New Machine and Insurance

[dosco]

So ... I had an in-home test recently to make my new ENT (recently hired by my "old" ENT) happy.

He came up with a new script, and his DME contacted me. I spoke with someone there who was very nice, but told me they don't participate in my insurance plan. I'll have to meet a $500 deductible and then pay an additional percentage ... total bill is something like $650. They only carry Airsense and Dreamstation machines (which sounds good) ...

Sigh.

I'm going to call my insurance company and attempt to find a DME in their network.

$600 is worth it in terms of better sleep (I've been back on the CPAP and IMO I feel better with the APAP ... of course it could also be confirmation bias).

We'll see.

-Dave

[srlevine1]

So ... I had an in-home test recently to make my new ENT (recently hired by my "old" ENT) happy.

He came up with a new script, and his DME contacted me. I spoke with someone there who was very nice, but told me they don't participate in my insurance plan. I'll have to meet a $500 deductible and then pay an additional percentage ... total bill is something like $650. They only carry Airsense and Dreamstation machines (which sounds good) ...

Sigh.

I'm going to call my insurance company and attempt to find a DME in their network.

$600 is worth it in terms of better sleep (I've been back on the CPAP and IMO I feel better with the APAP ... of course it could also be confirmation bias).

We'll see.

-Dave

Dave,

With all due respect to the parties involved, I would never take the advice of a DME or a physician connected with a particular DME without doing my own research. Beware of referrals, kickbacks, and laziness.

As for insurance, it does not hurt to ask for "non-insurance" pricing and/or "package (machine, mask, hose, case, DC power adapter, etc.) pricing,. Remember, you are the customer, its your money, and there are any number of vendors offering the exact same product line.

By all means check with your insurance company -- and if you are on a company insurance plan, ask the company for the name of their representatives. It appears that some insurance companies -- especially those with outside representation -- are afraid to lose the company's business should employees start looking for better deals. Being "in network" is often better that being "out of pocket."

While there may be manufacturer's price limitations on the machine. there is nothing from preventing them from discounting other items to sweeten the deal. Also, ask if the deductible applies to physician services, equipment, or both. Negotiation -- not capitulation. And, don't be fooled by the "service" issue -- warranty repairs can be done by any authorized DME who usually returns the machine to the manufacturer.

Best of luck with a better night's sleep.

[Sleeprider]

The big question is, are they quoting an auto machine, or the cheapest option? You can stay in-network, and get the auto machine for less, or just go buy from Amazon for about $430 for a Dreamstation Auto.