctor do I think I have found one who really cares.

Hi Michelle,

I had blue cross for awhile. I think that Blue Cross may pay your $200. rental (yes outrageous). The way I understand it, they often pay a flat cpap "code" cost no matter how expensive cpap equipment you are able to get from the DME. You may just need the proper prescription to get what you want from one of the DME .

Georgio

Being a Medicare consultant I have found that DME FRAUD is RAMPANT

Beware of the games being played by DME companies and report any suspected fraudulent activities you believed have happened to the united states office of the inspector general.

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Well, Roberto beat me to the comment about "thedean".
This poster has rarely ever posted anything worthwhile here on the forum and generally will badmouth anything intelligent posted by anyone else. When all else fails, make disparaging remarks about someones grammar??? What's with that??? "thedean" is generally useless.....
It would be wise for anyone here to ignore anything posted by "thedean"......'nuff said.....

Michelle -- if the doc prescribed you an Auto CPAP machine, the DME cannot deny you that equipment, so their statement they will only "loan" it to you is a falsehood. My DME tried to pull that one on me as well, at which point I asked my doc to write me a prescription for the exact make and model that I wanted, which she did. I still have my Auto CPAP they said they could only loan me......They don't want to give you that one because they won't make quite as much profit -- not your problem!!!!!!!

You're doing great!!!! Put that foot down and keep it there

Take care
cheers
goose