Cost of CPAP supplies

[mythbuster]

Hello fora,
   This past year, I started using a CPAP machine. I'm happy to report that I have adapted to it, it generally works, and I am much more rested now. However, I'm trying to puzzle though the best way to get the supplies at a reasonable cost. Currently, I am using the durable medical equipment company designated by my insurance for automatic supplies every 3 months. The billing is byzantine, and it really seems to me that the direct purchase of these supplies form CPAP.com or the like would be much cheaper. The last bill was almost $300 after insurance plus a $100 co-pay!

I realize that all insurance plans are different- but please tell me if my gut is right and I am being massively overcharged? Also if you have an equipment provider that you like, please recommend them. They all have terribly shady reputations.

[Anselm]

I find medical billing and insurance very confusing so I end up usually just paying out of pocket through online suppliers like the one you mentioned.  Be aware that many products are no longer available through eBay since they are considered prescription products. I can buy a cushion for the full face mask but not the entire mask itself.  However, you can buy these items from the online stores with no problem.  A machine will still require a prescription.   I always travel with extra supplies since some stores will not sell you items without the prescription which can be hard to get when away from home.

[Langue_doc]

You're probably being charged for supplies that should be covered through your insurance provider. I would suggest talking to your physician and to the insurance company for clarification. I've been using a CPAP for years now, and have never had to pay for supplies.

[kaysixteen]

I agree with langue doc.   I have never paid a cent for any CPAP supplies in a dozen years of use.  Check your insurance carefully.

[clean]

I have already fired two cpap supply companies and the third is on the ropes! 
They seem to think that my annual copay is theirs for the grabbing!  Regardless of my deductible, the cpap folks are supposed to give me the BCBS rate and THEN that applies to the deductible. They seem to want to charge me everything up front, and only after my deductible is met are they required to charge the other rate.  Well, folks, it dont work that way with BCBS! (At least my branch!)

The first one I fired sent me a bill for supplies like 18 months late!  You can not figure out how to bill me on time, you dont get more money from me! 

Current company is trying to get me to order things with a computer on a phone line, and when I refuse to provide the credit card to pay a sight unseen bill, they are stumped.!   I tell them that once they send me a statement on what they are charging, then I will compare that bill with what BCBS Says they are to charge!   

Anyway, I need to call BCBS tomorrow and then call the suppliers order department and get it figured out.

 

[AmLitHist]

ALHS and I have both had similar experiences to Clean's. We've gone to getting everything from Amazon and/or cpap.com.  Also, we can filter on Amazon for "FSA eligible" and use my flex spending card.  We save easily 50%, and sometimes even more, over the medical supply place's prices. The service is much faster for the same brand-name items.

[Langue_doc]

I'm curious as to why one has to pay for CPAP supplies. I've had two medical practices just send the prescriptions for supplies to the CPAP companies and three different insurance carriers, including BCBS, pay them directly. The only payment on my end would be the co-pay for the sleep doctor. These appointments would be to ensure that I was in compliance sleep-wise with the insurance requirements. Now, horror of horrors, the doctor can see my sleep habits directly; until I got my new ResMed CPAP, I had to take the chip from my old ResMed to the doctor's office for it to be downloaded so that the doctor could discuss my sleep--good and bad--with me.

[clean]

I think that my university is my insurer, and BCBS is the administrator. I understand that they simply administer the plan for the university.
Medical equipment is not covered at 100%
After my deductible is met, I pay 20%.... But no mater if my deductible is met or not, the price I am supposed to pay is the negotiated price for the item or code (or something).
They providers seem to 'forget' that they are bound by the price even before my deductible is met.

Maybe they think taht they are doing me a favor... charging too much so that I will fulfil my deductible faster! 
(bastards!)

Anyway, tomorrow I need to call BCBS and then the medical equipment company to compare what I should pay with what they are trying to make me pay! 

Anyway, I am not covered at 100%.  In fact, I have to 'rent' a machine for at least 6 months before BCBS will approve me buying it.  That is on the horizon as I have started a new plan year, that should take care of much of my copay right there!