Forum · Insurance will not cover accessories such as mask, hoses, filters, etc

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[-] HumorousIndigoLeopard3313 +0 points · 7 months ago

I am on Tricare standard. My health plan covered the CPAP and accessories before, when I was on Blue Cross/Blue Shield. My doctor does not have a contract with Tricare, however.

Do I need to switch doctors when I am very satisfied with my pulminologist?

Does anyone have a source of reasonably priced accessories for the ResMed AirSense 10? I've been using my tube and mask for quite some time now, and really need replacement supplies that don't cost hundreds and hundreds of dollars.

Thanks for your help!

JB Arlington, TX

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[-] wiredgeorge +0 points · 7 months ago Sleep Commentator

I don't understand how Tricare works so can't comment on switching doctors or the insurance aspect. I have been using the same hose for 15 months and counting and don't see any issues with it but can't believe the cost of the hose is all that much. As far as masks, you didin't mention which mask you use. I have two masks I use, a Simplus and a Amara View. The masks are two parts and the part that fits on your face (let's call it the cushion) is replaceable and doesn't cost all that much. I use one about every 6 months or more and spend about $30 on Amazon for a replacement cushion. I have been using the Amara View for 15 months and it has become my main mask and I have never replaced the cushion but bought a replacement, just in case. Hard to gauge if $30 every 6 months or so is something to be considered financially but I still have my own business and can afford these type things which may not be the case for everyone. Good luck!

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[-] DanM +0 points · 6 months ago Sleep Commentator

Hi JB. Insurance plans vary widely by company and even by plan within an insurance company. Tricare standard's representatives should be able to provide a directory of providers available to you. However, if your physician is not part of their plan, an insurer will usually either not pay or pay at an out-of-network rate. As for supplies for your AirSense, the supplies are usually provided by a home care company. I encourage you to contact Tricare and ask what equipment providers they contract with. Usually, the home care company only needs a prescription to be able to fill your supplies, and they will generally bill your insurance. Good luck, and hope this helps!

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[-] IntellectualRedVioletSandpiper9984 +0 points · 6 months ago

I kid you not...go to eBay and type in cpap. Lots of brand new hoses etc. probably fell off a truck somewhere. Much cheaper than insurance prices.

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