Helping my mother with CPAP

I am a CPAP patient and this forum helped me get started many years ago. Now I need help for my mom.
My mom is 79 years old and has visual impairment from a stroke (this is relevant later)

She had a Sleep Study in July. She had an AHI of 43. She REALLY needs CPAP.

Last week she was mailed a machine from Rotech.
She is visually impaired. She is terrible when it come to electronics. She lives alone. I live 12 hours away from her.

She called Rotech and they attempted to help her over the phone. This is not ideal when you are visually impaired. They sent her videos. Again, visual impairment..... The biggest issue was mask leaks, it is a nasal pillow mask, but all it does is blow air all over her face.

She made special arrangements to have someone drive her to Rotech. I'm not sure they could have been less helpful. They were rude. They gave her a different mask, they didn't show her how to put it on, they didn't turn on the machine. She had lots of questions, but it didn't matter. I'm not even certain the machine has been set for a nasal pillows mask.

Last night she tried the new mask, it was even worse. She called Rotech this morning asking for help or to try a different mask. They told her "too bad you can't get another mask for 90 days but we will sell you a mask"

I have always been able to exchange masks as often as necessary if it's inside 30 days. Has something changed? Her insurance is Medicare / Humana.

When I first started with CPAP members of this board educated me about DME companies and I fired my first company.

I need help getting my mother away from Rotech. They have an F rating with the better business bureau and it sounds like they've earned it.

I have private health insurance so I don't know about CPAP and Medicare and the nuances of that. We are inside 30 days, does anyone know the process of changing your DME if you have Medicare?

I absolutely welcome any and all advice you can provide me.

Does your mom have a Medicare Advantage plan or the original Medicare plan?

Sheriff

EO_123 wrote: ↑

Thu Aug 29, 2024 5:47 pm

I have always been able to exchange masks as often as necessary if it's inside 30 days. Has something changed? Her insurance is Medicare / Humana.

Here's the deal with masks and insurance and DMEs.
Insurance only pays for one mask or piece of equipment per the replacement allowance schedule and that hasn't changed.
Now the mask manufacturers themselves have a 30 day return policy where it doesn't matter how many masks a person has tried and they will reimburse or credit the DMEs the cost of another mask when the person's insurance won't pay yet because of the replacement allowance schedule. It does involve the DME needing to do some documentation of the return and need to supply a different mask. The sad fact is most DMEs are too lazy to do the little bit of extra work to get reimbursed and just tell the patient what your mom was told that they won't supply another mask until the patient has satisfied the replacement allowance time frame or that the patient has to just buy (out of pocket) another mask to try.

Rotech could supply your mom another mask if they would just do that little bit of extra work to get reimbursed so that they aren't losing money. You have already found out that Rotech doesn't really have the desire to really help their patients. My suggestion is find another equipment supplier that has a mask exchange policy that is more liberal (those DMEs are out there but hard to find) who will do a better job of taking care of your mom's needs.

EO_123 wrote: ↑

Thu Aug 29, 2024 5:47 pm

so I don't know about CPAP and Medicare and the nuances of that. We are inside 30 days, does anyone know the process of changing your DME if you have Medicare?

Process hasn't changed. You can change DMEs at any time you wish. You can fire Rotech at any time...but it might be easier to do it now. It may or may not require returning the machine and getting a new machine from new DME.