Insurance schedule

[Roman Hokie]

Good evening. I think my DME is an idiot. Aside from the fact that he requires me to notify him monthly to send me my 2 filters and 2 nasal pillows, I think he's on his own schedule. I have BCBS.

If I recall correctly, it seems that I should get the pillow interface / mask every 3 months, 2 pillows and 2 filters a month (technically every 2 weeks), a tube every 3 months, and the humidifier every 6.

Does this sound right?

According to my DME, he says:

1 pillow a month, 1 filter a month, tubing tub and "headgear" every 6 and mask every 6. I appreciate the advice of the masses here. How do I address him on this? Or do I call BCBS and complain. (At least I have no copays or coinsurance on this. Thank you in advance.

[ChicagoGranny]

Or do I call BCBS and complain.

No, call BCBS and ask them for a copy of the replacement schedule. It's their replacement schedule, not the DME's. Even within BCBS, policies vary, so no one here can tell you what your policy says.

[chunkyfrog]

What she said.
Get it in WRITING, confront them with any discrepancy, and , if necessary,
TAKE YOUR BUSINESS ELSEWHERE.

[LSAT]

Good evening. I think my DME is an idiot. Aside from the fact that he requires me to notify him monthly to send me my 2 filters and 2 nasal pillows, I think he's on his own schedule. I have BCBS.

If I recall correctly, it seems that I should get the pillow interface / mask every 3 months, 2 pillows and 2 filters a month (technically every 2 weeks), a tube every 3 months, and the humidifier every 6.

Does this sound right?

According to my DME, he says:

1 pillow a month, 1 filter a month, tubing tub and "headgear" every 6 and mask every 6. I appreciate the advice of the masses here. How do I address him on this? Or do I call BCBS and complain. (At least I have no copays or coinsurance on this. Thank you in advance.

Some insurance (including Medicare) do not allow regular shipments of supplies ...the patient must request them. IMO..no one needs the supplies on a regular basis. Who needs a new hose every 3 months they never wear out. Same with most masks and humidifiers.
Because they are free doesn't mean you have to take them....that's why out healthcare system is in the shape it is in.

[Guest]

Call your Ins. (as already said) but also make sure the DME is only billing for what they are sending not what you think they should send.

[Greekjim]

I went to the new DME place cause I got new insurance and the lady at the desk never heard of the new F20 mask when I went to order. Not happy with them.