[Caymus]

My current CPAP Machine is displaying a message that it should be replaced. I obtained it years ago while I was on private health insurance.

I remember that the buying experience was somewhat of a nuisance. The "Sleep Doctor" seemed mainly interested in selling supplies and I was required to have numerous office visits until it was fully paid. During the visits they would just read the sleep results to me that I could see on the Airsense App. Plus, if I didn't log the required sleep hours, I would be required to pay their full price.

I notice that I can buy a unit online for probably much less than my deductible was at the time. I also notice I can pay for a "prescription".

Does anybody have experience with obtaining one on Medicare and is it worth the hassle compared to a direct purchase?

[Keefelane66]

Originally Posted by Caymus

My current CPAP Machine is displaying a message that it should be replaced. I obtained it years ago while I was on private health insurance.

I remember that the buying experience was somewhat of a nuisance. The "Sleep Doctor" seemed mainly interested in selling supplies and I was required to have numerous office visits until it was fully paid. During the visits they would just read the sleep results to me that I could see on the Airsense App. Plus, if I didn't log the required sleep hours, I would be required to pay their full price.

I notice that I can buy a unit online for probably much less than my deductible was at the time. I also notice I can pay for a "prescription".

Does anybody have experience with obtaining one on Medicare and is it worth the hassle compared to a direct purchase?

oes Medicare Part B pay for a sleep apnea machine?
Yes. Original Medicare Part B (medical insurance), which pays for durable medical equipment (DME), helps cover some of the costs of sleep apnea machines if: Your doctor diagnoses you with OSA after a sleep study. Your doctor and device provider participate in the Medicare program.Jun 1, 2023

[metoo21]

Be sure to check with your doctor and Medicare as you may be required to have quarterly visits as a stipulation for they paying for it in full or partially.

[BrianL99]

Originally Posted by Caymus

My current CPAP Machine is displaying a message that it should be replaced. I obtained it years ago while I was on private health insurance.

I remember that the buying experience was somewhat of a nuisance. The "Sleep Doctor" seemed mainly interested in selling supplies and I was required to have numerous office visits until it was fully paid. During the visits they would just read the sleep results to me that I could see on the Airsense App. Plus, if I didn't log the required sleep hours, I would be required to pay their full price.

I notice that I can buy a unit online for probably much less than my deductible was at the time. I also notice I can pay for a "prescription".

Does anybody have experience with obtaining one on Medicare and is it worth the hassle compared to a direct purchase?

It's a pain in the butt, but probably worth it, in the long run.

You'll likely need to have a new Sleep Study and a new prescription, depending on how long ago your last one was. Even if you've been using a CPAP for 20 years, it's start all over time.

You can hook up with any medical equipment provider you want. Don't listen to what the Sleep Study people tell you, start with the Medical Supplier you want to use. Check Google recommendations. Some are better than others, none are great.

They can set you up with a Sleep Study and get the prescription for equipment. I stopped trying to figure out the "deductible" thing with Medicare a long time ago, but the Deductible will be much cheaper than buying one on your own (I've done that for 20 years).

The good side, is they'll send you more equipment than you can possibly use. Medicare pays for a ridiculous amount of "maintenance". You'll get new masks every few months, new headgear, new filters. Most of the stuff will be covered by your Insurance and/or Medicare. I have boxes of extra stuff.

You can specify to the Equipment Supplier, which CPAP you want and what mask you want.

They are required by Medicare Regulations, to deliver it in person and give you "training". You *may* have a "compliance period", where your use in monitored, to make sure you use it. I think the usual standard is a minimum of 4 hours per day at least 22 days out of a consecutive 30 day period within the preceding 90 days.

It's a hassle in the beginning, but once you get your machine, it's easy and most suppliers have online ordering. Below is the Medicare regulations & the "maintenance" schedule is attached here.

https://oig.hhs.gov/oei/reports/oei-07-12-00250.pdf

[villagetinker]

Yes, you need to have the doctor give you a prescription for the equipment, then it is covered. We use MyDMEdoc in the villages, (Spanish Springs), Medicare covers a new machine every 5 years, and all of the masks, tubing, etc., on a quarterly basis. myDMEdoc is great once you get your account and equipment set up.