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+--- Thread: Insurance coverage (/Thread-Insurance-coverage)
Insurance coverage - BlueSky1958 - 10-26-2023
Just started CPAP maybe 8 months ago. Went through same co. that supplied machine for my supplies, but, does anyone know if I have to KEEP going through them or can I buy out on the open market? Will I.nsurance still cover their share? I know I have to keep in compliance tracking so not sure how that would work. Please advise on the ins and outs
RE: Insurance coverage - Gideon - 10-26-2023
You can purchase from anyone (most require a prescription for mask and machine).
Reimbursement depends on your insurance.
RE: Insurance coverage - Sleeprider - 10-26-2023
Your insurance will pay the most for in-network providers. Take a look at their website or call to get a list of in-network DME providers. You can choose any provider on that list and maximize insurance reimbursement.
RE: Insurance coverage - Irod - 10-26-2023
I was told by machine provider who my Health Insurance partners with to buy from them when I have met my deductible because it will be covered by insurance. If I have not met my deductible shop on Amazon because the same items I buy from them can be bought online at much cheaper prices. Call you insurance folks first so you are clear on their requirements. I was also told I do not have to take supplies I don't need just because they are scheduled or covered - I liked that as well. Free or not if I don't need it I don't want it.
RE: Insurance coverage - BlueSky1958 - 10-26-2023
I've met my deductible but for my supplies I'm still responsible for 20%. I suppose I can just compare that to Amazon prices and go with whatever is cheaper. How do you know you're not getting crappy China stuff if you go the Amazon route?
RE: Insurance coverage - Sleeprider - 10-26-2023
There are better choices than Amazon. You are paying 20% of what your insurance pays for in-network equipment. Your insurance has probably negotiated a "reasonable and customary" price for each item, so you're probably paying much less than the quote from any in-network supplier. Your cost with an in-network provider should be less with coverage than online prices, but not always. Amazon does not sell CPAP equipment or complete masks, so my suggestion is to to either use listed in-network providers from your insurance, or get on the mailing list for Supplier #1 and get the discount codes. You will get name-brand equipment from Resmed or Philips....which may or may not be manufactured to specifications in China. Even the OEM stuff has China components.
RE: Insurance coverage - Irod - 10-27-2023
My supplier was absolutely certain I would have better pricing offered on ResMed than ordering through them if my deductable wasn't met and my ResMed mask and liner are on there. I didn't check filter but Resmed Brand Masks and Hoses were there - not knockoffs. I have met my deductable, I probably will every year - but I appreciated them telling me hey use us when deductable is met, shop around when it isn't.