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How to Replace Your CPAP in Only 666 Days

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Re: How to Replace Your CPAP in Only 666 Days

#251

Post by shimon »

mikebenfield wrote: post #250
_qua wrote: post #183

Earlier quoted context omitted.

As someone who treats people with CPAP, it’s absurd how many people get them and then don’t use them hardly at all. Yes there’s an adaptation period where you need to get used to using it, but you do need to use it for it to do anything. It doesn’t seem crazy for insurance to want to not keep paying for something that is sitting under a pile of clothes in the corner.

I tried to use a CPAP machine for a while. I honestly could never figure out how I was supposed to breathe with it. At all. It seemed to be physically impossible. I'd try for a while each night, then get frustrated and stop so I could get some sleep. Completely useless to me. Fortunately I was able to just return it, but if I hadn't been able to, why should that mean insurance wouldn't cover it? I was prescribed this…

Insurers don't want to pay for unnecessary treatments, including equipment. Maybe your provider could have done a better job selecting the right mask or settings for the CPAP? Maybe they could have trained you in their office?

I'm not saying the surveillance and payment-held-hostage model is the best, but it does at least attempt to provide some useful incentives.

Re: How to Replace Your CPAP in Only 666 Days

#252

Post by shimon »

patja wrote: post #212
pas wrote: post #157

Earlier quoted context omitted.

> They may be the third-party administrator charging back to an employer, can you please elaborate on this? does this mean that some companies (employers) directly see and pay their employees medical stuff on their books? > Ultimately for Anthem, this claim cost them a lot more to handle than if they had just paid out in the first place ... well, of course, but the whole middleman game costs the US many many many ser…

This is how a lot of big companies work. They self-insure. They set the rules, pay all the bills, and the insurance company just administers things. If you work for a company that does this, be aware that the things you dislike about your insurance coverage may well have been designed that way by your employer, not the insurance company. Don't curse the insurance company when you don't like the benefits. Ask your man…

Almost every sufficiently large employer does this. Instead of paying premiums to an insurance company which owns the risk (and also makes a profit from that) the large employer pays the actual costs of care, and a percentage to the insurance company for the administrative work (using their provider network, claims processing systems, etc.).

Re: How to Replace Your CPAP in Only 666 Days

#253

Post by ebergen »

seattle_spring wrote: post #180
dmazzoni wrote: post #170

I use Kaiser Permanente as my health care provider. For those who aren't aware, it's one of the few "integrated care" providers in the U.S., meaning they act as both the health insurance and health care provider. Now, Kaiser is FAR from perfect - they have their share of problems. But....this sort of nightmare is not one of them. With Kaiser, doctors are free to prescribe whatever they think is medically necessary, a…

I'm a Kaiser member and have to get CPAP supplies through a company called Apria. It has been the absolute most godawful experience I've ever had dealing with a company. Worst than a thousand Comcasts. I genuinely don't understand how you could be a CPAP patient with Kaiser without dealing with Apria?

I was supposed to go through Apria during the shortage a few years ago. They kept giving me longer estimates for when a machine would be available. After calling and waiting a few weeks I bought my own online and had it the next day. It was worth the out of pocket to get a cpap sooner as I was barely able to function at work due to sleep issues.

I refuse to do business with Apria. They’re the worst company I’ve ever dealt with.

Re: How to Replace Your CPAP in Only 666 Days

#254

Post by bhoops »

candiddevmike wrote: post #123
bhoops wrote: post #106

Why dont you just ask someone coming from India to get you one ? They are available over the counter in India and there are a lot of Indian people hopping on a flight to the US all the time. I am sure there is someone in your office you can request, or someone in your locality.

You really need a professional to configure the CPAP, otherwise it can mess up your lungs (too much airflow) or make your sleep apnea worse (not enough airflow). That's why these are considered a prescription--the prescription is the settings on the machine.

Yes thats somewhat true, but I find that such professionals are very hard to find. Not just in India, but all over the world. OTOH there are sites like apneaboard.com and reddit/r/SleepApnea where you can learn to configure for yourself.

Re: How to Replace Your CPAP in Only 666 Days

#255

Post by Karunamon »

snakeyjake wrote: post #198
Karunamon wrote: post #159

Earlier quoted context omitted.

How does that not demonstrate the ineffectiveness of the regulations? Plain old consumer device safety stuff would apply here.

>How does that not demonstrate the ineffectiveness of the regulations? The only reason there was a recall was because of the regulations and the gargantuan and slow bureaucratic apparatus surrounding Philips. Philips tried, and would have succeeded without the regulations, to brush this off. They stalled, delated, cajoled, and lied. Consumer protection laws (i.e. just sue after someone dies) are almost worthless in t…

First off, thank you for the information.

Second, this comment would have been better without the final three paragraphs, which amounted to flame bait.

Re: How to Replace Your CPAP in Only 666 Days

#256

Post by NelsonMinar »

mikebenfield wrote: post #250
_qua wrote: post #183

Earlier quoted context omitted.

As someone who treats people with CPAP, it’s absurd how many people get them and then don’t use them hardly at all. Yes there’s an adaptation period where you need to get used to using it, but you do need to use it for it to do anything. It doesn’t seem crazy for insurance to want to not keep paying for something that is sitting under a pile of clothes in the corner.

I tried to use a CPAP machine for a while. I honestly could never figure out how I was supposed to breathe with it. At all. It seemed to be physically impossible. I'd try for a while each night, then get frustrated and stop so I could get some sleep. Completely useless to me. Fortunately I was able to just return it, but if I hadn't been able to, why should that mean insurance wouldn't cover it? I was prescribed this…

I'm sorry to hear you had that problem, you're not alone. I hope you found some alternative treatment that works for you! It's possible to succeed with CPAP even if it's hard at first, too, with various adjustments. I hope you've found a way to get a good night's sleep.

Re: How to Replace Your CPAP in Only 666 Days

#257

Post by hypercube33 »

patja wrote: post #116
londons_explore wrote: post #108

Earlier quoted context omitted.

In most places you can at least get back the court fees (which are typically a few hundred bucks). Unfortunately sometimes you can't get back the court fees, and in situations like that, rather than spending $3000 on some new medical gear and battling insurance I would be very tempted to go to eBay, buy it 2nd hand from someone for $150, and just use that. Better time/effort/money/result tradeoff IMO.

eBay is pretty good at enforcing their policy banning sales of medical equipment requiring a prescription. They yank any listing for a CPAP very quickly.

A lot of stuff is over the counter now so why aren't cpaps and other durable (overpriced) medical equipment?

Re: How to Replace Your CPAP in Only 666 Days

#258

Post by matheusmoreira »

mlinhares wrote: post #89
nimos wrote: post #67

Earlier quoted context omitted.

Honestly I don't think most people need a "fixer" - just any local friend. Either they will know the expected bribe amount or they can figure it out. Also you might be able to get them to do stuff for you where all of the sudden the bribe is 1/10 the amount because they are local. Maybe if you are doing more serious stuff like business or real estate it makes sense.

In specific countries, like Brazil, “fixer” is a real job (it’s called “despachante” there) and it’s supposedly someone that knows the bureaucracy and how to navigate it. Most of the time when you need to deal with a government agency you’d go through one of them. They don’t advertise that they’ll bribe people to get it done but that’s how it works.

Their services are well worth it, bribes or not. The less you interact with brazilian bureaucracy, the happier you are.

Re: How to Replace Your CPAP in Only 666 Days

#259

Post by nvm0n2 »

p_l wrote: post #230
nvm0n2 wrote: post #227

Earlier quoted context omitted.

You got lucky. My father went to a&e recently with breathing problems due to some non COVID respiratory virus. He was struggling to breathe. They had zero free beds and he stayed overnight on the chairs waiting to be admitted. Eventually they found him a recliner. And then of course you have the constant strikes and inability to even see a doctor at all unless you win the game of phone lottery. The NHS may have a sim…

Part of it is a Tory problem - when they changed how the funding gets distributed, so that overall bigger fund is divided now into smaller pieces that still have to cover the same population, but without the scaling benefits that previous allocation provided. It's visible in other systems too, where for example you end up with local government politicians fighting for "prestige" or even perceived need to have a speci…

The NHS doesn't have a problem with too few patients anywhere. Just look at the chaos of the recently opened dentists that saw massive queues down the street, where police had to intervene to control the crowds. The reason: the dentist was new and accepting NHS patients.

A system that can't even provide dental slots without needing police to break up fights is a catastrophically failed system and it is a huge problem of the UK that people have loyalty to this dying corpse of a department.

Re: How to Replace Your CPAP in Only 666 Days

#260

Post by pareidolia »

mikebenfield wrote: post #250
_qua wrote: post #183

Earlier quoted context omitted.

As someone who treats people with CPAP, it’s absurd how many people get them and then don’t use them hardly at all. Yes there’s an adaptation period where you need to get used to using it, but you do need to use it for it to do anything. It doesn’t seem crazy for insurance to want to not keep paying for something that is sitting under a pile of clothes in the corner.

I tried to use a CPAP machine for a while. I honestly could never figure out how I was supposed to breathe with it. At all. It seemed to be physically impossible. I'd try for a while each night, then get frustrated and stop so I could get some sleep. Completely useless to me. Fortunately I was able to just return it, but if I hadn't been able to, why should that mean insurance wouldn't cover it? I was prescribed this…

CPAP makes breathing harder than normal. It's antiquated technology, superseded by something called bilevel-CPAP (BiPAP) which has the quality that it makes breathing actually _easier_. It's slightly more expensive than plain CPAP so insurance and doctors withhold it from the patients and try to keep it a secret.
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