[Equipment] CPAP hose question

[Annahms33]

I have had many questions since I have started my CPAP last week and one that has been on my mind lately is about the insulated hose. I feel like when I got my CPAP and supplies from the DME company, that she gave me bare minimum. So my question is, was I suppose to get the insulated hose with my machine? She gave me the light weight hose and the nasal pillows with only one size pillow and no way to adjust. I go in today to talk about using a different mask because the nasal pillows do not stay on no matter what I do. I just feel like they are trying to give me a stripped down model of what I need. Also, I am not sure if there is anything else that comes with it that she has not provided. Any advice would be helpful!

Thanks in advance!

[FrankNichols]

Welcome to the forum!

Every DME experience seems to be different. As to what they are "supposed" to do, there doesn't seem to be a standard. Mine let me fiddle with some masks and pillows etc and I pick which I wanted. Then she gave me a couple extras to help get started until I have the auto order system primed and working. I also got the slimline hose and a bag to put it all in. That was about it, well except for the 7 foot long 8 1/2 wide printed receipt/contract.

I decided I wanted to try a P10 instead of the F10 I am using and called them. They said my insurance would let me change the type of mask or pillow once every 6 months, and that I could also change once to start with as a "warranty" swap if I didn't like my first choice. So, basically I can change the type of mask once up front, there after only on the replacement schedule approved by the insurance company (or pay for it myself).

The "for free" was confusing, until she explained that the insurance company will only pay for each supply item on a fix period (filters monthly, mask cushions monthly, hose 6 months, mask head gear 6 months or something like that.)

As to the insulated hose. I think you mean the climate hose, which is heated. That is optional, and my insurance will cover it if I ask for it. I decided to try the slimline they started me with as see how it works. The heated hose (climate control) is to prevent "rain out" when humidity condenses in the hose. Depending on how you are setup, that condensation can run into your mask and give you a wet face or wash out your nose... The heated hose prevents that. However, depending on your unifier settings, and how dry your home air is, you may not need the heated hose. I decided to not get it to start, and to order it at my first replacement if I find I need it.

Other than that, you have everything you need I think. Some people get lots of different masks to try, and extras, but if your insurance is paying it doesn't really matter. If you don't have insurance, then ask for as much free as you can get

[justMongo]

Seems common practice for DMEs to remove the extra pillows that come with the P10.
It comes with 3 different size pillows; and they remove 2 pair.
I am not a lawyer, but this seems to me to be theft and fraud -- in my opinion.

As for the hose. I assume you are speaking about the heated hose.
Unless your script specifically called for the heated hose, they will not issue it.
They typically do not even issue a hose that's genuine OEM... Usually a cheap knock-off to maximize their profit.

I despise this practice so much, that I buy supplies that I know do not require a prescription online -- out of pocket.

[awoodby]

What worked well for me, may help you.

When I talked to the DME pre-pickup, they told me I would get the "dreammachine" like everyone else (surely what they get the best kickback for), and I coudn't request anything else, it had to be on the SCRIPT.

SO! Called the (very unattentive) sleep clinic, told them I wanted the resmed autoset 10 and the exact mask I wanted, and the climateline heated hose so I wouldn't get rained out. The receptionist wrote it down, probably got the dr's signoff, and called it in within an hour or so, I checked back up, it was all set. And this is with a quite hands-off sleep clinic. Thing is, it's no matter to THEM.

When I DID go to get pickup they almost took back the autoset because it does autoset and my starter script is just a single number, but I told them I fluctuated a lot and we would be using it soon, and I needed that set because I was using software (sleepyhead) to track my progress for other conditions I'm dealing with.

It would have been easier if when I'd called asking for the autoset, I'd also asked for that second number (a range), then there'd been no issues whatsoever.

In short, yes, the DME is going to give you whatever they get the best kickback/deals on, just like your dr uses whatever DME gives HIM the best kickback, and on down the line. (it's how US medical works :/)

For masks, I got on ebay and picked up a nuance NONpro and like it actually better, less nose damage, but whatever. It was like $55.

Feel very free to tell your doctor what you want and why. He/she work for YOU, if you want something for any particular reason by all means ask, doesn't cost them anything to give you what you want.

[FrankNichols]

In short, yes, the DME is going to give you whatever they get the best kickback/deals on, just like your dr uses whatever DME gives HIM the best kickback, and on down the line. (it's how US medical works :/)

Interesting, my DME wanted to give me the AirSense 10 CPAP, since the Rx called for a single pressure and they told me if I wanted something else the doctor had to put it on the script. I called the doctor and said I wanted the Elite and the Rx was updated. When I went in to pick it up they said they only had the Autoset in stock and were giving me that unless I wanted to wait since it did what the Elite did and could be set to CPAP.

In my case the doctor and I have a good working relationship and he understood what I wanted and why. As far as DMEs, he didn't care which DME I used at all. However, in my case, I have Humana/Medicare and Apria has the exclusive contract with them, so, if I wanted the insurance to pay, I had two choices 80/20 with Apria or 70/30 with a deductible for out of network for anyone else. I went with Apria.

So, I think everyone's experience is a little different. I do prefer that the doctor and the DME supplier not be associated at all. I see way too much possibility for graft there.

[Mosquitobait]

Interesting, my DME wanted to give me the AirSense 10 CPAP, since the Rx called for a single pressure and they told me if I wanted something else the doctor had to put it on the script. I called the doctor and said I wanted the Elite and the Rx was updated. When I went in to pick it up they said they only had the Autoset in stock and were giving me that unless I wanted to wait since it did what the Elite did and could be set to CPAP.

Dang it, we DEMAND that you take a higher end top-of-the-line machine. Don't argue with us...

Good for you that you got an autoset.

[sdb7802]

I remember going to the DME when I got my first cpap. They had all of these cool looking machines on display. Then they brought out this dorky piece of sh!t they thought I would settle for. I told them if they wanted my business; I was going to pick out my machine or I was going somewhere else. They caved. It's funny how some things are completely @ss-backward from how they should be.

[Jim Bronson]

DMEs must be very different. My original script didn't specify a ClimateLine hose, and I didn't even know about them until I started reading this forum. So I called them and they told me to stop by and they would just give me one. They've been sending me replacement CL hoses with my supplies every since.

[FrankNichols]

DMEs must be very different. My original script didn't specify a ClimateLine hose, and I didn't even know about them until I started reading this forum. So I called them and they told me to stop by and they would just give me one. They've been sending me replacement CL hoses with my supplies every since.

I agree, it seems we all have very different experiences - ie. you milage may vary.

My DME is one of the most despised on this forum, and yet, I have had no problems with them at all, my experience has been more like yours.

[cate1898]

Welcome to the forum Annahms33! Definitely try the ResMed P10's. The headband holding them on makes a difference as well as the size of the nasal pillows. Make sure you get the right size pillows and headband strap. Regular and 'For Her' which I believe is 1" shorter. It made all the difference in the world for me. Regular headband gave me tons of leakage, whereas the 'for her' headband works perfectly and brings my leakage down to very low.