Insurance Co. Headache!!!!!

It's too late for you guys to help me, but this story might help someone else.

My insurance company (Aetna) just screwed me big time.
Got a bill from my DME for $56 for one month rental of my cpap. I was supposed to only have to pay $5.
Call up my insurance, and find out that I DO have to pay the $56 per month! I'm told, that money will go towards my yearly deductable. But wait a minute, I was told I MET my deductable before I started therapy!!!
THAT, is when I find out, for the first time, that my insurance "year" goes from July 1st - June 30th, NOT Jan-Dec!!!!

Before I agreed to RENT my cpap, I spoke with both my DME, and insurance co. to see if it would work out cheapper to BUY the unit instead of renting it. I was told, it would ONLY cost me $5 a month for 13 months to RENT it ($65) or @ $250 to buy it. This was at the end of June. IF, they would have TOLD ME that starting in July, I'd be paying $56 a month, I would have BOUGHT the machine in the first place!!!!

I am on a fixed income. An additional $50 a month is a financial hardship for me. I'm not looking for sympathy, I'm just trying to give a heads up to future OSA newbies to CHECK your insurance benifits before you decide to rent, or buy your equipment!

Sorry to hear of your predicament, but this type of thing is a HUGE problem (and added expense) for new users.
Every rental/payment plan needs to be evaluated. If the payments run past the "insurance fiscal year", the deductibles start over again. And.....probably not so coincidentally, the payment periods are set up over longer periods for just that reason......to minimize the insurance provider's expense.

When all is said and done, it's probably more economical to purchase this stuff out-of-pocket from an online seller.


Den

Wulfman wrote: When all is said and done, it's probably more economical to purchase this stuff out-of-pocket from an online seller.


Den

It is for me! I am getting an AutoSet II online for same or less than "renting" the Escape II from local DME. Plus, I don't have anyone hassling me about anything!

***TAXPAYERS NOW SPEND $60 BILLION A YEAR SUBSIDIZING THE INSURANCE INDUSTRY!*

https://www.youtube.com/watch?v=A0Su9lEHVA8

ScrappinMom wrote:

Wulfman wrote: When all is said and done, it's probably more economical to purchase this stuff out-of-pocket from an online seller.


Den

It is for me! I am getting an AutoSet II online for same or less than "renting" the Escape II from local DME. Plus, I don't have anyone hassling me about anything!

Same with me. I did the math and calculated that my percentage of the payments (on their inflated prices) would be about what I'd end up spending out of pocket.....with no reimbursement from the insurance provider. In my case, I was (and still am in my retirement) in a self-insured PPO and upon inquiring before I ordered, found out that they would reimburse me for 80% of my out-of-pocket purchase, so that's what I did......and saved everybody some money. By purchasing online and up front, there's no hassles with the DMEs regarding compliance and making your own pressure adjustments.
Some insurance providers will reimburse and some won't, but that's a conversation that needs to take place beforehand.
DO THE MATH!!!

Den

Georgio wrote:***TAXPAYERS NOW SPEND $60 BILLION A YEAR SUBSIDIZING THE INSURANCE INDUSTRY!*

And gosh, just think how far that $60 Billion could go in actual healthcare services instead of the insurance companies' pockets...makes ya ill.

You're gonna LOVE this!!!
I got another bill from my DME yesterday.......for $100.........for reading my "Smart card"!!!!

I had to send it in to them, so they could send the data to my insurance company, and get paid.. As I understand it, that's standard procedure. I didn't know that I had to pay for that! I called my DME, and spoke with a manager. She was actually very understanding, and helpful. She told me that they bill the insurance companies $100 for having to submit the data to them, and the insurance companies usually pay it. Since mine didn't pay, they sent the bill to ME. I told her that it was insane to charge me for something that THEY needed.

She said to forget about the bill.

You might want to start worrying about "How much your DME is going to charge you for talking to one of their managers". They likely have a mininum charge just for a manager talking with you.