Getting equipment and supplies

I started on PAP last November, and am coming up on the 3 month get supplies mark. One thing I have noted about my Insurance (Cigna) is that their coverage information either on the website nor the handbook I got from my company contains any information at all about what is covered. I am really fortunate in that my plan covers 100% in network, but getting information about what is in-network is like pulling hens teeth, and its worse to find what is covered.

The DME is no better. They require a phone call (for which you must annoyingly sit on hold for a while) and then the person doesn't have information about you specifically, they just know what can usually be done. All very frustrating in this day and age of information always at the ready.

Really, at least the supply part of this process should be a refill process with your supplies listed and when they can be filled next, and a shopping cart. Why aren't they more on the ball? Well, I think that is because the insurance companies have reduced competition by selecting limited players.... It's hard to believe that with the markup on these things that there isn't a more consumer friendly process!

Some call the frustration you're dealing with part of non medical barriers to treatment.

I can feel your pain.

Online vendors will be very easy to deal with. But they're rarely in network.

Sleep Review just had an article on a new retail outlet for cpap and supplies. ..neat to be able to see and compare. Just visited a retail outlet in Milwaukee. Probably not in network.

For folks coming to the forums that have given up on cpap. ... how much of a factor was the frustration dealing with supplies a factor in your giving up on cpap?

I have been using Nationwide provided thru my AARP find them great.

The company I deal with is great in getting my supplies to me quickly. However, they call every two weeks to try to get me to order something. Then when the bill comes in, they guess at what my insurance will pay and bill me according to what they want. I tell them every time that I won't pay until I get an EOB from the insurance company. They say that is fine and yet I get nasty letters threatening to send me to a collection agency. I call and they say, don't worry about it, that's just how we do things. I am looking for a new supplier!

Ruby you bring up some good points. We probably all agree that when a home care company treats you well it's a good thing and has a positive impact on your outcomes but how does it make you feel towards your therapy when you have one that doesn't help or that is annoying? Might be an interesting question.

A number of the companies may have automatic billing systems that can't be told "Ruby always pays as soon as she gets her EOB so don't send her payment notices for at least xxx days". If they realized the impact, they might fix it. What do you all in the forum think? How does "being bugged" make you feel towards the company vs towards your therapy?

My situation is somewhat different now that I under Medicare these past 5 years... The first ~3 years I was covered under a senior Advantage program with a nationally known HMO the DME supplies were prompt but they almost always sent me more supplies than I had requested but I pretty much automatically received Medicare payments! Since leaving the HMO's Advantage program, despite remaining with the same DME company, they cut off my Medicare payments and eventually refused to accept any supplies requests from me. Their (the DME co) explanation is that the HMO had NOT correctly completed the Medicare paperwork. I have tried 4 Sleep Medicine MD during the past 2 years and none (thus far) have been willing and/or been able to successfully help me satisfy Medicare's paperwork appetite... thus NO Medicare benefits from my DME. I will soon be looking for my 5th Sleep Medicine MD ! Sam