cpap user on how to get a new machine with high deductible ins

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Superboiler
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cpap user on how to get a new machine with high deductible ins

Post by Superboiler » Sun Mar 11, 2018 9:44 am

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I have high deductible insurance and so I would have to pay for any CPAP equipment that I might need.

Currently I use a Resmed S9 with a pressure setting of 9. My last/first sleep study was in 2012. I didn’t feel that I received much guidance or choices and so I am very hesitant to go that route again …especially given the fact the this time around I would pay everything out of pocket.

I was thinking about a new AutoSet CPAP. Leaning towards a Dreamstation based on the iPhone App. I occasionally download data now into Sleepyhead on my S9. I would really like to try and adapt unit to see how this might work. Currently my S9 gives me an AHI in the 1-3 range.

Advice/Question - I have a prescription to get a sleep study. If I go that route, I would look for a home study option because of cost. The other option is to just get an AutoSet unit - maybe craigslist, Amazon, or online. So far most of the home sleep study sites online send the equipment and do the study but I have not been able to find one that gives you a prescription so I can shop on my own. It appears most will allow you to get a unit from them but don’t give you an actual prescription. Is anyone aware of a place that will do the home sleep study at reasonable cost and then give you a prescription?

The other option might be easybreathe.com. They have an option to get get the prescription CPAP package for $99. This would be the cheapest. Opinions?

Presumably they give me an auto unit and maybe some broad pressure range setting. I was thinking this might be the best route. The other options is do their home sleep study which costs $299.

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ChicagoGranny
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Re: cpap user on how to get a new machine with high deductible ins

Post by ChicagoGranny » Sun Mar 11, 2018 10:06 am

Superboiler wrote:
Sun Mar 11, 2018 9:44 am
Advice/Question - I have a prescription to get a sleep study.
Not sure what this means. Didn't know that prescriptions are written for sleep studies.
Superboiler wrote:
Sun Mar 11, 2018 9:44 am
Presumably they give me an auto unit and maybe some broad pressure range setting. I was thinking this might be the best route. The other options is do their home sleep study which costs $299.
The only value in a HST is to diagnose you with sleep apnea. It seems you are already diagnosed.

Superboiler wrote:
Sun Mar 11, 2018 9:44 am
It appears most will allow you to get a unit from them but don’t give you an actual prescription.
Any doctor can write a prescription for CPAP. Have you asked the practice that did your sleep study in 2012 to give you an updated prescription? They can still specify whatever settings were on the original prescription. You can change the settings at home.

If that fails, you could ask your family doctor to write a script. I know a guy that got his dentist to write an updated CPAP script.

What happened to your original script? You should have kept a copy, and most online providers will honor it indefinitely.

Superboiler wrote:
Sun Mar 11, 2018 9:44 am
Leaning towards a Dreamstation based on the iPhone App.
That sounds silly. Do you have any other reasons to change machine brands? Your ResMed seems to work well. A machine with a different algorithm might not be suitable for you. As a general rule, ResMed is preferred over Philips.

Also, there are several ways to get a machine without a script.

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jennmary
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Re: cpap user on how to get a new machine with high deductible ins

Post by jennmary » Sun Mar 11, 2018 10:26 am

Honestly......I made the decision to just buy "used". Yesterday I drove 2 hours to pick up a brand new resmed airsense 10 autoset. A woman with an insurance that fully covered her machine had decided that she wasnt even going to try the machine for a single night. So I scored a brand new machine with 0 hours on it, heated hose, regular hose, all the other basics and even a brand new mask all for $250. I would honestly search all if your local sales listings and see what comes up for an auto. But I also don't feel I currently need a doctor or sleep study.....if you feel that you would benefit from a new sleep study then absolutely get one.

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ChicagoGranny
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Re: cpap user on how to get a new machine with high deductible ins

Post by ChicagoGranny » Sun Mar 11, 2018 10:48 am

jennmary wrote:
Sun Mar 11, 2018 10:26 am
Honestly......I made the decision to just buy "used". Yesterday I drove 2 hours to pick up a brand new resmed airsense 10 autoset. A woman with an insurance that fully covered her machine had decided that she wasnt even going to try the machine for a single night. So I scored a brand new machine with 0 hours on it, heated hose, regular hose, all the other basics and even a brand new mask all for $250. I would honestly search all if your local sales listings and see what comes up for an auto. But I also don't feel I currently need a doctor or sleep study.....if you feel that you would benefit from a new sleep study then absolutely get one.
There are two possible problems here.

1. If the woman is insurance-naive, she may later find her insurance company was renting-to-purchase. When she can't show compliance, they may demand the machine be returned.

2. The woman knows exactly what she is doing, has obtained the machine with plans to sell it and is committing insurance fraud.

TedVPAP
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Re: cpap user on how to get a new machine with high deductible ins

Post by TedVPAP » Sun Mar 11, 2018 11:26 am

I am also on a High Deductable Plan.
I needed a new machine. Since I stopped seeing my sleep doctor every 6 months as he wanted, he would not give me a new script. My family doctor did not feel comfortable writing the script.
I bought without a script using paypal. Submitted the receipt to my HSA to reimburse myself with my tax free dollars.

Although a script is required to buy machines and masks in the USA, you can find people selling without a script.
I bought new equipment from a dealer I found on craigslist. Equipment was drop shipped from the manufacturer.
I bought Dreamstation APAP with heated humidifier and a P-10 mask for $490 a year ago.

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Re: cpap user on how to get a new machine with high deductible ins

Post by SewTired » Sun Mar 11, 2018 11:57 am

Call your primary and ask if s/he will give you a prescription at your next appointment. Bring a few pages of data if you have it. Explain that you want an automachine that provides data so that you can set your parameters based on how you sleep each night. You've already been diagnosed and your report shows that you religiously use your machine - you just need to replace it. If you mention that you are paying cash rather than going through insurance, that might help. This is your best bet to get a new machine with a warranty. My primary was reluctant before I had a sleep study, but now that I've been diagnosed, he doesn't have an issue signing off on the prescription especially after I explained that I haven't seen a doctor since the first appointment - just RNs.

I have bought machines via Craigslist and OnOffer out of state. In both cases, these were owned rather than that drop ship place. I asked for a photo of the machine hours and whether a smoker had used the machine and why they were selling. Pay for them via Paypal. You will have some protection if the machine doesn't work or isn't as described.

I've seen the dealer that TedVPAP talks about on Craigslist. So, you have his recommendation and as I said, use Paypal to buy it.

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Jeramief
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Re: cpap user on how to get a new machine with high deductible ins

Post by Jeramief » Mon Mar 12, 2018 8:12 am

My prescription is lifetime so I have a copy in my file cabinet which I used to buy a second machine for use when away from home. I used my FSA card/account through work to purchase second machine which I use 2-3 nights every week and sometimes more if I go somewhere over the weekend the second machine is so worth it for me my second machine is a dDreamstation go. I have seen machines for sale on eBay and Amazon and many other places without a prescription.

prodigyplace
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Re: cpap user on how to get a new machine with high deductible ins

Post by prodigyplace » Mon Mar 12, 2018 8:28 am

If ResMed is working for you, it it recommended you keep with that brand. Different brands use different algorithms.

This looks like a good deal from a trusted vendor. A used S10 AutoSet with heated tubing for $550

https://www.secondwindcpap.com/ResMed-S10-AutoSet.html

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chunkyfrog
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Re: cpap user on how to get a new machine with high deductible ins

Post by chunkyfrog » Mon Mar 12, 2018 9:00 am

Note: secondwindcpap sells low hour used machines and zero hour open box.
A high hour machine may be cheaper elsewhere, but secondwind does offer a warranty.

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Superboiler
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Re: cpap user on how to get a new machine with high deductible ins

Post by Superboiler » Sun Apr 01, 2018 7:43 am

Belated thanks for all the replies. Great comments. I managed to get a copy of what I think is the doctor’s prescription from my sleep study five years ago. So now I have options.

My interest in a new unit is so:

* Try out the autoset function. I have my current unit set to 9 based on my study but in quest for better sleep, I would like to try the newer autoset.

* Data - right now I have to pop the card out to get data. I would prefer to have a unit that has a smartphone-like app. From what I have read, Phillips Dreamstation is best...Airsense 10 much less so. In reality, it seems all the cpap vendors are a little behind in the smartphone app area.

So my original plan was to get a Dreamstation, but the comment to stay with a brand that works has me rethinking this. Is the Resmed to Dreamstation jump too risky given I have to pay for this? Can anyone comment on this?

Thanks



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LSAT
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Re: cpap user on how to get a new machine with high deductible ins

Post by LSAT » Sun Apr 01, 2018 8:41 am

Superboiler....check your PMs

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Re: cpap user on how to get a new machine with high deductible ins

Post by D.H. » Sun Apr 01, 2018 9:46 am

To the OP. Your AHI is < 1, which is considered very good. Therefore, I don't see any urgency in replacing the machine.

If you want to do this, you might want to put all your stuff into the same year (such as your colonoscopy, a comprehensive heart exam, etc.) in order to meet you deductible.

If you do get a new machine, make sure to keep the old one as a backup!

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