Was I Cheated By The Equipment Supplier?

[Fats Drywaller]

Even if you can find a decent used machine on Craigslist the cost of the supplies would kill you.

It ain't necessarily so. I do OK so far after firing my former sleepydoc & DME and disassociating all of my sleep-apnea activities from my insurer, and I'm retired and on a very low budget (and Medicaid). As a few folks have observed in various discussion threads lately, the insurers' replacement schedule for masks, parts, and supplies is very much overestimated. A mask will easily last a couple of years, a mask cushion or nosepiece six months to a year, a hose a year or two, a humidifier tank a couple of years at least, and so on. Filters cost me 42¢ per month and Dawn dishwashing liquid about the same.

However, the expensive part is trying various masks to find the ones that are workable for you. Even there, you can use the return-for-refund "insurance" that some online suppliers offer: pay some amount up front to have the option of getting the rest of your money back within 30 days, or whatever.

[CB91710]

The people who really get ripped off by this system are those without insurance. They pay the full inflated price and don't benefit from the marked down price the insurance pays.

Except in those cases, one can simply buy consumables from one of the vendors on the list, or Amazon.
Even though my insurance covers 100% with no copay, I still buy a fair amount of equipment online.  The hoses that my DME provides are cheap junk... not actual Resmed hoses... yet they bill twice what I buy real Resmed hoses for.

[Sleeprider]

The people who really get ripped off by this system are those without insurance. They pay the full inflated price and don't benefit from the marked down price the insurance pays.

Except in those cases, one can simply buy consumables from one of the vendors on the list, or Amazon.
Even though my insurance covers 100% with no copay, I still buy a fair amount of equipment online.  The hoses that my DME provides are cheap junk... not actual Resmed hoses... yet they bill twice what I buy real Resmed hoses for.

Dispensing generic junk is a valid way for a DME to increase margins. The way around it is to use the proprietary heated hose like "Climateline", and make that part of your prescription. Filters are no big deal either way will work okay.

[joesetx]

This is how medical billing works.
The charge has no relationship to the cost and is extremely inflated.
Medicare or the insurance company pay according to a fee schedule that pays a small fraction of what they are billed.

There is no transparency.

Consumers no ability to comparison shop.

If you are paying cash God help you.

No this system does not make any sense.

[Homerec130]

Looked at the billing paperwork that came with my new machine. Mask and headgear was billed as a single unit. In the past with my old unit, my Quatro FX mask was also billed as a single unit, the cushions were extra. The mask and headgear came in a manufacturer's sealed commercial packaging. With my insurance, I just look at it and say, okay, that is what I got and you paid for all of it.

I am on Medicare with a real good supplement.

Homer

[Fats Drywaller]

... No this system does not make any sense.

<rant>
That's for sure. I see indications all over the place of the bureaucratic disease, whether originating with the insurance corporations or the medical-industry lobbyists or (with Medicare & Medicaid) the legions of Congressdroids over the decades. One big cause is all of those droids at various levels trying to justify their jobs. They sit around and make up stupid new rules because they have nothing better to do. They can't put some scheme in place and get it to where it's working OK and then just leave it alone. They have to keep messing with it, and inevitably it becomes a huge mess.

(Grumble, grumble ... kids these days ...)
</rant>