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As I am new, I have not had to deal with this yet. Don't we have a choice, even with insurance, where we get our supplies from?

Well, it depends . . .

If you have the financial resources, you can go ANYWHERE you want. Our hosts at CPAP.com are wonderful to work with, and I highly recommend them if you can't find a local DME who will provide what you want at a fair price (Brick and Mortar DME's will almost always OVERCHARGE you if you're paying out of pocket--a few won't, most will).

If you don't have the financial resources to pay privately, or you're just not willing to do that because you already pay for your insurance and DME coverage, whether or not you have a choice of suppliers depends on your insurance. HMO's generally give you no choice. For example, my HMO is Kaiser and it's Crapria or nothing. I can't really afford to pay for my own equipment, so I'm stuck with Crapria. Sometimes I do pay for my own supplies just so I don't have to put up with their crap.

Other insurers may give you a few choices and you get to pick. If you're still on private insurance, you may have some leverage. If your doctor is well known to the DME's and regularly refers patients, you may have some leverage, if you know what your insurance will cover and don't let them play games with you, you may have some leverage.

But the story may be different on Medicare. Medicare has narrowed the choices of DME's considerably by adopting the new competitive bidding process. Usually there are only 2 or 3 DME's in a given market, and because of the competitive bidding process, the DME's who won the bids are going to slice everything to the bone to squeeze out any profit. So the process of getting the equipment you want is changing, and what worked a year ago will no longer work. You can't play one DME against another, because for the most part only the "big and bad" players had the ability to win the competitive bids. They are going to preserve profits by offering only limited formularies for which they make the most profit, even if your individual preferences aren't satisfied.

Technically you ALWAYS have a choice, but in reality it may not be much of one.

thanks Janknitz, I still have BCBS where I work - not sure how long I can afford it, but for now okay - it is an interesting problem for sure.

Everything is or will go Generic soon. I have been using American Home Patient for six years and recently the Liberty Mirage FF mask Mouth Cushions are a piece of Crap. Paper thin and no support.

joshelmintz wrote:Yes they took away my resmed. I was on a resmed BiPap for 2 years and still felt lousy. I had another sleep study a few weeks ago and it turns out that I have complex apnea. The resmed I was on was treating obstructive but wasn't designed to treat the centrals. During my sleep study they added a backup rate and said I did much better. So the sent me to Apria instead of my other DME. They gave me the respironics BiPAP st. Not a fan! Been having issues with bad leaks, and still feel bad. I did switch my mask going from a hybrid to the wisp nasal. Going to try that one tonight. But to answer your question no I did not get to object and really didn't know that there was much of a difference until now. If this doesn't work I may be getting an ASV and if that's the case I'm fighting for the resmed!

At least there was some sort of reasoning going on, at least in the beginning. Make no bones about the fact you are unhappy, especially to your doc, as getting a particular brand is really dependent on the doc, who has to write a specific rx in order to guarantee a specific machine, and even then, they might try to change it. I hope for the best for you!

Things are certainly changing out there, especially for Medicare. I was referred by my old DME, who lost the bid, to CPAP Care Club. Still waiting for my order, but since I use the heated hose from Resmed, it would be hard for them to switch. At least they did not try to get me to switch to a different hose. They seem great so far. I have yet to get the order, though, so an update is in the works. So glad I had an alternative to Crapria!

One thing about hoses is that they are relatively inexpensive. I bought my hubby a replacement from our hosts, a generic one I think, but it is every bit as good as the one he got from our original doc.