Hi,

I found out yesterday that I have mild sleep apnea.  A company is meant to be calling me today so they can come around with a mask and fit it for me.  Is it just this simple?  Obviously they will know what kind of mask that will be best for me, etc.  My main concern is will it be covered by my insurance.  My doctor said that it will be covered for the 1st 2 weeks and then they expect you to pay for it (because they are confident that it will work).  What if it doesn't work?  Do I just give it back?  If it works what do I have to pay for and how much will it cost?  I really am clueless because it is all new to me.  I'd appreciate any help.

Thanks!
Wendy

Hi Wendy,

First of all, congrats on taking the next step to feeling better.  I know when I got my diagnosis it was almost a relief because I finally knew why I felt so exhausted.

Trying to deal with all the issues involved is pretty overwhelming if you don't know where to start and the questions to ask.  Coming to this forum is definitely the right step.  I have found lots of great information on this forum and everyone gives such great advice.

Covered by your insurance company?  You need to call them and ask what your benefits are as related to Mild Sleep Apnea.  I know insurance companies and policies vary so much...some cover the equipment and some don't.  Also, if they say it's covered, get it in writing WITH a list of the DME's that they work with.  ALSO, what equipment is covered and the percentages...CPAP, BIPAP, APAP, masks.  I know my insurance company will cover the equipment, but only if I go through a certain supplier.  Don't rely on the supplier your doctor is sending to be the one that your insurance will cover.  Find out from the insurance company and get something in writing.  I know I said that before, but it does bear repeating over and over.  As to cost?  That depends on your insurance and what they have worked out with the supplier they accept.

Now as to equipment.  Call the company that your insurance company does use and request they bring different types of masks.  While they may know what's popular, that mask may not work for you.  I went through five masks before finding the one that worked for me.  Also, when trying on the mask be sure to lay down and have the CPAP on.  This will allow you to better decide on the mask.  A mask that isn't comfortable or has a lot of leaks, will make it more difficult for you to be compliant with your treatment.

Good luck,
Melinda

wendyj.usa wrote:

Hi,

I found out yesterday that I have mild sleep apnea.  A company is meant to be calling me today so they can come around with a mask and fit it for me.  Is it just this simple?  Obviously they will know what kind of mask that will be best for me, etc.  My main concern is will it be covered by my insurance.  My doctor said that it will be covered for the 1st 2 weeks and then they expect you to pay for it (because they are confident that it will work).  What if it doesn't work?  Do I just give it back?  If it works what do I have to pay for and how much will it cost?  I really am clueless because it is all new to me.  I'd appreciate any help.

Thanks!
Wendy

Hi Wendy,

The most important thing is the MASK or interface (possibly nasal pillows either). If the mask ain't right, it will be very hard to become compliant.

When the rep calls make sure to see ALL available masks, try them on, connect to the cpap machine and lie down, move around until such time as you are happy.

BY way of information, you have (not in any particular order) ResMed (nasal, full face masks and nasal pillows), Respironics (similar), Fisher & Paykell (similar) DeVilbiss (similar), plus many more. They are all interchangeable (ResMed machine with Respironics mask etc).

Don't be afraid to ask to see more products, look surprised if they say they haven't. Wendy, you'll get one good crack at this so make it your best one.

Best of luck.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Thanks Melinda, I called my insurance co. and they said that the CPAP mask is covered and something about changing it every 3 months is covered.  Is that the oxygen or something?  I don't know anything about any of this.  I just have to call them to make sure this company (who I don't know the name of yet because they haven't called me) is covered by my ins.  I will make sure to try different masks and ask them to bring different ones for me to try.  Thanks for your help.

Thanks Daniel, I'll make sure I try all the masks available.  Are there any masks that are better than others or does it just depend on the person and your likes and dislikes?  Thanks for the info on the different brands.  

Wendy

Your doctor probably sent you to a supplier that is covered by your insurance, but it's wise to check. The 3 month replacement is a new mask every three months. There is no oxygen. The cpap uses room air, usually humidified with heated distilled water.

Hi, Wendy -

Welcome to a very supportive club.   This group is great about answering questions and offering advice.  

I, too, was overwhelmed 7 weeks ago when I was diagnosed and got my CPAP.   It's now my best friend.

If you have the option of getting a heated humidifier with your machine, do it.  Without it, you may experience extensive dryness in your nose and lungs....  

Let us know if you need any information!

Good luck.  Relax and sleep well!!!!