Post
by johnthomasmacdonald » Sun Dec 01, 2013 12:03 pm
I have to admit that i find these complaints over MY waste of the insurance company resources quite amusing.
As background, i've have the same insurance company throughout my apnea saga - I pay $1500 a month for it.
WHen i first tried to get a sleep test based on my symptoms and the diagnosis of a sleep doctor that i went to see, they refused. The only reason i can think is that i am not overweight at all and i'm not dozing off during the day.
So I paid the $300 myself for a home test which diagnosed moderate sleep apnea and i bought the PR system one APAP machine - i think that was about a $1000. It didn't work for me at all. I couldn't stand it and was going to give it up.
I next bought a custom made dental appliance for another $1000, that didn't work.
Throughout this i tried to get the insurance company to pay for an overnight sleep test given my sleephead printouts but they refused.
I felt i was suffocating when inhaling on my apap machine, so based on what i found out here, i bought a new Resmed VPAP bilevel ( it was s or t, i can't remember) - another $1000 or so. This was the biggest breakthrough, with exhalation relief i could at least use the unit through the night.
However my AHI numbers were through the roof, so I bought a PR system one bipap/apap - that didn't help at all and was less comfortable than the straight resmed bipap.
In talking to people here and looking at my printouts, it became obvious that i needed an asv machine to deal with all the centrals i was getting. So i bought a new Resmed S8 enhanced ASV and for the first time i was consistently getting ahi numbers down around 5 but i still had severe nocturia - i was getting up 10 times a night to urinate and an average night was half a gallon of urine - this was without drinking anything after 6Pm and the urine was like water- clear and odorless.
At this point, the rules from Obamacare requiring the insurance companies to cover preventative medicine kicked in and all of a sudden they were willing to pay for sleep tests - which i didn't want. At this point all i wanted was for someone to listen to what was going on with me and look at the sleepyhead printouts.
No luck, they made me go through one overnight sleep test to confirm that i had apnea ( exact same results as the home test), a titration study - followed by months on the PR Bipap/apap to document its failure and then then a night on the resmed ASV machine.
They then tried to stick me with an asv machine that was older than my s8 enhanced and had no sd-card or any data other than hours used and pressure - it had been discontinued 6 years ago.
I fought this for months and finally got the s9 asv machine with auto epap and heated hose that i wanted - my average ahi is now below 0.5 and i never wake up to urinate and i can drink a liter of coke right before going to sleep and i don't wake up.
Now, i don't own this machine it is a rental.
As to how often i need hoses and masks replaced, my pressures spend much of the night maxed out at 25psi, so unless you are at this level i don't think that your experience is pertinent. I certainly know that that mask needs to be replaced now - it leaks badly and the velcro straps are falling apart given how tightly i have to connect them - maybe there is a better way to put it on but the dme or hospital has never tried to instruct me beyond what i do.
I've also bought my own backup unit a PR ASV 950 unit from papman on this forum, it also has auto epap but lacks the heated hose.
To sum up, in my 16 months of sleep apnea, I've paid for: a home sleep test, PR system one APAP, PR system one Apap/bipap, PR system one ASV with auto Epap, a Resmed vpap bilevel, a resmed ASV s8 enhanced. i've also bought about 40 or 50 masks until i've found one that sort of works along with loads of filters - I've since given away all the machines except the rental and the PR 950 backup with the corresponding filters and extra hoses i always had purchased.
All this time i've had supposedly great insurance - they paid for - 3 in house sleep tests which told me nothing i didn't already know and i didn't want, they RENT an S9 ASV auto epr machine for me and have provided a total of 2 masks and 2 hoses
Yet, somehow, I'm scamming the system and am responsible for the high premiums in the us - the highest on the planet earth actually with an outcome down around that of Cuba