Update II: Someone (DME?) is Lying to Me...

For what it is worth, here is the medicare rules on equipment replacement when it is broken so it needs to be replaced before the five years: http://www.medicareinteractive.org/page ... d=1532#top

Of course, this doesn't have much to do with loaners.

Your DME did not give you appropriate rental equipment and violated your prescription. It does not work with your humidifier. Medicare has traditionally paid for loaner equipment while equipment is being repaired. You need to have you doc talk to the DME and say that the equipment MUST work with your humidifier, otherwise they are not complying with your prescription. If they don't have the equipment they need to refer you to who does.

If I were you, I would call Medicare tomorrow and explain that your CPAP machine broke, tell them exactly which model it was, when it was purchased, and that it is at the DME for repairs. Explain they gave you a loaner CPAP to use but that they did not provide you with a humidifier on loan, and that the humidifier you already have, the one that went with the broken machine, is not compatible and so WILL NOT OPERATE with the loaner CPAP machine you are currently using. I would be sure to tell them you were ordered the humidifier by the Dr when he ordered your CPAP machine, and that you NEED it to prevent more medical problems. Ask them how to get a humidifier that will work NOW with the machine you are using on loan. It takes a while to get through to someone at Medicare on their 800 number (that telephone number is on a Remittance Advise paper they sent you) but keep at it. I am not a Medicare patient, so I don't have the number, but I know there is one because I have used it before to call for elderly friends and my Mum when I had a question about their benefits, and my Mum is in another state so I don't have one here. You should have the original invoice from the DME when they first provided you with your CPAP supplies (the one that broke), and also the Remittance Advise from Medicare that says how they paid, because it will have special file number on it that they might want to be able to look up on their computer. If you don't have the Remittance advise or the original invoice from the DME, they can probably still find that info in your file, but they might not have time to wade through all your medical invoices that they have in the file for you, for the past 2 years. If you have the file number from the Remittance Advise they sent you, I think it will help you to get them to help you faster.

If that fails, maybe you need to look into purchasing a stand-alone humidifier that might work with this loaner, and then see if you can sell it on Craigslist when you are done using it, after you clean it very well. Since there is no air from your lungs going INTO the humidifier, it should be easily cleaned with hot soapy water I would think, as long as you use distilled water. Ask your sleep lab how they clean their humidifiers, it CAN be done. My sleep lab uses humidifiers for their patients having sleep studies, and does not discard them, they clean them and use them again with another patient the very next night. Good luck, I hope you find someone to help you at Medicare tomorrow. If nothing else, if what the DME is doing is illegal by not loaning you a humidifer, Medicare will know and they will work on fixing the problem with the DME.

goldfinch wrote:For what it is worth, here is the medicare rules on equipment replacement when it is broken so it needs to be replaced before the five years: http://www.medicareinteractive.org/page ... d=1532#top

Thank yew for that very informative link!

codinqueen wrote:If I were you, I would call Medicare tomorrow and explain that your CPAP machine broke, tell them exactly which model it was, when it was purchased, and that it is at the DME for repairs. Explain they gave you a loaner CPAP to use but that they did not provide you with a humidifier on loan, and that the humidifier you already have, the one that went with the broken machine, is not compatible and so WILL NOT OPERATE with the loaner CPAP machine you are currently using. I would be sure to tell them you were ordered the humidifier by the Dr when he ordered your CPAP machine, and that you NEED it to prevent more medical problems

I do have the humidifier. I am just trying to figure out why I had to go through so many hoops to get it? It should not have been necessary to have to fight for it like I did.

This is a case where being a professional advocate has its advantages. But still it would have been nicer if she had just done what she was supposed to in the beginning!

ThomasMcKean wrote:

codinqueen wrote: I am just trying to figure out why I had to go through so many hoops to get it? It should not have been necessary to have to fight for it like I did.

It doesn't surprise me for multiple reasons. The world is complicated. Medicare is complicated. People's motivations are complicated. DMEs are busy, the amount of paperwork they have to deal with because of insurance and medicare is huge. When pressed there may be a temptation to wing it, instead of puzzling out an issue. There may be a perception that humidifiers aren't important and that a machine is a machine. How many people are as obsessed with data capabilities apart from this forum? How many people care about the humidifiers? I don't know.

goldfinch wrote:It doesn't surprise me for multiple reasons. The world is complicated. Medicare is complicated. People's motivations are complicated. DMEs are busy, the amount of paperwork they have to deal with because of insurance and medicare is huge. When pressed there may be a temptation to wing it, instead of puzzling out an issue. There may be a perception that humidifiers aren't important and that a machine is a machine. How many people are as obsessed with data capabilities apart from this forum? How many people care about the humidifiers? I don't know.

Anyone who has to go on life support every night SHOULD be obsessed with the data. That don't mean they are, only that they SHOULD be. I would guess a majority are unaware that there are even machines which can provide that kind of data because they have chosen to trust the dr and DME and not educate themselves.

As for the humidifiers, I recall reading from a fella on here what that if he doesn't have one, he gets nosebleeds. I am not that bad off, but I would think anyone like him would certainly care about the humidifier!