DMEs and insurance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
davelikesbeer
Posts: 250
Joined: Tue Jun 21, 2011 11:45 pm
Location: California

DMEs and insurance

Post by davelikesbeer » Fri Aug 05, 2011 11:35 pm

Are there any DMEs, online or brick & mortar, that take insurance and can set up auto orders?
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Janknitz
Posts: 8512
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: DMEs and insurance

Post by Janknitz » Sat Aug 06, 2011 10:23 am

Every DME that's B&M can and should, a few online suppliers will bill your insurance. Contact your insurer FIRST to understand what they cover and if you must use a preferred provider. See "what you need to know BEFORE you meet your DME" in my signature below.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

xyz
Posts: 407
Joined: Fri Dec 07, 2007 1:38 pm

Re: DMEs and insurance

Post by xyz » Sat Aug 06, 2011 12:25 pm

Before selecting or using a DME you must always ask your insurance company if your plan (insurance companies have thousands of plans, often linked to specific employers) has a requirement to use a specific DME, or list of DMEs.

Otherwise if you buy something or use a service, you could get a big bill that is not covered by insurance.

The hard part is getting a CS rep at the insurance company who knows. One tip is to ask them what DME stands for. I'm serious. I have never spoken with a CS rep who did _not_ know what DME stands for who could give me a straight/correct answer to a DME-related question.

Ask them to guide you to their webpage that shows the list of approved DMEs. And/or mail it to you. But no verbal-only answer. CS reps have a 50-50 probability of being wrong. On a good day.

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archangle
Posts: 9293
Joined: Sun Mar 27, 2011 11:55 am

Re: DMEs and insurance

Post by archangle » Sat Aug 06, 2011 12:32 pm

If relevant, find out who the "in network" DMEs are for your insurance. It can make a big difference in money payout.

You can also run into the problem that your DME is in network, but when you buy something later, they're not in network, and it's not covered or is covered at a lower rate, higher price, and you have to start a new deductible.

Asking them to "prequalify" before a big purchase can help sometimes.

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