Help!

Hi folks, I'm new to the forum. I had my Cpap titration last week and I'm going in today to meet with my doctor. I was having 130 incidents per hour, which is obviously very severe. My insurance company will pay for 80% of my machine. Does anyone know if I have to pay anything up front, or will the medical store bill my insurance company? I need this machine ASAP! Any advice is appreciated!

Depends on the insurance and the DME. Often you must pay the 20% up front. (Machine, Humidifier, Mask) Sometimes, if the DME doesn't know how much the insurance will pay, you will be billed. You pay 20% of the amount the insurance pays...NOT...20% of what is billed.

Sometime too you can rent to own, and the payments are quite manageable.

John

jessress wrote:Hi folks, I'm new to the forum. I had my Cpap titration last week and I'm going in today to meet with my doctor. I was having 130 incidents per hour, which is obviously very severe. My insurance company will pay for 80% of my machine. Does anyone know if I have to pay anything up front, or will the medical store bill my insurance company? I need this machine ASAP! Any advice is appreciated!

Before you SIGN anything about taking delivery on the machine you will be sleeping with for the next five years you need to read and re-read What you need to know before your meet your DME by JanKnitz. Lots of good info and advice.

Second, JanKnitz also has a guide to Data Capable Machines that is up-to-date and reflects what's on the market now.

Third, my Advice to the newly diagnosed may be useful.

Fourth, if you need help understanding all the acronyms and terms used on the sleep study report, my Understanding the data in your sleep test will be useful.

I've been billed, never needed any money up front. You can call the insurance co. and DME to be sure.

jessress, read carefully before you let your DME (CPAP seller) give you a machine, even a loaner.

You have a golden opportunity not to be screwed by your CPAP supplier like most apneacs do.

All CPAP machines will probably cost the same if you have insurance. Your DME will probably try to screw you by giving you a machine which doesn't collect data. This makes it much harder to treat your apnea correctly.

Read robysue's link and other info on this board. Do not accept a ResMed Escape machine or Respironics "Plus" model. Other models from the same manufacturer will be much more capable and will cost you the same.

You have the right to choose a different DME who will give you the right machine. Don't let your doctor or sleep lab bully you into buying from their buddy.

LSAT wrote:You pay 20% of the amount the insurance pays...NOT...20% of what is billed.

Oops, keyboard hiccup! Should be 20% of the amount the insurance allows.. Insurance pays 80% of the allowed amount.