Is it normal for the DME to allow a customer to try two or three different masks during the first weeks?  Does  the doctor prescribe the mask and I have to talk to her to get another?

The mask they brought is OK but there are others that look like they might be much better for the way I sleep.  (I move a lot and sleep on my sides and stomach if at all possible).  I mentioned that I'd like to try the ResMed Activa to the DME owner on the phone and she said "We only handle Resprionics and another brand".   The implication was that I would have to
pay for it if they ordered it.   Do DME's have contracts to handle only certain brands?  

I've never had to deal with Medical Suppliers before and do not know what is customary.  Perhaps someone with more experience can tell me.  

SIDE QUESTION:  Even allowing for a profit to cover the personal service they provide, it seems they are charging me and my insurance company a lot for the supplies and options. $50 dollars for the tube that goes from the CPAP to the mask (to be replaced every 4 weeks),  $364 for the Resprionics humidifier/heater.  $14 for a disposal filter every 2 weeks,  $142 for the Comfort Gel mask to be replaced every 12 weeks,  etc. etc.    plus the rent on the machine of course.   True, I'll have to pay only 20% of this but it adds up.  I know they have o make a profit, but is this normal?  

Just wonderin' and snoozin'     !!
Phil





          
  

there must be a misunderstanding, the tube and mask often last for several years and dont need frequent replacement, the mask and tube neednt be replaced any more often than 12 months, IMO
the filter should last much longer than 2 weeks

masks and the airhose benefit from frequent washing in water and mild detergent, the silicone rubber tends to absorb body and skin oils

try to find some other place that has a wider range of masks , also its a big help to find someone who is well experienced at fitting masks and is kind and patient

I doubt the need for humidifiers or heaters, unless having problems without them

[quote="philchenevert"]Is it normal for the DME to allow a customer to try two or three different masks during the first weeks?  Does  the doctor prescribe the mask and I have to talk to her to get another?

The mask they brought is OK but there are others that look like they might be much better for the way I sleep.  (I move a lot and sleep on my sides and stomach if at all possible).  I mentioned that I'd like to try the ResMed Activa to the DME owner on the phone and she said "We only handle Resprionics and another brand".   The implication was that I would have to
pay for it if they ordered it.   Do DME's have contracts to handle only certain brands?  

I've never had to deal with Medical Suppliers before and do not know what is customary.  Perhaps someone with more experience can tell me.  

SIDE QUESTION:  Even allowing for a profit to cover the personal service they provide, it seems they are charging me and my insurance company a lot for the supplies and options. $50 dollars for the tube that goes from the CPAP to the mask (to be replaced every 4 weeks),  $364 for the Resprionics humidifier/heater.  $14 for a disposal filter every 2 weeks,  $142 for the Comfort Gel mask to be replaced every 12 weeks,  etc. etc.    plus the rent on the machine of course.   True, I'll have to pay only 20% of this but it adds up.  I know they have o make a profit, but is this normal?  

Just wonderin' and snoozin'     !!
Phil


Hi Phil,

Don't know the situation in the US, but I believe you should be allowed choose 'the best mask for you', not because it is the only brand they carry.

With regard to the costings.........they are daylight robbery not to mention the timing of replacements. The hose from the mask to the machine lasts anywhere from 6/12 months and longer (in Ireland these are free to those renting cpap eequipment as they are part of the machine). Disposable filters, can last at least 3 months (again free in Ireland). Mask replacement is normally every 6 months.

CPAP therapy might prove to be quite expensive.

Daniel


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

(Anon)

With CPAP equipment there are costs and there is cost recovery. In the U.S. these can be thought of as two separate items. Sound complicated? It is!

Costs. In my experience it is much much less costly to buy the equipment directly over the internet than it is to go through durable medical equipment providers. In addition, the selection over the internet is extensive, you can get anything on the market. For machines, humidifiers, and masks you need a prescription. For replacement parts (hoses, filters, etc.) you don't.

Cost recovery. Many insurers want you to buy from "preferred providers." They have different cost recovery formulas if you buy your equipment from anyone other than their preferred provider. In my case, the two preferred durable equipment providers near my home carried a very limited selection of equipment (one type of CPAP machine and two types of masks). My insurer covers 80% of the costs from a provider on the list. Buying "out of network" they cover about 40% (and only after haggling).

The problem with buying over the internet is that you have to figure a lot out for yourself. For the novice this can be overwhelming.

Many durable medical equipment providers have leasing options. I would suggest leasing the CPAP machine and humidifier (you'll have to buy the mask) from the provider to get used to the equipment and see what you like. After several months you will have figured it all out. Faster if you refer to this forum and pose questions. Then, return the equipment to the provider and buy what you want over the internet. Masks, in particular, require much experimentation so having the larger array of choices from the internet is a great benefit (after 15 months I'm still fiddling and tweaking).

With regard to the ancillary equipment, hoses can last more than a year if you clean them regularly. I just replaced mine after 15 months of continuous use. You can get replacements over the internet for around $20. Replacement filters are $10, or less, depending on the type of machine.

I'm envious of Daniel and the excellent cost recovery provisions available to him in Ireland. The health care system in the U.S. is broken, but I guess that is a subject for another forum.

Good luck.

Excellent advice, rpad.   I peeked at the prices in the closest local DME once.  That convinced me that buying all my equipment from online stores and online auction sites was the route I'd go.  I've never regretted it.

One tiny correction that I think you'll like.      You can add "mask" and "humidifier" into the list of things that can be bought from online cpap supply stores without needing a prescription at all.  The online stores I've bought from require a prescription only to buy the machine itself.

You're so right about it being a good idea to rent a machine (or two, or three)  for awhile when first starting, to be sure what machine suits you.

There's at least one online cpap store that has recently begun handling all the filing for insurance reimbursement (just like a local DME would)....welcome news for those whose insurance companies will let them shop more widely than at just one or two local bricks-and-mortar stores on a list.

technically masks can require a prescription, and I think you might find that as a Your Mileage Might Vary kinda issue.  Anything that has a federal legend stating that it has to have a prescription or on the order of a physician, should require an rx.  But RG is  right, there are places that do not require it...

I have found personally for myself that I can buy all CPAP and related devices without a prescription.  Having the cash seem more powerful than a piece of paper.  But of course the correct answer is listed above.


_________________

Haku wrote:

I have found personally for myself that I can buy all CPAP and related devices without a prescription.  Having the cash seem more powerful than a piece of paper.

That's true with nearly any prescription drug also...think about all the viagra spam in your email! If you have the money and are willing to take the risk you can order vicodin and other narcotics too. Personally I see a big difference in the risk of getting a mask without a script then getting drugs....I can't really see anyone using a mask just for fun other then as part of a Halloween costume. If masks were avaiblable over the counter completely you can bet insurance companies would stop paying for them in an heart beat.

My company allows customers to try on masks from our "sample" box before deciding on a mask.  (All masks are disinfected after trial)  We don't let customers take the samples home for sanitary purposes.  (would you want a used mask?)  

Most insurance plans have a limit on how often masks can be replaced.  As for the cost of machine rentals/ masks/ tubing/filters...those prices are set by the insurance plans  ie. Blue Cross, Medicare, HMO's etc.  How often they need to be replaced is only a suggestion.  If you clean and take care of your mask, filters, tubing etc.  They often last much longer than the time until the insurance "allows" you to get a replacement.  In other words, when they will pay for one.

My biased opinion about getting DME from the internet...who is providing support and setting the pressure??  Masks for CPAP
do require a doctor's prescription per the FDA.

Thanks to all for their advice.  Concerning the replacement items, there was no misunderstanding.  It is spelled out in a paper they gave me detailing the costs: every 4 weeks they will be sending me a new tube and filter, every 12 weeks a new mask, etc. etc.  and naturally billing for them.  

The wonderful advice from everyone is helping a lot.  I've talked to them and they have agreed to let me try two other Respironics masks and (reluctantly) to see if they can get the Activa.  They did explain that it is easier to service clients if they have all the equipment from one or two
companies rather than bits and pieces from many.  This makes sense to me.

Working out the costs it is startlingly clear how much can be saved by buying the machine instead of renting it over just a year period.  

Gee, it's nice to have friends !!!!!

Who will set up the cpap ? Give me a break.  If you can hook up that new PC or that plasme TV with DVD you can 'hook up' the cpap .

About Insurance. Why would you want to pay 2X to 5X for cheapo equipment from a DME when you could buy online and get top shelf for what you copay is with insurance .  We can inject ourselves with all sorts of drugs. Test our blood sugar. ...........But we cant be trusted to hook up a cpap without supervision... No wonder I can't afford insurance.

Chumley