Service Life of a machine

[GP49]

Since 2014 I have owned a ResMed 9 ASV machine, prescribed because I was diagnosed with central sleep apnea.  About a month ago it displayed a "Motor Life Exceeded" warning upon being shut off.  My sleep specialist doctor is no longer in his former practice and it appears that a prescription from such a specialist is required to acquire a new machine (I am on Medicare and it would be totally covered if prescribed).  How long after this warning appears can one expect the machine to continue to function, while I am seeking a referral to a new practitioner?

The availability of repair facilities or of a replacement motor (I am a retired electronic/mechanical technician and very likely could do a replacement myself) was never mentioned, either by the local sales outlet for ResMed (who were rude and dismissive) or by the national sales office of ResMed (who were courteous but offered no option other than to buy a new one).

[Melman]

This machine has served you well for much longer than the generally accepted lifetime of 5 years. Machines commonly run for longer than 5 years which is the medicare replacement schedule. but I suspect 10 may be unusual. I think it is hard to predict how much longer it will function following the warning.

[staceyburke]

I believe that any Rx from a Dr is enough to get the replacement machine. When my bipap was recalled I had no machine at all. I went to my primary care Dr with why I needed my machine )OSCAR reports) and she gave me a prescription for a new machine. Then there was no question because it was a replacement machine.

[srlevine1]

As far as I know, and it worked for me in 2023, a prescription from a PCP will suffice to get you a replacement machine under Medicare. 

However, it will be a rental for 13 months, after which you will own the machine. 

Moreover, there is a compliance protocol that includes a 30-day compliance report and a face-to-face meeting with your doctor within 90 days. I was allowed to do the face-to-face over the internet due to a pandemic provision that may have since expired. The doctor will file a form letter with Medicare attesting to your continuing need and benefit from therapy.

I did not have to take another sleep test as my case was previously documented and I could present evidence (using ResScan) of continued compliance. 

Your DME will walk you through the process as they have a financial interest in your decision. 

Caveat: I don't know if this applies to an advanced device like a bi-pap or ASV, which might require additional documentation. 

BTW: If your current CPAP prescription mentions a "lifetime need" or says "99 months," it's valid for as long as you need therapy. Make sure a new prescription contains the lifetime feature.

Best -- Steve

P.S. ResMed is worthless in answering patient questions as they consider physicians and DME providers to be their customers, not end-user patients.

Medicare and CPAP Compliance

If Medicare covers the cost of your CPAP equipment, you should know that they will want to make sure that you are using the equipment. Medicare refers to this as "compliance." Compliance is the measurement of how much you use your CPAP equipment and if it is working for you.

As far as Medicare is concerned, you are not compliant unless you are using your machine at least 4 hours each night for 70% of the nights. So, if you use your machine 22 days out of 30 for at least 4 hours a night you are compliant. If you use your machine for 3 hours, 59 minutes, and 59 seconds, you did not use it enough so you were noncompliant.

When documentation begins

Medicare considers the first 90 days a trial period. Documentation of compliance begins after 31 days of usage but before 90 days of usage. In other words, documentation must be done between Day 32 and Day 89 of the time you started using the machine.

How documentation is done

Patients must have a download of the CPAP usage from their machine and a face-to-face meeting with their sleep medicine physician who also documents other information, as noted below.

[GP49]

Thanks to all for the quick and informative response.  

Because my health has changed for the better in ten years (I no longer have congestive heart failure, after cardiac artery bypass surgery), an ASV may no longer be necessary; but at times when I am in the twilight, half-asleep condition, I still note that it takes over ventilation, apparently when I stop breathing.  A standard CPAP would not do that.  We'll see what the new sleep doctor finds out, or the old one if I go back to him in his new practice.

[Sleeprider]

GP49, your S9 VPAP Adapt will produce useful data in OSCAR software. We could help you to interpret just how much your machine helps you (or not) if you will post a chart from Oscar. Your PCP can renew your Rx for a Resmed Aircurve 10 ASV (HCPCS Code E-0471) to replace your existing machine which has exceeded its useful life. I would be very reluctant to suggest you discontinue therapy in spite of your improved health. Approaching a sleep specialist would likely result in sleep tests and unpredictable results in terms of being prescribed an appropriate device. Your ASV treats both obstructive and central apnea as well as variable breathing, hypoventilation and hypopnea. I is the best positive air pressure therapy available almost regardless of your issues.

Your S9 VPAP Adapt can be renewed with a new motor, reset of run-hours to zero, and optionally new seals and calibration for a cost of $230 plus shipping at Supplier #28. That is basically a new machine without the error code at a fraction of the cost of a new ASV device.

[GP49]

THAT is definitely useful information! THANK YOU.

[srlevine1]

I can vouch for Supplier #28's speed and great service. They reconditioned my "motor life exceeded" 5+ year-old S10 with a new genuine ResMed motor, seals and calibrated my device which is now my backup/travel machine. They zero-timed my machine and there are no pesky messages.