Apria Health

[jbgilm]

I have been working with a supplier of cpap equipment and supplies for a while but have grown increasingly disenchanted with them. I'm now looking for an alternative supplier. CPAP.com seems good but they are not in my insurance network. Have any of you used Apria Health, and if so what has your experience been like. Has anyone used cpap.com as an out-of-network provider, and if so were you able to be reimbursed by your insurance company?

[LSAT]

Crapria...Billing is horrible..noted for shipping the wrong items....poor customer service...Use at your own risk.

[jbgilm]

Sounds like my current supplier (Adapt Health). Is there a good supplier?

[ChicagoGranny]

were you able to be reimbursed by your insurance company?

You need to ask YOUR insurance company. Policies vary from company to company, and within one company, there are different policies with different terms. No one here knows YOUR policy.

[raisedfist]

Having dealt with Crapria before, I'd rather pay more out of pocket than deal with 3rd parties.

[Wulfman...]

I have been working with a supplier of cpap equipment and supplies for a while but have grown increasingly disenchanted with them. I'm now looking for an alternative supplier. CPAP.com seems good but they are not in my insurance network. Have any of you used Apria Health, and if so what has your experience been like. Has anyone used cpap.com as an out-of-network provider, and if so were you able to be reimbursed by your insurance company?

Yes! But MY insurance provider ( a PPO ) at the time considered me to be "in-network". Some don't.
BUT.......YOU NEED TO ASK THEM FIRST.
Here's my story:

viewtopic.php?f=1&t=48759&p=445592&hili ... ed#p445592

As I said, my initial purchase (through CPAP.COM) was reimbursed 80% and everything I have purchased since has been "out-of-pocket"......even after I went on Medicare. So, 15 years of not having to deal with local DMEs. It's been worth it!

PS. I'm not sure if it was mentioned in that link, but after I purchased my equipment out of pocket, I made out an invoice to my insurance provider (using the insurance codes included on my invoice from CPAP.COM) and sent it to them......and they reimbursed me from that invoice.


Den

.

[chunkyfrog]

Liklihood of getting Medicare to do that: slim, very slim.

[Pugsy]

Liklihood of getting Medicare to do that: slim, very slim.

How about slim and none for places like cpap.com.
They wouldn't necessarily have to accept assignment but there are still a boatload of rules and regulations that cpap.com would have to do which includes they would have to file to Medicare even if they didn't take assignment.

Medicare really doesn't want or have provisions now for Medicare patients to file their own claims. They don't want it. Years ago...yeah but not not now. If you dig deep in the bowels of the Medicare rules there is a complex description of what to do if you want to file a claim yourself but they make it so difficult most people won't understand what to do. I was looking at it about 6 months ago and my eyes glazed over and I used to work in an office where I filed Medicare for the doctor so I have some working knowledge of what they were talking about.

Medicare will NOT reimburse for cpap.com purchases.....period.
Now other insurance....it's a maybe depending on the particular plan and whether they offer "out of network" reimbursement and would consider an online supplier even "out of network".....some won't even consider which is essentially what Medicare does with places like cpap.com. No provision at all for anything out of "network"....doesn't matter if takes assignment or not...still out of network.

[Janknitz]

Sounds like my current supplier (Adapt Health). Is there a good supplier?

Very, very rarely, people are able to find a good supplier. Even more rarely, a good supplier covered by their insurance. And often, that good supplier gets bought out by a larger company like Crapria and any good service goes away.

The bottom line is this:
1. If you want your insurance to help pay for equipment and supplies, you're going to have to put up with poor service, messed up billing, lying and cheating about 99% of the time.
2. If you pay your own way (there are ways to save money on all the supplies and equipment) you're on your own, but if relatively intelligent you don't have to put up with a load of baloney, spend all your time arguing and fighting. You get what you want, when you want, and no game playing.

I include in "pay your own way" working with our hosts at cpap.com. They are one of the few good suppliers, but they don't take most insurances.

[chunkyfrog]

My DME is a small local mom n pop operation.
I have used them for over 10 years.
I wish them well, and dread the thought of ever being forced to use a less respectable outfit.

[SleepGeek]

I also have used Apria and stopped. They took me to court for non-compliance and lost cuz I took out their modem they never told me about so they never billed Medicare. But my compliance was 120% and the judge was impressed with what I showed to him.
It seems like any supplier who begins with 'A' is worthless.

IF you just need supplies and don't need the useless tech that comes with the Homecare companies give Verus Healthcare a chance. They take Medicare and Medicare Advantage plans. I have been using them for several years now and have no complaints. They deliver what I order and deliver on time - no aggravation from the house visit techs who usually know less than you do.

[jbgilm]

My new plan, based on your wise advice, is to skip the supplier and buy stuff when I need it from CPAP.COM, and submit bills to my insurance. But I have to find out first if the insurance company will cooperate in my plan. One reason to avoid the supplier is that they are always trying to push me to order new hoses, tanks, etc. I just learned from another discussion here that many of you never replace your hose or tank. Makes sense to me! Thanks for the help.

[Janknitz]

My new plan, based on your wise advice, is to skip the supplier and buy stuff when I need it from CPAP.COM, and submit bills to my insurance. But I have to find out first if the insurance company will cooperate in my plan. One reason to avoid the supplier is that they are always trying to push me to order new hoses, tanks, etc. I just learned from another discussion here that many of you never replace your hose or tank. Makes sense to me! Thanks for the help.

Unlikely that your insurance will "cooperate" but maybe you'll be lucky. Let us know.

Especially if insurance is paying, it is a good idea to have at least one spare of all the "consumables" just in case something breaks unexpectedly. Most mask frames and short hoses don't have to be replaced often, but you will need face and nasal cushions and straps replaced fairly regularly (though usually not as often as the replacement schedules permit except the velcro straps which need replacing sooner than the 6 months most insurers require for replacement).

Filters are often cheaper online than your insurance co-payment. I got a pack of 52 for $12. Crapria charged me an $8 co-pay for every 3.

[ChicagoGranny]

But I have to find out first if the insurance company will cooperate in my plan.

Absolutely.

Here is advice from cpap.com website.

Insurance
Purchasing through CPAP.com is often cheaper than your copay and deductible through insurance. CPAP.com is a cash only medical distributor that does not accept insurance assignment, does not have an NPI number, and is not a participating provider with any insurance companies. A pre-populated example insurance form is available for all CPAP.com orders. To view and print the form, log into your CPAP.com account. The pre-populated form may be used to seek reimbursement from your insurance company. CPAP.com is out of network for private insurance companies. Check with your private insurer to see if they will reimburse your purchase. Medicare, Medicaid and other government run healthcare programs will not reimburse CPAP.com purchases.

[jcrocketman]

I recently purchased a CPAP and some supplies through CPAP.com and filed a claim through my insurance. My insurance company ( a very large National company) made it as difficult as hell. First of all, they buried their claim form on their website so deep that I had to call them to find it. Basically, once signed in it wasn't available. I had to sign out and go through several layers to get a copy. Then the fun began. There wasn't really any way to submit it other than e-mailing it to them. They made me resubmit the form about 5 or 6 times, each time rejecting the form and sending a vague explanation of rejection. Finally after they figured out I wasn't going away, pushed it to their Texas branch to process as a courtesy to me I might note! (CPAP.com is located in Texas). 2 months later they reimbursed me at 60% (out of network). The ironic part of this is my insurance would have been charged 2 or 3 times more for the CPAP from a DME than from me buying it through CPAP.com, yet they pay me back at 60% of what I paid! While I wont go through that again, I have found that buying supplies & equipment by myself is much cheaper than getting my insurance and a DME involved. When I first started this journey in 2015 my DME was constantly sending me supplies I didn't need at a crazy premium. After my deductible & 20% copay for an in network provider I was paying a significant amount more than just buying what I needed on the internet.