Insurance question

My insurance allows me $10,000 for DME per year. So far they have spent about 5,000 so my question is, Should I try just as hard as I can to build up supplies and stuff in an effort to use up all the money or is that unethical.

Most insurance allows you to receive cpap supplies on a scheduled basis. It would be good for you to find out what your insurance company's schedule is and then order your supplies accordingly. The answer to you underlying question is, "Yes, take all the supplies that they allow."

amos

The more that any insurance company pays for any incurred expenses the more the insurance company will need to raise rates to compensate for outgoing payments. While most insurance companies cannot raise their rates on an individual's policy, they will then raise the rates for everyone.

So on one hand, it is your insurance premium (or employer's) or combination dollars at work, the end result for "getting your money's worth" will be increased premiums for someone.

This is one reason why health insurance premiums are skyrocketing. People want to get their money's worth. Can't say as I don't blame them but in the end it just comes back to bite them in the butt.

I personally will get what I need for my therapy to continue to be effective and have "spares" in case something breaks but I don't feel the need to get excesses of items, that even though they are allowed per the supply schedule, aren't really items that need to be replaced that often.

Thanks peeps, I think I am just mad because each time I speak to my DME and the insurance company I feel like I have been in a fist fight or something.

Hoze-Zay wrote:I think I am just mad because each time I speak to my DME and the insurance company I feel like I have been in a fist fight or something.

Understood and certainly we do feel like we have to gear up for battle sometimes.

Get the equipment you feel you need. Just remember that what goes around, comes around in some form or another. Don't let them short change you by any means but you don't need to accumulate 10 hoses over time, stuff like that doesn't need to be replaced as often as the normal standard schedules will allow.

Heck I found the Respironics premium hose for $6 at Amazon.com along with 6 of the fine filters for my machine for another $6. Those were less than my co-pay would have been from DME inflated prices and will get me by for a long time and I didn't use the DME which gouges so bad on these smaller items.

Pugsy wrote:The more that any insurance company pays for any incurred expenses the more the insurance company will need to raise rates to compensate for outgoing payments.

So far, this year, my insc. company has a net profit of ~$300,

That is just figuring what I have paid in monthly premiums.
The money they have paid for my cpap equipment is really
MY money, that I gave to them.
The only benefit to me is that it is pre-tax money.
They haven't spent a dime of their money on me this year.
If you include the premium that my employer is paying,
they are making a tidy profit from my policy.

Pugsy wrote: This is one reason why health insurance premiums are skyrocketing. People want to get their money's worth.

I disagree.
People want something for their money.
Health care is skyrocketing because of the greed and corruption
in the insc., medical and drug industry.
Exp: DME policy for choice of cpap machines.

carbonman wrote:I disagree.
People want something for their money.
Health care is skyrocketing because of the greed and corruption
in the insc., medical and drug industry.
Exp: DME policy for choice of cpap machines.

And I am not saying don't get your money's worth. All I am saying is that this skyrocketing cost, for whatever reason, comes down to increase in premiums. Those big insurance company CEO's want nice fat paychecks and bonuses.
When the charges for anything covered by health insurance is incurred, the buck gets passed down to the lowly consumer.

No, it isn't "right" but it is what it is. Some people feel better if they get their insurance premiums back in the form of goods and services. So be it. I don't blame them one bit. All I am saying is that if enough people get their "money's worth" from their insurance company, then they can expect to see higher premiums and start the cycle all over again. Patient CPAP supplies are just a small little beans that gets counted but it does get counted in the expense category.

Will it make any difference in premiums if I don't make use of every scheduled replacement supply? Probably not. But I will feel better about not wasting resources. I certainly am not advocating that others do what I do. It is a personal choice. OP in this thread wanted to know if it was okay to stockpile supplies since his insurance company has a lot left available in dollars. I only mentioned the ramifications that occur with ANY spending. Stockpiling or getting just the essentials, they both will and do factor into the overall premium equation. I was only commenting on the general cause and effect that occurs with any insurance related expense and the resulting overall bottom line for insurance companies looking for any excuse to increase premiums. Our CPAP supplies (masks, hoses, pillows) are merely little drops in the large bucket of medical expenses that have gotten way out of hand. I was not attempting to debate the high cost of health care. I was just mentioning what occurs when this high cost gets filtered down to the consumer.