Monthly rental cost of CPAP exceeds the retail cost of the device

[vroomvroom]

I'm set up for an appointment with the DME next week. They said that based on my insurance, there will be a "rent to own" program of 10-13 months, at about $125/mo. The cost of the Resmed A10 Autoset is only $883, which means that the monthly costs of the device will far exceed the actual MSRP of the product. 

I know I still need to meet the deductible and then I am responsible for 10% co-insurance, but why should my insurance carrier have to eat the cost of the charges above and beyond the value of the device? Ultimately, those overage charges end up as the collective patients' responsibilities as part of increased premiums.

[Gideon]

I hate to say it, but welcome to the system.

What do you want to do, go through the system pr purchase on your own?

[Big Guy]

I'm leasing my CPAP machine / accessories. I have insurance. I'm paying $9.08 per month and my insurance picks up the rest. I don't have any idea as to the actual full lease cost.

I started on Sept. 10th, 2018, and it will become mine on Oct. 10th, 2019.

[vroomvroom]

I'm leasing my CPAP machine / accessories. I have insurance. I'm paying $9.08 per month and my insurance picks up the rest. I don't have any idea as to the actual full lease cost.

I started on Sept. 10th, 2018, and it will become mine on Oct. 10th, 2019.

This is interesting. Have you met your deductible already? Perhaps that's why your monthly payments are so low?

[Sleeprider]

Call your insurer and verify they will REQUIRE rental. Many companies will pay off the machine once the compliance period is satisfied in less than 90 days. The 13 month lease maximizes profits for the DME and ensures your deductibles apply in two calendar years. Your insurance may allow direct sale, or a shorter rental period before ownership. Alternatively, your insurance may allow you to buy "out-of-network". Typically the copay is a larger percentage of your cost. If you costs are significantly lower for a direct sale, you may be better off taking the out of network reimbursement. The DME seeks to maximize profit, and structuring the sale as a 13 month lease works for them. You have to be the one to find out if it's best for you.

As you know, you can get that machine for $625 from Supplier #33. You have to decide what works best for you.

[vroomvroom]

I hate to say it, but welcome to the system.

What do you want to do, go through the system pr purchase on your own?

Lol, thanks. Ultimately, I think it still makes fiscal sense to go through the system. 

Current deductible met: $0/$700

If we take a conservative estimate of $100/mo for the CPAP and supplies (originally they told me $125/mo), I'll reach my deductible in 7 months. 

If we assume the program ends in 10 months, I'll pay $10/mo for the next 3 months, for a total of $730 for an $883 machine. 

If they make me go 13 months, then I'll have paid $760. 

Obviously, my insurance will have paid more (at 10 months lease, they will have paid $270, and at 13 months lease, they'll have paid $540). Combined with my expenditures, this exceeds the cost of the machine.

If it wasn't for the fact that it was is my first machine and I would appreciate hands-on guidance with it, I'd go with an online DME, just so it's one more person not supporting exploitative pricing. 

The one other benefit of meeting my deductible is that other items will be cheaper, I suppose.

[Gideon]

Download SleepyHead/OSCAR and we will be happy to help you through your journey in any way you wish.  From helping you to frame your conservation with your doctor to assisting you with understanding what is going on including the adjustment of your settings.
My signature contains a number of links to help you along the way

[vroomvroom]

Download SleepyHead/OSCAR and we will be happy to help you through your journey in any way you wish.  From helping you to frame your conservation with your doctor to assisting you with understanding what is going on including the adjustment of your settings.
My signature contains a number of links to help you along the way

I appreciate it! I plan on getting the software once my machine comes in next week! They've confirmed that it's going to be a new one, but I read the wiki and will be prepared to check the clinician menu to confirm hours used!

[Sleeprider]

Did you read my post #5? http://www.apneaboard.com/forums/Thread-...#pid287352

[vroomvroom]

Call your insurer and verify they will REQUIRE rental.  Many companies will pay off the machine once the compliance period is satisfied in less than 90 days. The 13 month lease maximizes profits for the DME and ensures your deductibles apply in two calendar years.  Your insurance may allow direct sale, or a shorter rental period before ownership.  Alternatively, your insurance may allow you to buy "out-of-network". Typically the copay is a larger percentage of your cost.  If you costs are significantly lower for a direct sale, you may be better off taking the out of network reimbursement.  The DME seeks to maximize profit, and structuring the sale as a 13 month lease works for them. You have to be the one to find out if it's best for you.  

As you know, you can get that machine for $625 from Supplier #33.  You have to decide what works best for you.

I didn't even see this reply until just now! Thank you for that info! 

I am going to call my insurance back and ask them what they're planning on doing. I do recall from a prior conversation that the insurance rep said "we don't the the complete terms of what you'll be paying until we get the billing from the DME," so there's still hope that there aren't any shenanigans going on. 

I think mathematically it makes sense to pay off the $700 deductible so that future expenses this year would only cost me 10%. The $625 price is excellent, though! How are they so much cheaper than anyone else?