It's official -

So my Pulmonary Doc's nurse calls me back and said I did much better on my 2nd sleep study (while I was on the CPAP) and that the CPAP Clinic will be contacting me to get everything set up. I am not meeting with my Doc until Jan 5 to go over the results but I think we can get the Equipment set up sooner. I do have a few questions...

So what happens next? I am a stomach sleeper about 75% of the time with my face half-buried in the pillow. I am thinking that the Breeze Mask or Aeiomed's Headrest might be my first choice just due to my sleeping position but I am not sure. A few questions:

1. Do I get to choose my own mask and is it covered by insurance?
2. Do I get to choose my own machine and is it covered by insurance? - If I do get to choose, what is the best machine and will give me the most feedback/data?
3. How much out of pocket can I expect?
4. What else can I do, research-wise, before the CPAP Clinic contacts me to start this process?
5. I have not even been over the results with my Pulmonary Doc..that appt is Jan 5. I just was told that the CPAP Clinic would be getting in touch with me...I assume it is normal to get setup with the cpap even before you get full results from the sleep doc? I know that I have apnea - so this is not a surprise.

Swim_Bike_Run wrote:1. Do I get to choose my own mask and is it covered by insurance?
2. Do I get to choose my own machine and is it covered by insurance? - If I do get to choose, what is the best machine and will give me the most feedback/data?
3. How much out of pocket can I expect?
4. What else can I do, research-wise, before the CPAP Clinic contacts me to start this process?
5. I have not even been over the results with my Pulmonary Doc..that appt is Jan 5. I just was told that the CPAP Clinic would be getting in touch with me...I assume it is normal to get setup with the cpap even before you get full results from the sleep doc? I know that I have apnea - so this is not a surprise.

1. If your prescription says "Mask of user's choice", then definitely yes. Most DMEs will let you try what THEY think is appropriate. Insurance usually pays for a new mask, typically every 6 months.
2. That one varies widely. Unless your 'script is specific, you'll need to be persistant to get what you want/need. If you plan to manage your therapy, that means "fully data capable". Insurance usually provides machines on a rent-to-own plan, typically taking 10-12 months until it's yours.
3. Depends on insurance. Mine was $15 copay on masks and $25/mo copay for machine.
4. Talk to your insurance folks. Ask questions here. Read the Wiki here. Decide if you want to take control and to what degree (it will impact your choice of machine.)
5. Mine didn't work that way, but there's no reason to wait, really. You won't get a machine until your doc prescribes it. But that could easily happen before he meets with you.

Good luck! And stick with it! Sometimes it's a pain in the...um...BUT it's worth it. You'll soon be feeling better than you have in a long time.

Before choosing a mask, you need to find out from the sleep study results whether you breathed through your mouth. If you did, you are going to need a full face mask. I have two of them and can sleep all night on my tummy with either mask.

Thanks for the quick replies. I am a nose only breather (most of the time). I am actually excited about the mask....that probably seems weird but I am looking forward to getting rid of this fatigue! I wonder how I can find out about what type of script was written...

SBR

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If a mask is not comfortable on you don't accept it. You are the one who has to wear this not them so only accept what you can comfotably wear or what is the most comfortable that isn't leaking all over on you. Minor leaks can be adjusted, but do not take a mask that leaks around your eyes.

Do get a copy of your script. Scan it or what ever but turn it into a pdf file and store it away that way. I have a copy of mine on my desktop, laptop, on my USB drive and in my work email. I should always have access to my script anytime I need it that way.

Go ahead and call your insurace company. They will be glad to tell you. Find out what they will pay and what your deductibles will be. Find out if they will purchase outrite, rent to own where they rent it for a year then it's yours or if they rent if for a month or two then pay for it. If you are paying a deductible the cheapest route for you would probably be to have them rent it for a month or so then purchase it outright.

You are getting a heated humidifier with this correct?

Gerry