Another small rant.

[Terry]

Since I actually do have insurance, I figured that I'd save some money and use it to get my replacement mask.

So I called "my" DME, who wanted me to set up an appointment for two weeks out to "discuss" it with them. I said I don't want a discussion, I just want a mask. In fact, I want it mailed.

No dice.

So I said "you guys aren't the only game in town" and hung up, and called another place.

They seemed friendly enough, but apparently my printed prescription wasn't enough for them so they called my doctor and wanted a copy of my sleep study. So I could get a new mask.

Then the doctor's office called me to ask if it was OK to send them the sleep study and I said "hell no!" I just want a mask. So two days later, I find that they sent it anyway.

So now I call back the new place and said "Now can I get my mask?" "Sure, let's setup an appointment for next week".

I asked if they actually *had* the mask I wanted and she said "No, but we can order it when you come in."

You know what? FU** ALL OF THEM. I'm NEVER going back.

I just ordered it online and I'll have it in a few days. It cost me an extra ~$60 over my insurance copay, but I don't have to kiss anybody's ass or take time off from work or wait two weeks.

There's really no point to this except that I find it infuriating that my insurance only covers "Preferred Providers" who's only qualification is that they make my life difficult.

I'm starting to suspect that's why they do it. If I pay for the insurance and don't use it, the insurance company pockets the money.

[AlanE]

Yup I understand that. I buy some of my stuff through suppliers without bothering my DME/Insurance. I get it cheaper and much faster. An example: buy filters from suppliers and get it in a couple of days - buy through DME and wait 3 weeks... wow.

[Sleeprider]

Terry, check into your out of network coverage. I have used it more than once. If a copay applies, it may be twice the rate for out of network but you do get reimbursed. Most online providers provide receipts and codes that are acceptable for insurance reimbursement, even if it is not in-network.

[Terry]

Terry, check into your out of network coverage. I have used it more than once. If a copay applies, it may be twice the rate for out of network but you do get reimbursed. Most online providers provide receipts and codes that are acceptable for insurance reimbursement, even if it is not in-network.

I checked. My Out of Network Coverage is "$0" and "0%" . . .

Health insurance is such a freaking scam.

[Mosquitobait]

Terry, first, you should understand that DMEs may be REQUIRED to see you to get your mask. That is what I found out about Medicare. They can't just send it to you unless your doctor's prescription lists a specific mask for you. For me, that's a 28 mile round trip - but at least I'm not taking time off of work. I'm returning the mask that I got 2 weeks ago due to excessive leaks. We'll see how well that goes.

[GTOdude]

ebay.

[Terry]

Terry, first, you should understand that DMEs may be REQUIRED to see you to get your mask. That is what I found out about Medicare. They can't just send it to you unless your doctor's prescription lists a specific mask for you. For me, that's a 28 mile round trip - but at least I'm not taking time off of work. I'm returning the mask that I got 2 weeks ago due to excessive leaks. We'll see how well that goes.

I think I'll stick with online vendors from now on.

They seem perfectly happy to take my money and send me stuff and have no interest in making me "do stuff" "just because".

[dzwiss]

"I think I'll stick with online vendors from now on.

They seem perfectly happy to take my money and send me stuff and have no interest in making me "do stuff" "just because".

X2
Although I must say that after I bought my new mask, my DME is now supplying me with monthly supplies for it with only my insurance copay.

[Phill]

Reading what you guys go through I wonder who gets the rawest deal, you or those of us on socialised healthcare.

[49er]

Terry,

I went through this BS initially when trying to get a mask from an in network DME. It seemed they all wanted compliance information so I narrowed it down to the DMEs who were asking for the least amount of paperwork such as a mask and a sleep study.

And yes, I did ask my insurance company if they were allowed to do this and the answer was yes. And when I asked about using an out of network provider, the rep couldn't answer whether I would get reimbursed or not and I just remember being so frustrated like you were at all this BS.

Anyway, I thought I had satisfied the requirements of one DME but at the last minute, they wanted progress notes from my then sleep doctor. So I got really assertive and said the only thing you need from me is the prescription which you have. I then mentioned that I really didn't need to give a copy of my sleep study but did to be cooperative.
I think they could tell I was ready to move on and at the last minute agreed that they had everything they needed from me.

I have had some frustrating moments with them but compared to the other horror stories mentioned on this and other apnea boards, I really can't complain.