Purchasing online vs. bricks and mortar dme

I am expecting a visit from a recommended DME within a few days with my S9 Autoset. As near as I can tell, the contracted insurance price is north of $1050. The same machine can be purchased from CPAP supply, an onlin supplier for about $200 less. Since i have a high deductible HSA policy, I pay the full freight either way, although with an online, cash only provider, it does not count toward my deductible. i am interested in saving the$200 (likely more than that once you factor in mask, humidifier, etc.) and wonder if there is any big downside to purchasing online.

Will CPAP supply help with setup and such over the phone? Is it worth paying the local DME additional funds?

thanks for your replies.

Newbie

If you purchase the machine from an online retailer, I believe that you should get all the manuals with it. If not, you can get them online. People here will also be able to help you with setup questions. I would say there's no reason not to buy the machine, humidifier, hoses, etc. from an online retailer.

The mask is another issue... When you are just starting out, it can be hard to find the right mask, and you might need to try several different masks. If you go through a brick and mortar store, you can return the mask within 30 days if it doesn't work out and get another one instead. They have an arrangement with all the major manufacturers for this free return policy. If you order your mask from an online supplier, you are on your own with sizing, and it's harder to try multiple masks. I think some of them offer an "insurance policy" where you pay an extra $10-15 for the ability to return the mask for a refund if it doesn't work. So if you find the right mask on your first or second try, it's probably better to go with the online supplier. But if you end up having problems with finding the right mask, it might be cheaper (and less stressful, depending on how helpful they are) to go through a brick and mortar store. Once you've found the right mask, you could then order all your replacements online.

energyguyoly wrote: Will CPAP supply help with setup and such over the phone? Is it worth paying the local DME additional funds?

Cpap.com will set up the machine per RX requirements if there are any stated.

It is not difficult to get into the clinical menu to set things yourself. Online purchase will supply the clinician manual. DME purchase will likely have them remove the clinician manual but it is easily obtained online. Do a forum search for a post by member Uncle_Bob and look in his signature for manual and software download info.

DME purchase of masks will enable you to take advantage of free trial period. Be sure to check out what their policy is. Most mask manufacturers offer 30 day free trial but often DME set their own company policy. Also check to see what replacement schedule the insurance uses for new masks and/or replacement parts.

Check with insurance company to confirm if machine and humidifier is full purchase outright or rent to own for a period of time and when would a new deductible requirement possibly impact out of pocket expenses.

Do the math. What other costs might the insurance absorb after deductible has been met might you incur? If deductible starts new in January it might factor in to your decision.

Pugsy wrote:Cpap.com will set up the machine per RX requirements if there are any stated.

Do you have to indicate that in some specific way?

When I ordered mine, my prescription clearly stated 11 cm H20 but as delivered the machine was set for APAP 4-20 cm H20.

Can you buy on-line, pre-pay and then manually submit the claim to your insurance yourself?

Many insurance companies have procedures in place for submitting pre-paid claims to them for reimbursement -- based upon what you say about your deductible you wouldn't get reimbursed but you may be able to get it applied to your deductible.

JointPain wrote: Pugsy wrote:Cpap.com will set up the machine per RX requirements if there are any stated.



Do you have to indicate that in some specific way?

When I ordered mine, my prescription clearly stated 11 cm H20 but as delivered the machine was set for APAP 4-20 cm H20.

My understanding from the wording on the RX requirement section that I read 2 years ago was they would do as per stated on the RX. It is not stated as such nowhttps://www.cpap.com/cpap-faq/Prescriptions.html
So it is possible I either misread or they have changed procedure.

Tip10 wrote:Can you buy on-line, pre-pay and then manually submit the claim to your insurance yourself?

Many insurance companies have procedures in place for submitting pre-paid claims to them for reimbursement -- based upon what you say about your deductible you wouldn't get reimbursed but you may be able to get it applied to your deductible.

That's what I did in 2005 when I started on this journey. Bought all my stuff (initial purchase) from CPAP dot COM and then created an invoice with me as the billing party and my insurance provider as the party being billed and sent it to them. My deductible had already been met with the sleep study and all, so, since they considered me to be "in-network", they reimbursed me for 80% of the equipment purchase (the only thing they wouldn't reimburse me for was the software and card reader since there were no insurance billing codes for them). All of the other billing codes were on the invoice I received from CPAP dot COM, so I basically duplicated their invoice.


Den