DME Pricing for supplies

[entropy]

Hi folks, long time lurker here.

Got my first BIPAP a Dreamstation from Amazon, back when they were selling them.  Got loads of info on how to set it up here.

Well, as a result of the recall, I decided to "go legit" get the at home sleep study and get a new device.

I got a prescription, and the insurance company sent me to Lincare.  Picked up the machine, an Airsense 11, hose, mask, nasal pillows etc.

So I'm on the one year rental plan, and then after that I own it.  (or so they say)

I have been used to buying my own supplies, bt I figured I would check with the Lincare 888 number.  I have a high deductible, so ethis stuff is going to be out of pocket for me.

I asked for the price of a heated tube (Seem hard to find on line for the 11) and the nasal pillows.

I was told that they don't have pricing!!! I was like "Uhhh, really?"  We have to bill you first so your insurance company will pay for it. They hemmed and hawed and gave me the number to the billing office.  I called, and was on hold for 45 minutes and hung up.


Is this how these people operate?  Seems like a shifty business if they can't tell me how much I am going to pay, doesn't it?

[Crimson Nape]

It seems that Lincare caters mainly to the Medicare crowd and not really setup for private insurance.

[OpalRose]

The best practice is not to trust anything a DME tells you.  
Call your insurance and find out what your portion will be on supplies.  Some folk pay nothing, while others pay 20% of the negotiated price.

As far as them not knowing the price you would pay for a heated tube for the A11, your DME probably doesn't know until they actually bill your insurance.

From what I've heard, there are supply issues for heated tubing, filters, etc. for the A11.
Other members here have reported that these supplies are hard to find.  

If you're paying yourself, you would do better purchasing from Amazon, Ebay, etc.  
There is a Supplier List at the top of the page where you can check to see if the A11 supplies are available and the cost.

[Millstone50]

The going rate at 2 DMEs here for the ClimateLineAir 11 is CA$100 (US$79)

[Big Guy]

The going rate at 2 DMEs here for the ClimateLineAir 11 is CA$100 (US$79)

I think the last time I checked the number of my ClimateLine heated hoses, it was 11 or so. I just received another one less than a week ago. 

[Millstone50]

I think the last time I checked the number of my ClimateLine heated hoses, it was 11 or so. I just received another one less than a week ago. 

I think it corresponds to your machine. AS10 uses the CLA10, AS11 uses the 11. They slightly change the connector so you're forced to buy a new one. Like most CPAP supplies, the markup is about 250%.

[cathyf]

I have been used to buying my own supplies, bt I figured I would check with the Lincare 888 number.  I have a high deductible, so ethis stuff is going to be out of pocket for me.

Well if they send it through your insurance, then you will pay whatever the insurance-company negotiated price is, and what you pay will be applied to your deductible. If you have a heart attack, or cancer, or just a freaking biopsy, you can blow through any deductible. (A year and a half ago I had surgery where I was only in the hospital for a few hours, but did have general anesthesia. $12,000 and I wasn't even there overnight!) Any money that you spend now might end up getting you to your deductible faster.

And depending upon the arm-twisting power of your insurance company, you might end up with just as good a price as with amazon, etc.