Machine Prices?

[Lolagirl]

I currently am using a new machine loaned by the sleep clinic. I have been advised that the Resmed Airsense 10 autoset was sold by the clinic for 2400$. The exact amt my insurance will pay for machine. I’ve seen this machine online for sale in Canada for less than $1000. I told the insurance company that the machines were cheaper elsewhere and they knew and were looking into the charges for machines. Wth?

[ardenum]

for $2400 you can get VAuto + 2 masks

[Fats Drywaller]

If you're getting the machine through insurance, you're stuck with whatever seller your insurer will authorize. Very few online sellers can bill insurance (Supplier #30 is the only one I know of); at most they'll give you a claim form and help you to file the claim yourself, to be reimbursed by insurance eventually if you're lucky. As Supersleeper wrote in this post, you need prior approval from the insurer to do that or to use any out-of-network seller.

It's a racket. Does any insurer really care about the artificially inflated prices? The patients care, especially if they're paying out-of-pocket or have high deductibles, but the patients have no political or economic power.

If we apnea patients had some lobbying group like AARP, maybe the $$$$$ home-medical-device industry, the insurers, and the DMEs would pay some attention. Not otherwise, I don't think.

[DaveY]

In Canada, you can buy from an Canadian online CPAP dealer new APAP units in the CAD$600+ range. In May 2018, I bought my backup, Resmed Airsense 10 Autoset for Her (regular tube, but no mask) for CAD$805 with free ground shipping from Ontario (CPAPOutlet). There were cheaper units elsewhere, but I was a past customer with the online company.

For OSA, I would only consider either Resmed Airsense 10 Autoset or Autoset for Her or Philips Respironics Dreamstation Auto.

Sleepyeti (based in Alberta?) currently has a very good deal on the Dreamstation Auto for CAD$660ish. First time customers can use a promo code to get 10% off their first purchase. Their pricing on Resmed Airsense 10 is not quite as competitive at just under CAD$900.

Papsmart is another online Canadian CPAP dealer. No experience with either Sleepyeti or Papsmart however.

Other dealers that I have bought CPAP supplies before include Supplier #32 (no prescription required for a CPAP/APAP unit to my understanding -- based on their FAQ months ago) and MonsterCPAP...and of course, Amazon Canada. No prescriptions required for masks and supplies here in Canada (unlike the USA).

Dave

[Cpapian]

I currently am using a new machine loaned by the sleep clinic. I have been advised that the Resmed Airsense 10 autoset was sold by the clinic for 2400$. The exact amt my insurance will pay for machine. I’ve seen this machine online for sale in Canada for less than $1000. I told the insurance company that the machines were cheaper elsewhere and they knew and were looking into the charges for machines. Wth?

You can order your system through Supplier #32.  They will prepare a Predetermination for your insurance company.  When you order, you pay them and your insurance company will repay you.  Shipping is free on purchases greater than $100.  They will match prices on Canadian suppliers. They are in Ontario.

They have packages or pick n choose, your choice based on what is best value.

I have ordered from them a few times.  Sometimes received product the next day.  

You will need masks and replacement cushions, so its is better to save your insurance benefit for them.

I am in Ontario where the Provincial ADP plan pays 75% of the cost and they regulate the amount the DME can charge for the machine.  The regulated price for a Airsense for her is $860.  The regulated price for the regular airsense is $1,020.  DMEs must be registered with the government to use the program.  That means, non registered DMEs can sell for whatever they want.

Some provinces offer reimbursement.  Alberta does under certain circumstances related to work necessity.

The insurance company has a vested interest in your claims being as high as possible because they charge an administration fee (typically 15%) on the claim amount.  Over the long term high claim costs ultimately result in claw back of coverage.  So don't be surprised if they are not helpful.



Sleep Yeti looks good.  They are in Alberta, I believe.

Don't get sucked into the So Clean system.  Wait a bit, read about it here before you make that commitment.  When I was first diagnosed, I thought it sounded like a good idea.  Fortunately. I  didn't buy it and now I've been around for a while,  I see no need for it.

[Lolagirl]

Thank you for the info !

[DaveY]

CAD$749 at Papsmart for the Airsense 10 Autoset/Autoset for Her, heated tube and a FFM. There may be other equipment/supply options too. Might be worth it wait until Black Friday and/or Cyber Monday deals too.

Dave