CPAP Concerns

[OpalRose]

Wow, sounds like your neighbor has been through a lot. Glad the surgery has worked out for him though.

He could try local Verterans Administration Clinics, although I have no idea if they accept donations.

[Sleeprider]

The original post has a number of lessons, and the first one is, the medical system will not help you. You must have a backup CPAP and physical copies of any prior sleep studies and prescriptions. If your primary care doctor will accept treating your apnea needs, that is far superior to using specialists and clinics. Normally your doctor can write a script very quickly upon request, and knows how to deal with insurance denials. A recent trend is for DMEs to insist on more studies and justification for issuance of equipment. The way around this is to work directly with your insurance. Again, having a backup machine removes any urgency behind this kind of replacement need.

People with high deductibles and copayments should consider whether buying with insurance is worthwhile. In the U.S., machines are available at less than half-price through a number of online sellers. Auto CPAP under $500 and BiPAP-auto under $800, and no one to monitor your compliance, and complete freedom of settings. I personally have a very low tolerance of medical system interference considering these readily available alternatives. Most of these sources will recognize any old prescription, if they check at all. More of us need to take control of our therapy, and not tolerate being bullied by doctors (particularly specialists), clinics, and suppliers. The cost of tolerating that treatment is very high compared to just asserting your own control

[Apnea Infant]

The original post has a number of lessons, and the first one is, the medical system will not help you.  You must have a backup CPAP and physical copies of any prior sleep studies and prescriptions.  If your primary care doctor will accept treating your apnea needs, that is far superior to using specialists and clinics.  Normally your doctor can write a script very quickly upon request, and knows how to deal with insurance denials.  A recent trend is for DMEs to insist on more studies and justification for issuance of equipment.  The way around this is to work directly with your insurance.  Again, having a backup machine removes any urgency behind this kind of replacement need.  

People with high deductibles and copayments should consider whether buying with insurance is worthwhile.   In the U.S., machines are available at less than half-price through a number of online sellers.  Auto CPAP under $500 and BiPAP-auto under $800, and no one to monitor your compliance, and complete freedom of settings.   I personally have a very low tolerance of medical system interference considering these readily available alternatives.   Most of these sources will recognize any old prescription, if they check at all.  More of us need to take control of our therapy, and not tolerate being bullied by doctors (particularly specialists), clinics, and suppliers.  The cost of tolerating that treatment is very high compared to just asserting your own control

Sure Sleeprider, you are absolutely right in all you have written. However you are a highly intelligent individual who obviously have the nous and $$$ to be independent. There will be many who are not so and will require help and support in more ways than one.

I do not profess to understand the situation in America in so far as health care is concerned but what about those who do not have private insurances? Do they then refer to Medicare? And do all Americans qualify for Medicare?

Personally, in my journey which I have written about on this forum many times before, it was long and protracted but exhaustive. At times exhausting. However, without the thorough investigation as to what I was/am suffering from, I would not be where I am now. 

I do agree, beyond diagnosis we have to take decisions ourselves and you've certainly (and others here) have been there for me for which I am grateful. It must be tough for those who cannot afford to help themselves financially.

[c2workout]

Well Forum readers this is exactly why you need to read and follow the forum.

Sleeprider  has once again Hit the Nail on the Head with this one. 

20 years ago I paid nothing for my CPAP, I have been in the same basic health plan, dealt with the same sleep clinic , same hospitals,etc.  what has changed mostly is this DME stuff and insurance costs.   not sure back 20 years ago but my CPAP I am sure was not cheap and it lasted 19 years so it was a good one.  But the point is You have to do your homework which I did not and now it will my cost is 1.5 times what it would have cost me for my APAP.   My co pay for the in- clinic Titration Study  was over $1200.00 + I have to pay half the cost of my ResMed  AirSense10 autoset which online if you do not shop for the best price is about $830.00.  So if I basically do my math here $1200.00 + $415.00 = $1615.00   So I will have paid 1.94 times the cost if I would have only done my homework and found a Doctor to write me a script ordered the exact same AirSense10 autoset and as it worked out looking over all the test results this machine would have set its self up for  the pressure I needed and thanks to the forum I now know how to read my results  and I could program in my correct pressure settings.    And on top of that I could have paid for a smaller CPAP travel  machine and I would now own both machines with my smaller travel CPAP as my Backup unit.  And I would have still spent less money.

As the forum will advise doing what I am saying is not the Medical and the best course of action it is just the way it worked out in my case it would have not made any difference  but hindsight is always 20/20.    But the more knowledge you gain and the better resources you have (apneaboard.com) Data from SD cards from you APAP, Sleepyhead software, and the questions you ask can take you a long way to better understand you apnea concerns that the course of treatment you will/may need.

Thanks again Sleeprider

C2workout