03-23-2018, 04:13 PM
(This post was last modified: 03-23-2018, 05:32 PM by Mosquitobait.)
RE: Does the 80/20 insurance really save over a self purchase?
Depends on what you are getting. If you are happy with knockoff filters and hoses, you can usually get them cheaper from online retailers. If you want and can get brand name supplies, the 20% from a local supplier is cheaper if they take your insurance. For instance, the Resmed heated hose is $17 with my Medicare copay and $40 online. Resmed brand filters, if you can find them, are about $6 pack/2 online, and $1.50 for Medicare copay (taking these from memory) plus shipping.
For a bipap, the 13 month payment, if it starts in January, is probably going to be a lot less than you pay for one from online. The cpap, at best you might break even with an online distributor. Still, there are a number of members here who have never bought a new machine, always getting one 'out in the wild' via Craigslist and such. I know I saved hundreds of dollars getting my used, unused Airsense For Her.
Finally, be sure to check with your insurance since Durable Medical equipment often doesn't fall under the deductible at all. Just a straight copay.
RE: Does the 80/20 insurance really save over a self purchase?
It totally depends on your insurance. For my insurance, it was dead even; so I decided to do it through insurance, so it would count toward my yearly deductible of cost-share.
RE: Does the 80/20 insurance really save over a self purchase?
I have been at this awhile, and it does totally depend on your insurance. What is your deductible/year? If you don't anticipate meeting your deductible, you could be better off buying it yourself because the markup going through insurance is incredible. I have bought my CPAP supplies through Amazon, Ebay, etc. Why? Because I usually pay 60 to 75% less or more doing that. So I certainly don't want to overpay for supplies if I am not going to meet my deductible for the year. Plus the supplies I am buying are the real things. Not the 3rd party knockoffs medical suppliers will send you.
A CPAP machine is a whole other ballgame. Insurance companies want to "rent to own". Not only do you have to pay a significant markup on the machine (at least 100% more), but chances are the rental will extend over two insurance years and you will have to pay a double deductible.
My first machine I ran through insurance. It was a crappy brick machine with no bells and whistles. My second machine I just bought new straight out, for a fraction of the insurance markup costs. My third machine I bought a used top of the line APAP machine with less than 10 hours from Secondwindcpap, Supplier #2, Commercial Link Removed (great to work with by the way). I didn't have to argue with the insurance company over what machine I had to buy, I didn't have to worry about paying "marked up" rental costs for months, and I didn't have to hassle with the insurance company over was I or was I not eligible for a new machine.
Again, it does all depend on what kind of insurance you got. But it is definitely a game. The DME suppliers are getting their cut, the insurance company is getting their cut, and the manufacturers are getting their cut. Save as much money as you can if you don't have the best insurance.
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RE: Does the 80/20 insurance really save over a self purchase?
(03-23-2018, 04:13 PM)Mosquitobait Wrote: Depends on what you are getting. If you are happy with knockoff filters and hoses, you can usually get them cheaper from online retailers. If you want and can get brand name supplies, the 20% from a local supplier is cheaper if they take your insurance.
Your fortunate if you get brand name filters and hoses from your DME. I have delt with 3 and they supply knockoff filters and hoses. The hoses are much lesss flexible than the Resmed original.
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RE: Does the 80/20 insurance really save over a self purchase?
You are correct. When I had the DME supply me, I got crappy hoses not near as nice as genuine Resmed products and the same with the filters. Have bough the originals off of Ebay or Amazon with no issues and less cost.
RE: Does the 80/20 insurance really save over a self purchase?
No deductible left. Home sleep lab took care of that. I will be rolling into 2019 on the rental.
RE: Does the 80/20 insurance really save over a self purchase?
(03-27-2018, 04:34 PM)Jamizer Wrote: You are correct. When I had the DME supply me, I got crappy hoses not near as nice as genuine Resmed products and the same with the filters. Have bough the originals off of Ebay or Amazon with no issues and less cost.
One way to assure getting a good hose from your DME is to order the heated hose. Apparently there is no generic substitute.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Does the 80/20 insurance really save over a self purchase?
I just picked mine up last week. We will see.
04-10-2018, 02:39 PM
(This post was last modified: 04-10-2018, 02:48 PM by Mosquitobait.)
RE: Does the 80/20 insurance really save over a self purchase?
(03-27-2018, 02:26 PM)Melman Wrote: (03-23-2018, 04:13 PM)Mosquitobait Wrote: Depends on what you are getting. If you are happy with knockoff filters and hoses, you can usually get them cheaper from online retailers. If you want and can get brand name supplies, the 20% from a local supplier is cheaper if they take your insurance.
Your fortunate if you get brand name filters and hoses from your DME. I have delt with 3 and they supply knockoff filters and hoses. The hoses are much lesss flexible than the Resmed original.
As mentioned, I order the heated hose and then they are stuck with Resmed brand as there isn't an equivalent. For the filters, Lincare provided them from the office since the warehouse doesn't stock them (there's a hint!). One of my requirements when I switched to my current DME was that I only wanted Resmed brand filters and so far, that's what I've got. FWIW, Supplier #1s hyperallergenic filter is closer to a Resmed filter than the rest of the knockoffs.
A lot of the Slimline hoses sold on Ebay are not genuine Resmed brand. Some of them aren't bad, but they were sold as GENUINE so I complained repeatedly to Ebay. Ebay finally stepped up and did something about that. If you look closely, most of the titles now say 'generic' Resmed hoses or they will lose their accounts. The Resmed brand hoses don't make that weird tooby sound when dragged over stuff (including blankets!).
RE: Does the 80/20 insurance really save over a self purchase?
(04-10-2018, 02:39 PM)Mosquitobait Wrote: (03-27-2018, 02:26 PM)Melman Wrote: (03-23-2018, 04:13 PM)Mosquitobait Wrote: Depends on what you are getting. If you are happy with knockoff filters and hoses, you can usually get them cheaper from online retailers. If you want and can get brand name supplies, the 20% from a local supplier is cheaper if they take your insurance.
Your fortunate if you get brand name filters and hoses from your DME. I have delt with 3 and they supply knockoff filters and hoses. The hoses are much lesss flexible than the Resmed original. Now they say Resmed generic. I shot them a message complaining about that. They should not be able to use Resmed in the brand name.
As mentioned, I order the heated hose and then they are stuck with Resmed brand as there isn't an equivalent. For the filters, Lincare provided them from the office since the warehouse doesn't stock them (there's a hint!). One of my requirements when I switched to my current DME was that I only wanted Resmed brand filters and so far, that's what I've got. FWIW, Supplier #1s hyperallergenic filter is closer to a Resmed filter than the rest of the knockoffs.
A lot of the Slimline hoses sold on Ebay are not genuine Resmed brand. Some of them aren't bad, but they were sold as GENUINE so I complained repeatedly to Ebay. Ebay finally stepped up and did something about that. If you look closely, most of the titles now say 'generic' Resmed hoses or they will lose their accounts. The Resmed brand hoses don't make that weird tooby sound when dragged over stuff (including blankets!).
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