Are there any Aetna In-Network DME suppliers that carry Resmed Airsense 10 Autosets?

[StoopidMonkey81]

So now that I'm done with the sleep study I get to go on the hunt for an APAP machine. I have Aetna PPO insurance and they provided me with a (dated) list of national mail-order suppliers and a way to search for brick & mortar DME suppliers in my area. The latter is so far hard to find (ones that carry APAP machines, anyway), and the former is a very short list that mostly carries Phillips Respironics machines. I'd like to stay in-network if possible since the sleep study ate up my entire deductible, and I don't know how bad I'll get hammered if I go out of network (likely with a separate deductible so large I'll essentially be paying for the entire unit out of pocket). Any help in this area would be greatly appreciated.

PS-If you're of the opinion that the Phillips machine is superior to the Airsense, that might be useful depending on how this turns out. I really am leaning towards the Resmed unit due to its smaller footprint (seemingly), more user friendly interface, the convenient pause button, the ClimateLineAir tube, and (honestly) the non-medical styling.

[big_dave]

You can find a more comprehensive list of mail-order suppliers by clicking the Supplier List link at the top of the page. I doubt that the insurance company would care which one you use because the mail-order suppliers don't handle insurance billing. You would have to submit an invoice for reimbursement.

Phillips Respironics machines are generally comparable to ResMed. Right now, there are some good deals on Phillips Respironics System One 60 series machines, which were recently discontinued. In case you're looking for something cheap, supplier no. 2 offers the DS560 APAP for $299, used with humidifier, but you would have to pay another $75 for the heated hose conversion kit if that is important to you. Unfortunately, the System One machines are butt ugly.

[DariaVader]

none of the online providers are likely to be in-network. I wish Insurance companies would be more transparent about who you can use. It is probably buried on their website tho.

http://www.aetna.com/dse/search?site_id=...abKey=tab1

you have to go to the bottom of the 1st column under hospitals and facilities and expand "more" then choose medical equipment and then enter your zip

If you were in Oregon like me, "Providence Home Medical Equipment" would be among your choices and they have standardized on Resmed APAPs. they were issuing the S9 when I got mine, but I suspect that has changed by now. So... it is possible.

If you have to pay 20%, get the amount from them outright - your 20% could come close to paying for a machine on your own - + Insurance companies like to lease them for a year and you pay 20% of the DME's contracted lease amount.

[StoopidMonkey81]

Whew, looks like I'm in luck! I just gave Apria a call and they said that Resmed Airsense units are now "standard issue" for their customers! I'll give an update once I'm through with the process with unit in hand. For now they gave me a laundry list of stuff they want from my doc's office and slight mods to the script.

[Mosquitobait]

I'm not going to lambast Apria, but you should be aware that many people have had problems with Apria not following through. Be sure if you are forced into a rental (and don't have Medicare) that you add to the contract some kind of words that state that Apria has 60 days to contact you about billing issues regarding your rental. Make sure the Apria manager SIGNS it along with you. Make sure you have a copy of that contract before you leave. What I've seen on the internet is Apria coming back months later saying that they haven't been paid by your insurance company for 6 months and you are now responsible for the whole thing in excess of hundreds of dollars more than if you bought the unit outright at an online retailer. Their reply is often "well, you signed it.".

[DariaVader]

You need to ask them "Which Airsense" since it comes in a brick model - (CPAP), a straight CPAP with data (Elite) and the Autoset APAP

[StoopidMonkey81]

I'm going to clarify this once the paperwork clears, but in my initial conversation over the phone I mentioned that I wanted the AutoSet and that the doc wrote on my script "If possible, issue patient AutoPAP that can be set to 8" and the rep said that should be sufficient. Fingers crossed.

[eseedhouse]

PS-If you're of the opinion that the Phillips machine is superior to the Airsense, that might be useful depending on how this turns out.

Well my DME supplier gave me a Resmed A10 Autoset but the lady who gave it to me said that she still thought the Philips Resperonic machines are better. But the head office decided on Resmed.

I think each brand has different strengths and weaknesses but they are both "good enough" so long as you get the data capable auto setting machines and not the single pressure no data bricks the same companies also supply.

For Resmed the consensus around here seems to be that the "For Her" version of the A10 autoset is the best machine of the A10 line. I can't say if they are right since I don't have that.

[LesPauloholic]

So now that I'm done with the sleep study I get to go on the hunt for an APAP machine. I have Aetna PPO insurance and they provided me with a (dated) list of national mail-order suppliers and a way to search for brick & mortar DME suppliers in my area. The latter is so far hard to find (ones that carry APAP machines, anyway), and the former is a very short list that mostly carries Phillips Respironics machines. I'd like to stay in-network if possible since the sleep study ate up my entire deductible, and I don't know how bad I'll get hammered if I go out of network (likely with a separate deductible so large I'll essentially be paying for the entire unit out of pocket). Any help in this area would be greatly appreciated.

PS-If you're of the opinion that the Phillips machine is superior to the Airsense, that might be useful depending on how this turns out. I really am leaning towards the Resmed unit due to its smaller footprint (seemingly), more user friendly interface, the convenient pause button, the ClimateLineAir tube, and (honestly) the non-medical styling.

AeroCare is in Aetna's network and can get you the Resmed Machine.