Changed insurance- need new DME

Insurance through wife's work [better coverage than mine would be]- however, they are changing carriers [still better].
I interviewed one of the local "accepted" DMEs today-- to see what they carried and get a general impression.

They carry both Respironics and Resmed machines [they are currently supplying primarily Resmed S9 auto as their standard machine]- I have a 3 year+ old Respironics M series CPAP machine. I asked how to communicate the schedule of when I need the next machine and she said "Things have changed a bit, most insurance companies do not replace after 3 years unless something is wrong with the machine". Respiratory therapist also said that there is no real setup to pass that information from one insurance carrier to another- but that since the new carrier had never purchased a machine that should be no problem when I felt I needed or wanted a change. I guess I am just including that info to see if you think she is correct? And wondering if this is "the time" to get a new machine- while changing carriers, rather than trying to prove I need one down the road a bit?

What drove me to make the contact today is that I am needing a new mask & headgear. I have used Optilife [nasal cushions], but went back to Comfort Gel because my wife felt I was losing too much air with the Nasal Pillows, snoring occasionally, and the exhaust air on the Optilife kept hitting her (Comfort Gel port shoots down instead of straight ahead). Problem is that when I ordered a replacement from my old DME, they sent me the Comfort Gel "Blue"-- my wife says they call it "Blue" because of the cold air she gets from the "new & unimproved" exhale port that is shooting slightly high of straight ahead--- [same problem- my wife says she doesn't like a cold shoulder any more than I do]. New DME RT said she thinks they no longer make the older Comfort Gel-- I could use a recommendation.

I see the banner "comparison" between Comfort Gel & Softgel-- what do you think??? Your responses would be greatly appreciated.
letchworth

I have no clue about the mask. My DME keeps trying to fit me with a full face mask, but I politely tell her I love my mask and to order what I want. My thoughts are if the new carrier will give you a new machine... take it. You can use your old machine as a back up. Also, find out from the new insurance company how often they will pay to replace masks (also filters and hoses). Get those on a routine basis. We don't know how bad O'bama-care will be, but it's gone from free to 25% more than we are paying now (the whole premise of O'bama-care was that people can't afford to have insurance and now it's going to cost 25% more). We also don't know what it will look like (if cpap equipment will be included). My thoughts are to get it now... because it may not be available when O'bama-care kicks in.

Sheriff

Ask this DME provider if they will be sure to get prior approval so you don't get stuck having to pay out of pocket for the S9. (How great that they provide a lot of S9 AutoSets!!!! - or were they talking the S9 Escape Auto?) To ensure that the new insurance doesn't notice the earlier date on your equipment order (script) will your family doctor write you a new script w/a current date for the new APAP?

Thanks to you both-- good ideas.... I will check into both. Family Dr., I see no problems there.

Any further input would be appreciated--- also looking for feedback regarding mask, if possible.

letchworth

Is the frame from your old ComfortGel mask broken? The ComfortGel Blue cushions and flaps fit the ComfortGel and vice versa. (As long as the frame size matches the cushion size.) Then get the CG blue mask from the DME and get replacement cushions and flaps.

I prefer the CG Blue cushions to the CG cushions. The flaps are the same.

You might want to buy a spare CG mask from cpap.com to have a spare.

Even if your old CG mask frame is broken, you might be able to take the elbow off of the CG mask and put it on the blue frame. I haven't actually done this, so I'm not sure if it can be removed and reinstalled.