Insurance coverage and RERAs

[kittenmittons]

I was diagnosed with UARS last week after an in-lab sleep study. I had zero apneas or hypopneas (though I did have hypopneas in an at-home study just prior to the lab test), but my RERA index was 5.25. They also diagnosed me with PLMD. I've attached the basic results.

BCBS denied my coverage for an APAP. My question is, should I appeal or just go ahead and buy the APAP and supplies. My sleep doc will be sending me my prescription so I can order online. Has anyone successfully appealed a denial due to no apneas or hypopneas?

Thanks!

[Homerec130]

Personally, I would go ahead and work with your doctor and file an appeal. My doctor has done it a couple of times with me, and we are starting the process of doing the same with my wife.