anyone with a CPAP machine? Does your insurance pay?

[Grumpy's Gal]

just curious. Does you insurance pay? for part of it? for all of it? thanks!

 

[jennyl772003]

Our insurance first paid to rent the machine, then after a few months they bought it. They also pay for a new mask every month (I think it's ever month, it's DH machine), which we get in the mail.

 

[Grumpy's Gal]

anyone else? I'm wondering why insurance companies wouldn't pay or do they all pay?

Thanks jennyl772003! I hope you are getting some sleep!

 

[justjulie]

Up here the government and private insurance (together) will cover up to a maximum of $1,800 - no mention of covering masks ...

 

[YachtClubWoman]

Yes - I have had a CPAP for about 3 years. I have never paid a dime including sleep studies, mask and machine. I have a tendency to break masks and have never had a problem.

I have a HMO through my job.

 

[disneyfan67]

My insurance has covered mine since August 2001 and I get a free mask every six months to a year. I have never seen a bill or a statement and have no idea that if the insurance has rented it or purchased it. I know my CPAP machine says property of Wallgreens healthcare systems on it.

I have HMO through my wife's job. Her company provides the insurance.

 

[kbkids]

Ours paid - 100%.

 

[kimmikayb]

our insurance paid for some of it. Worth it. Now I know my DH will sleep through the night and the snoring stopped!

 

[mrsmom]

My dd 12 has a had one for 3yrs and i paid 80% of the cost and i pay 80% for my supplies for it.
Kim

 

[Grumpy's Gal]

anyone know what determines if the ins co will pay part or all of it?

 

[megan4777]

anyone know what determines if the ins co will pay part or all of it?

I just had to deal with what our ins. co will pay for DH's CPAP and surgery.
Our insurance is through dh's work. I called the insurance company and was told that his work had set up to pay for 80% of an employee's CPAP machine/other equipment.

You should call your insurance company and ask them for a specific % or amnt that they will cover. Make sure you get a clear answer b/c the first time I called I was told, "yeah, it's covered." That's different than it's 80% covered.
Also ask if there are any specific requirements for getting/having the maching. DH must use the machine an avg or X hrs/ week (they track that through a card in the machine) for it to be covered.



I just wanted to add that if this post has half sentences or I don't make a ton of sense, it's b/c I just got DD#2 up and she's randomly hitting keys and poking at my mouth so I'm distracted.....

 

[GeorgeG]

I suppose it will depend on the insurance comapny and/or the coverage on an individual basis.

I've been on CPAP for 11 years now and the insurance always covered 100% of sleep studies and machines and equipment.

 

[Grumpy's Gal]

Thanks to all of you for that info. I think you are right.....I'm just going to have to call the ins company directly. I just hate doing that...........

 

[justjulie]

We're in the process of getting the results from the sleep study by the respitory tech pretty such sealed the deal - she's certain he's got it. Now, about masks, which one do you prefer - I've heard the one with the small tubes are more comfortable than the full mask if you can stand them up your nose ...

 

[RealMickeysGirl]

I don't remember paying anything for the sleep study but if I did it was probably $75 or $100 - seems to be the standard copay for my insurance.

I paid a little over $300 for my machine/heater/mask when I first got it. The Hospital told me it cost $1500 but I found it on the internet (at a reputable place - not ebay) for just under $800 so who knows how much the insurance company actually paid.

I just got a replacement mask and it was just under $20.

I like the mask with the gel insert - I have never tried the mask that just sticks in your nose. I have the kind that is the little triangle that fits over your nose.

 

[Stitchfans]

DD is laughing her head off at me right now. I misread your thread title outloud and thought it said crap machine. I guess I have been looking at the computer screen to long.

Sorry continue on with your thread.

 

[jennyl772003]

DH has the triangle mask with the silicon. It took him some time to get used to, and he sometimes breaks out a little from where the mask sits. I don't think he would like the nose kind though.

One thing that he thinks is a must... Get the machine that uses water. The other kind will dry you out and be very uncomfortable. Make them write it into the perscription.

 

[arminnie]

Be sure to check that you are getting it through a provider that works with your insurance company.

After my first sleep study I got one via a company the hospital gave me the name of. Not only were they NOT on my insurance's approved list - they were also totally disreputable. They charged me sales tax on the total amount (my insurance paid a portion). This was in CA where there is NO SALES TAX on CPAP. I even had an attorney verify that.

I wonder how many people they scammed on that one - they sure weren't sending the money to the state. I did two things - reported them to the state and immediately changed providers.

The second provider was totally covered by my insurance and gave me MUCH better service (in addition to not cheating me). I had a technician come out and fit me personally, was given prompt service, etc. The first provider just mailed the stuff to me.

I had a lot of problems and had a humidifier added plus was switched to BIPAP (which does not blow in as you exhale). Unfortunately none of it worked for me, and I eventually had surgery.

What no one ever told me (too polite?) was that losing weight is one of the best things to do and helps many people with apnea. It's kind of a vicious circle - with apnea you can be too tired to exercise and eat right. The extra weight can (not true for everyone) contribute to apnea.

After I had the surgery to fix the apnea I became my more active self and lost the weight without even really trying to.

 

[arminnie]

DD is laughing her head off at me right now. I misread your thread title outloud and thought it said crap machine. I guess I have been looking at the computer screen too long.

I have a "crap" machine - my carpet cleaner. I have a 13 year old dog and an 85 year old father who takes that Fleet stuff they give you before a colonoscopy just for the heck of it. I'm on my third "crap" machine in 5 years.

I am laughing now, but it is so NOT funny when I have to get it out.

 

[tinkwannabe2]

We are in the process of getting one for my DH right now. It all depends on your insurance plan. I believe it's considered "durable medical equipment." We will pay about $115 the first month for the machine, tubing and mask... then for the next 9 months we'll pay $15 for the machine. After that we owe it! GOOD LUCK!