Forum · Nail down costs

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[-] Athena1965 +0 points · 11 months ago

Has anyone else had trouble finding out how much the CPAP machine will cost? My insurance company says not even a co-pay. That there should be no charge to me. DME provider says it will be between 94 and $110 to pick it up and they couldn't give me a monthly charge they would have to see. My sleep coordinator said the initial charge will be somewhere between 150 and $200 and he had no idea what it would be a month maybe $25 month maybe more. They both said if you want the real number cause we can't give you a real number you need to call your insurance company. My insurance company says there's no charge to me!

Why is this so hard? Why can't somebody give me actual numbers?

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[-] wiredgeorge +1 point · 11 months ago Sleep Enthusiast

Ultimately, it is pretty much standard practice for a prescription to be filled and the DME set a machine up with an insurance company picking up costs or at least part of the cost. I am not familiar with any situation other than my own but that is the way it worked for me. The cost is "machine rental" and cost of associated supplies. Supplies consist of extra masks, extra cushions, extra tubing, extra filters and extra water reservoirs. My situation changed and I called to find out the status of my machine which was a tad older than a year. The support for the machine ran out but was told by both the DME and my insurance that I now owned the machine. OK, fine. Supplies? They sent enough stuff during the first year so that it will likely last for MANY years. I have BUNCHES of supplies and actually took myself off the auto supply of these supplies.

In any case, if I wanted to have a machine and just pay outright, I would check Craigslist. DOZENS of machines out there for sale and some real cheap. Find out what the DME wants to give you you and look around for one. While there are not as many machines on eBay, there are tons of inexpensive supplies.

Keep in mind your DME has a contract with your insurance company and you won't find out how much stuff costs TO THE INSURANCE COMPANY but many companies have direct sales if you are interested in spending too much. If you are going to pay a bunch of money to get a machine, just buy one. I only know the Resmed machine and if you do some search on youtube, you can find out how to set it up yourself. Also, keep in mind MOST of the ResMed machines I know of have different modes, if that is required; such as BIPAP, CPAP and APAP. The Resmed machines send a signal to a local cell tower and ResMed collects info based on your night's sleep such as AHI/hour, Leak/Min, hours of sleep and the like and you can view this info at myair.resmed.com after signing up and make better choices to control your own therapy. With other machines, you have to remove an SD card and download data to 3rd party software to get the same info (Sleepyhead) but that data is more detailed, if y ou are into detail. Sleepyhead is free. I don't use that software but you can probably locate it easily and there are those here who can help get you started if you don't go ResMed.

Hope that info helps.

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[-] ShiftWorker +1 point · 11 months ago

Hello Athena 1965, In my experience, it is the only experience I can speak of! My insurance has covered the cost of machine rental, mask, and every three months i am sent supplies for what wears out, A new mask every six months, a new cushion every month, new headgear every three months, new hose and filters for the machine and a new water tank for the humidifier about every six months. other then my Dr. copay there has been no out of pocket expense. I have purchased a couple of the newer masks on my own, but that was my choice! I have insomnia and do not fall asleep easily, over half of my time in bed is awake. I have asked my Dr. for a non habit forming sleep med, after trying a couple, I am able to fall to sleep relatively quickly. It has taken about Three months for me to get used to having something on my face, while sleeping. I have many times wondered if any of this is worth the trouble, I live and sleep alone, have now for a couple of years. I am feeling the benefit of a good nights rest with being able to go to sleep and actually get good sleep from not waking in an o2 starved panic. Athena 1965, keep trying, in my experience it has been a struggle, but in time it has been worth it.

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[-] Athena1965 +0 points · 11 months ago

So, if all they are telling me is true, $250.00 at pick up and $25.00 per month for 10 months, that is $500.00. I found a CPAP machine online for $189.00 or $8.72 per month. Benefit aside from a saving $311.00, no insurance company in my bed monitoring me.

Once I get a final answer on the costs, I will make my decision.

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[-] wiredgeorge +0 points · 11 months ago Sleep Enthusiast

Make sure you get a machine type that you personally can change the settings. ResMed settings are typically set by the DME but you can easily find out how to modify settings via the internet. I don't usually say this because a lot of folks want to monkey with the settings as prescribed because they perceive they have having problems of one sort or the other. Best to stick with prescribed settings. You can change humidity levels and ramp time but the pressures should be what the sleep study indicates. Good luck.

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[-] Athena1965 +0 points · 11 months ago

How can they possibly know what pressure I need from one at home sleep study?

Damn straight I'm going to be able to modify the Settings myself. My biggest fear is the continuous air that I have to exhale against will be too much. If I have to wait for the DME to change the settings, I'm never going to use this thing!

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