Weird. I’m supposed to change my mask every two weeks, so my supplier sends me six masks every three months. When I first got my CPAP it came with a set of masks in all sizes, and when it was time for me to reorder the first thing my supplier asked was what size I needed. From then on, that’s the only size they sent me.
Yeah, once your doctor has decided you need one, they should be willing to send copies of the prescription for you to buy a replacement, or a travel version, or other reasonable additions to your CPAP farm. If you ask for so many they they think you are reselling CPAP machines or something they might get cranky, but i don’t think there’s a huge CPAP -abuse black market.
And this is what pisses me off. Why should a mask be a “prescription needed” item? Is it potentially dangerous? Capable of being abused?Necessary to ration quantities?
No, no, and no. This is why I call the whole CPAP thing a racket.
I don’t remember by insurance trying to set me up with something like this, but I guess they did and I ignored it. Every so often they will send out a mass-email talking about “my equipment provider,” and I have no idea who they’re talking about. Whatever. I’m perfectly happy going to Amazon and spending a few bucks on a single nose piece when I need it every six months or so, rather than getting signed up for a flood of crap I don’t need.
As @Machine_Elf explained in their post, this is one manufacturer’s opinion. It is certainly possible to buy fully assembled masks online without a prescription, I have done it many times. Also mask parts, headgear and hoses, as many or as few as I want to order. Again, the rules may be different if your insurance is paying for any of it. Their requirements may be different.
My provider only sends what I ask for. I use nasal pads, and if I request a mask the package contains S/M/L; as for the pads themselves, they only send M.
I agree that the list prices are exorbitant, but what’s even more striking to me is the differential between list and what Medicare authorizes. The manufacturer and provider must still be breaking even or making a profit (otherwise they likely wouldn’t accept Medicare), which leads me to suspect that the “list price” was derived by consulting a dyspeptic Ouija board.
I truly hope the following doesn’t come off as a threadshit or humble brag. But this thread is genuinely very instructive for me. I currently have a HMO health plan through my job that I can carry over into retirement (soonish) at a not insignificant but at least slightly subsidized cost, including a smooth transition to a employer retiree Medicare Advantage Plan (better than your standard MA plan) at age 65 if I so choose (but only once, the choice is irrevocable if I don’t take the employer plan). I’d been weighing whether that eventual move is worth it or whether I’d be better off going with an outside supplemental plan or perhaps the rather more expensive and less tidy PPO option.
But one thing my current HMO plan has that many don’t is free medical devices. My HMO sleep analyst noted that when I got my CPAP. He said you literally cannot buy that coverage from my HMO on the open market and reading this thread is really driving that home for me. So my then state-of-the-art CPAP machine I got several years ago was 100% free. If I break it, I’ll get another for free (though I’m sure there is a limit of some sort). I call the vendor for supplies only when I need them, they look up my account name and send them out for free. No fuss, no muss.
On the one hand I’m not thrilled with sticking with my HMO over a PPO or something with more treatment flexibility if I start getting advanced cancers and the like. But the free devices thing definitely adds some fuel for thought.
I’ve been using a CPAP for years, and I was pleasantly surprised to find that after I became eligible for Medicare and my BCBS health coverage became secondary the next time I qualified for a new CPAP machine the cost was fully covered between the two of them. Also, the cost of my supplies is also fully covered.
I had a new sleep study last January, also fully covered. Since it’s been five years since I got my current machine I’m eligible for an upgraded machine. Unfortunately I couldn’t use that to have them pay for the travel CPAP I wanted for my recent overseas trip. However, I’m probably going to get an upgraded machine next year, just because I can.
… sounds like sleep apnea!
I never thought about it that way. I think his snort was a comment on the sleep study, but maybe it was a sign of apnea. Wouldn’t be the first doctor who failed to diagnose himself.