CPAP PURCHASE DILEMMA

garyland · Post by **garyland** » Fri Aug 05, 2005 8:10 am

My insurance company requires me to RENT a CPAP for one month before considering purchase. I have a $1,000 deductible for an in network purchase and $2,000 deductible for out of network DME equipment purchases. I have not used any of my deductible for in or out of network so far for 2005. The year is now 2/3 over.

Now here is the dilemma. Should I buy the cpap from the authorized company that my insurance company uses, and pay them the $1700 that they want for the purchase of a CPAP, which means I pay the first $1000 and the insurance pays 80 percent of the remaining $700. OR, do I buy the same machine on CPAP.COM for a TOTAL of $500, where the $500 gets applied to the OUT OF NETWORK deductible (the $2,000 one). WHICH MAKES THE MOST SENSE? Thanks, Gary

wading thru the muck! · Post by **wading thru the muck!** » Fri Aug 05, 2005 8:21 am

You will get great service from cpap.com, so considering it will cost you less to go buy from them, it seems to be the best option all around. That's what I did and have never regreted it. While your at it, spend a little more (still less than the $1000) and get an auto-pap. It will probably save you another visit to the sleep lab in the future. I recommend the REMstar auto with c-flex<--LINK. Remember that an auto machine can always be easily set to run as a fixed pressure machine if you so choose.

Let us know what you choose.

4Katie · Post by **4Katie** » Fri Aug 05, 2005 8:26 am

I think it's ridiculous what DME's charge for CPAP machines. In your situation I'd definitely buy straight from cpap.com

Good luck.

Sleepless on LI · Post by **Sleepless on LI** » Fri Aug 05, 2005 8:36 am

Gary writes:

Should I buy the cpap from the authorized company that my insurance company uses, and pay them the $1700 that they want for the purchase of a CPAP, which means I pay the first $1000 and the insurance pays 80 percent of the remaining $700. OR, do I buy the same machine on CPAP.COM for a TOTAL of $500, where the $500 gets applied to the OUT OF NETWORK deductible (the $2,000 one). WHICH MAKES THE MOST SENSE?

CPAP.COM, ABSOLUTELY!!! It is ridiculous to spend $1,000 when you can get a great machine, like a Remstar Auto with Cflex https://www.cpap.com/productpage/respir ... ifier.html or a Puritan Bennett Good Night 420e https://www.cpap.com/productpage/1541 for under $800. Please don't let the insurance companies "screw' you. These are two of the best machines out there and they won't cost you 1k out of pocket, especially at 2/3 of the way through the end of your deductible.

Keep us "posted" !!!

garyland · Post by **garyland** » Fri Aug 05, 2005 9:11 am

Thank you all for your advice. I will go with CPAP.COM and purchase the AUTO CPAP. I have the same machine without the AUTO. So now I have more questions since I was not previously aware of the AUTO machine.

1) Can I turn off the auto feature myself if I want to?
2) Do I need a special prescription from the doc for the AUTO instead of the regular REMSTAR PRO 2 C-FLEX with Heated Hum.?
3) Is the software option good? What will that do for me?

Thanks in advance,
Gary

PS By the way, I adjusted to my RENTAL machine by the 3 day where I use it all night every night. ALso, I bought the SUGGLE HOSE COVER that I love. It insulates great so I get no RAINOUT and the hose is quieter when hitting the bed frame or night stand.

Sleepless on LI · Post by **Sleepless on LI** » Fri Aug 05, 2005 9:35 am

Gary writes:

1) Can I turn off the auto feature myself if I want to?
2) Do I need a special prescription from the doc for the AUTO instead of the regular REMSTAR PRO 2 C-FLEX with Heated Hum.?
3) Is the software option good? What will that do for me?

Answers:

1) On the Remstar Auto with Cflex, you have the option of CPAP or APAP, and the option to use the Cflex or not.

2) Yes, you do need a special prescription for an auto machine from your doctor. It amazes me, though, when I read that a few doctors out there don't believe in them. Hopefully yours will do what you ask, within reason, of course!

3 )YES, YES YES, to the software being a good option. I compare it to sleepwalking, without software. You are asleep, but you don't know what is going on while you are. It is wonderful!!! It is worth every single penny.

Let me know if you are going with the Remstar Auto because if you are, I will provide you with a link (or you can read my post "Card Readers") that gives you a way to get the software and reader for less than what you'd pay on this site for the package. They charge $199 for both. I bought the software here for $99, but was given a link to a great site in Hong Kong that delivered in a week, where the reader was $24 and $6.00 s/h. So instead of paying $199 plus s/h, you will pay $123 plus s/h.

Let me know what you end up with. Good luck.

IWannaSleep · Post by **IWannaSleep** » Fri Aug 05, 2005 9:45 am

Sleepless on LI wrote:...2) Yes, you do need a special prescription for an auto machine from your doctor...

I did not need a special prescription to buy my auto. My doctor simply prescribed a cpap at 9cm but said i was free to purchase whatever type and brand of machine i wanted. She did recommend the Resmed Auto as having the best algorithm.

Now it might be that insurance companies require a special prescription in order for them to pay part of the cost, but I do not have dme coverage and so purchased my equipment myself. Which, after hearing of all the heartburn everyone has with dealing with their dme, I think I am thankful I didn't go that route. Also, due to the higher cost of equipment through a dme, you might not be saving that much when using one. On the other hand, if you need the help a good dme can provide, then it might be worth the higher cost.

Ron

wading thru the muck! · Post by **wading thru the muck!** » Fri Aug 05, 2005 9:49 am

You DO NOT need a special prescription to buy the auto machine from cpap.com

Sleepless on LI · Post by **Sleepless on LI** » Fri Aug 05, 2005 11:02 am

Sorry, but I'm going by what my DME made me do when I just got my auto. He had me call my PCP and have her fax over a new prescription for the auto machine. Maybe it is an individual insurance thing. I just went by what my own personal experience was. Didn't realize it mioght be different from company to company. My apologies for misinformation... !

th · Post by th » Fri Aug 05, 2005 1:09 pm

My insurance company requires me to RENT a CPAP for one month before considering purchase. I have a $1,000 deductible for an in network purchase and $2,000 deductible for out of network DME equipment purchases.........that is the same deal I had with my insurance company (UHC) and my DME( Apria).......What happened was my final bill for a ResMed 7 and a swift mask was $900.00 .(I HAD TO PAY) When my wife needed hers(CPAP equipment) I ordered online........If you need advice call the 800 number for respironics or resmed. Or ask here at cpaptalk which does not cost you a dime be happy & save your money if you deal with Apria you will have nothing but trouble and a big bill at the end
th

[quote="garyml"]My insurance company requires me to RENT a CPAP for one month before considering purchase. I have a $1,000 deductible for an in network purchase and $2,000 deductible for out of network DME equipment purchases. I have not used any of my deductible for in or out of network so far for 2005. The year is now 2/3 over.

Now here is the dilemma. Should I buy the cpap from the authorized company that my insurance company uses, and pay them the $1700 that they want for the purchase of a CPAP, which means I pay the first $1000 and the insurance pays 80 percent of the remaining $700. OR, do I buy the same machine on CPAP.COM for a TOTAL of $500, where the $500 gets applied to the OUT OF NETWORK deductible (the $2,000 one). WHICH MAKES THE MOST SENSE? Thanks, Gary

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