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+--- Thread: Medicare Rules (/Thread-Medicare-Rules)
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Medicare Rules - chzuck - 07-23-2024
Where can I find the rules or guidelines for Medicare on CPAP supplies? In particular, how I go about requesting to try a different mask.
A few months ago my local supplier gave me a mask to try, it did not work for me and I tried to return it the following week and was told to just keep it. I wanted to try something else and the tech gave me a psychology lecture and basically said, deal with it. Don't you have a 30 day trial period in which you can return it and not get charged and try another one? I would like to know what my rights are.
RE: Medicare Rules - SarcasticDave94 - 07-23-2024
With that treatment, fire this supplier and take your business somewhere else.
Medicare has time guidelines that need to be followed, however when starting out, some DME suppliers will help with policies that allow for mask changes early on. Apparently yours does not.
Ask them about their mask policy. But regardless of answer, just deal with it indicates they don't value your business.
Basic Medicare CPAP info
https://www.medicare.gov/coverage/continuous-positive-airway-pressure-devices
Supply schedule, look for table 2
https://www.ncoa.org/adviser/sleep/does-medicare-cover-cpap-machines/
RE: Medicare Rules - QT Pie - 07-26-2024
I’m on Medicare and bc/bs. My DME is AdaptHealth. I have 30 days to return unused supplies, supplies that are unused and still in sealed packaging. If I want to try a new mask, I wait until I’m eligible to replace my head gear (3 months). Otherwise, I go to the hospital sleep disorder office where a respiratory therapist and DME rep is available for walk-in visits to address mask and equipment issues. I have changed up masks during these visits as well, but can’t get additional new mask cushions until the 3 month mark after DME last mailed 3 month supply.
RE: Medicare Rules - chzuck - 07-26-2024
I stopped at my local DME and they said I am due a mask at the end of the month. So, I will go and be fitted for a F40 on the 31th. Hopefully all goes well.
RE: Medicare Rules - HalfAsleep - 07-27-2024
Glad that worked out. Be sure you get the exact size you need on the F40. The parts are mix and match. Perhaps prep ahead of time with Resmed’s handy dandy mask fitting gauge.
Ohhh…while you’re waiting, post some Oscars, exactly according to the instrux in the menu. My reasoning for this is that if your ipap really needs to be 19, the F40 might not be able to handle it, and might just go super leaky on you. So, let’s double check the settings while you’re in waiting mode.
RE: Medicare Rules - chzuck - 07-29-2024
(07-27-2024, 10:11 AM)HalfAsleep Wrote: Glad that worked out. Be sure you get the exact size you need on the F40. The parts are mix and match. Perhaps prep ahead of time with Resmed’s handy dandy mask fitting gauge.The reason for the gap is, I had stuffed up nasal passages and took the mask off for that time.
Ohhh…while you’re waiting, post some Oscars, exactly according to the instrux in the menu. My reasoning for this is that if your ipap really needs to be 19, the F40 might not be able to handle it, and might just go super leaky on you. So, let’s double check the settings while you’re in waiting mode.
RE: Medicare Rules - Narcil - 07-29-2024
Have you considered you might be experiencing positional apnea? seems to be what is driving the pressure so high.
RE: Medicare Rules - chzuck - 07-29-2024
(07-29-2024, 07:39 AM)Narcil Wrote: Have you considered you might be experiencing positional apnea? seems to be what is driving the pressure so high.
Yes, but my choices are limited. I am not comfortable on my back and I have neck issues and cannot sleep on my left side a lot.
RE: Medicare Rules - HalfAsleep - 07-30-2024
So, how are you sleeping if you can't sleep on your back or side? I can see this would be complicated!
FWIW if you're sleeping on your belly, be sure the air-out valve on your mask or hose isn't buried in pillows. This is a safety thing. I have to be careful even on my side with the F40, because the valve is right in front of my mouth, and I could easily snuggle down and smother myself in dreamy comfort if I forget to make space for it.
RE: Medicare Rules - SarcasticDave94 - 07-30-2024
Reminder, Positional Apnea when referred to here isn't necessarily body sleep position like you doctor might mention, but the head, neck alignment that kinks your airway externally.