VA Nebraska-Western Iowa Healthcare System

[Chibi's Dad]

Hi all,
I was recently diagnosed with moderate OSA and have an appointment for a CPAP machine fitting on June 13. I am going through the VA Nebraska-Western Iowa Healthcare system and was curious if anyone else uses them for their pulmonology care. I'd like to know how the Drs are and what machines they are likely to carry. Also, any experiences, good or bad. I have to travel anywhere from 150 to 250 miles for in-person care, so if the care is poor, I can always opt for private care through Tricare. According to my Dr note, he is prescribing a "titrating" machine, whatever that is. Any information would be greatly appreciated.

[Okie bipap]

It sounds like you are getting an auto machine. VA doctors normally issue either the Resmed AS10 Autoset or the Philips Responics Dream Machine auto. Both are good, full data machines. You will find a lot of help here on the forum. Several members of the forum got their machine from the VA. Since I have Medicare and Tricare for life, I chose not to use the VA. If you have a Tricare supplement, it might would probably be more convenient to use a civilian doctor that is closer to where you live.

[Julie]

Titration is the term used for testing what pressure of air is needed to deal with your apnea events (everyone's different of course) based on your sleep. Auto Cpaps (or Apaps) can titrate for you, though plain Cpaps do not. Auto machines can do plain Cpap, but not the other way around, plus they are more useful when you use software (e.g. free Sleepyhead that most use) that can tell you in detail what's what overnight and let you tweak therapy as a result.

[greatunclebill]

i have been retired usaf for 28 years and never used va. i paid my tricare annual fee and co-pays and got to cherry pick my doctors and facilities and dme's. there are no tricare supplements because by law tricare is always last payer. at age 65 tricare ends. you then pay medicare part b and tricare for life is free. medicare pays the first 80% and tricare or life picks up the 20% and all medicare deductibles, including dme items. in 3 years on medicare / tricare for life i haven't spent a penny out of pocket. drugs in both tricare and tricare for life are done thru exprees scripts so there is no need for medicare part d drug plans. my opinion is go to tricare where you control things.
thank you for your service.

[Okie bipap]

If you are retired military and are too young to qualify for Medicare, you can purchase Tricare supplement insurance. I carried a Tricare supplement until I went on Medicare. The supplement covered my deductible amount. I kept the supplemental policy on my wife until she went on Medicare. The only thing I used VA for was one minor knee surgery and for hearing aids for several years.

[Chibi's Dad]

Thanks all for your replies. At this stage, everything is helpful. As Okie Bipap sussed out, I'm not yet old enough for Medicare and Tricare for Life. Retired from the USCG in 2006. We've had Tricare Standard since moving back to Nebraska because the nearest prime provider is hundreds of miles away. I have never purchased a Tricare Supplement which is probably kinda dumb on my part. I have certain things I use VA for; mainly imagery and treatment for my disabilities, wellness care, and prescriptions for my chronic issues. I use my private Dr. for acute care and anything to do with my cardiovascular or digestive system. I kind of fell into the VA sleep study since it was offered, but I believe I still have the option to take my sleep study results to my private Dr. for follow on care. They've been very good about accepting records of tests done by the VA. Since I've generally had positive experiences with the local VA (except for gastroenterology), I think I'm going to go ahead and have them provide the PAP care. I'll be checking back in once my machine is issued.

[SewTired]

There is nothing to stop you from contacting the DME personnel through the VA to find out which specific model of machine they would be ordering for you so that you can research it.