Do I have to buy from Lincare?

I have some questions regarding the requirements for my CPAP machine I recieved through Lincare. Idk much in general as this diagnosis was unexpected and even the Sleep Doctor didn't expect the results because they said at 31 and not being overweight I'm not a typical case.

I haven't met my deductible so when Lincare called they informed me I would have to pay out of pocket and that I would have to pay $250ish +/- depending on the mask I chose at the time of my appointment. I misunderstood and thought this was all I had to pay and didn't realize I would still have to pay $100's+ a month ($50ish machine cost and cost of supplies vary depending on the month but varied for a total of $116 to $223).

So here's my question, do I have to order the supplies through the company that will be calling me to setup order shipment? Or can I just order on my own if I find a more affordable alternative? Realistically I'm unlikely to ever hit my deductible and will have to pay it all myself. However, the max amount my insurance allows to be charged is 1/2 what Lincare's list price is.

I was given the ResMed Airsense 11 auto with the P10 Nasal Pillows for her as well as a chin strap.

Nope, you can buy anywhere you want. Lincare (and any other DME) will try to sell you the maximum amount that your insurance will reimburse. Realistically, you don't need all those supplies. Your actual cost will be much lower that what you were quoted. There are lots of places to get masks, filters, hoses, humidifiers, whatever, competing online for your business.

And you can buy your own machine online, new or used, anywhere you want.

Chels91tn wrote: ↑

Thu Nov 02, 2023 2:18 pm

However, the max amount my insurance allows to be charged is 1/2 what Lincare's list price is.

You should speak directly with your insurance - ask what other DME suppliers they allow on your plan.
Be sure to write them down.
Get a copy of your equipment order from your doc or from Lincare.

You can also buy a new or used Resmed 10 Auto and pay Out-of-pocket for less probably.
Compare the prices.

Chels91tn wrote: ↑

Thu Nov 02, 2023 2:18 pm

So here's my question, do I have to order the supplies through the company that will be calling me to setup order shipment?

yes, or they'll come to your house and beat you up.


no, as others have pointed out, you can buy anywhere you choose. as long as you have a copy of your prescription, you can tell them to take a hike.

oh. and welcome to the zoo!

You for sure can use any DME that you want. I use Aeroflow because my first DME would not order a mask that I wanted. Everything comes right to my door, they are nice to work with and I am happy with them. I'm sure there are other good ones too. Maybe someone else will suggest one that they like.

You do not need to buy all the supplies they will try to sell to you. Most items last much longer than the recommended replacement schedule. Most of us keep one or two back up items on hand in case of breakage. My wife and I both use full face masks, and we usually change cushions once a year instead of the once a month recommended by the suppliers. We keep extra items on hand, but we change them out only when necessary. Things like to break or go bad on week ends when most DME suppliers are closed.

No you don't have to buy from Lincare if you don't want to.
You don't even have to keep the machine if you don't want to and they already delivered it.

If you want to use your insurance you would need to find another supplier that works with your insurance company and you would need to check with your insurance company as to your choices in suppliers.
I know you say you most likely won't ever meet your deductible but it's there just in case.
Bear in mind that most deductibles are calendar year deductibles and even if you use your insurance the deductible is likely to restart this coming January.

That said....given your high deductible and the fact it will likely restart in January...buying out of pocket will likely be less of a hassle and you probably can actually save some money.
You need to do the math to figure out your costs and try to put a monetary value on the "less hassle" thing.

My very first DME some 14 plus years ago was a LinCare office. I fired them straight away because they lied to me.
I never even accepted the machine.
I have never used my insurance (Medicare) to buy me a machine. I have always bought privately and usually for less money than my co pay amounts would have been.

Your masks will be your biggest ongoing expense after you have the machine and there are ways to limit those costs as well.

I don't know where you work but if they have some sort of provision for setting some pre tax dollars aside ...like in a FSA account...you could use those funds to buy your masks and other cpap items. Something to think about if you have that option.

Chels91tn wrote: ↑

Thu Nov 02, 2023 2:18 pm

the Sleep Doctor didn't expect the results because they said at 31 and not being overweight I'm not a typical case.

That doctor is poorly informed. Many young, skinny people have obstructive sleep apnea. It's not the size of the neck on the outside, it's the size of the airway inside the neck.

Since it has only been mentioned once in this thread, here it is again: you will need a copy of your prescription for most purchases.

Before buying a machine, post in this thread the model name.