Struggling with High Deductibe Insurance To Pay For My CPAP

by Paul M.
(San Diego, CA)

I have sleep apnea with health insurance I can currently afford, but with a huge deductibe. I know my doctor has to live, but I am delaying buying new CPAP headgear, sleep apnea masks, etc. and delaying my doctor visits, to save money.

Since I am on a strict budget and on the hook for a huge deductible while being older and unemployed, I need to figure out how to make this work. Assuming most doctor's are qualified in the U.S., is there any way to reduce the cost perhaps by putting my apnea treatment out for bid to a variety of doctors in the San Diego area? Your website is wonderful, but is there a Consumer Reports for apnea machines and accessories that would give me an unbiased concise listing of what is out there? Like Consumer Reports, a listing which would show me "best value" would be ideal> Along those lines, I can't afford mask wipes, is there a "do it yourself" mix I could make myself that would be just as good?

My apnea doctor is affiliated with a big hospital in San Diego. Sounds like an expensive way to go. Are there less expensive ways to go? How do I find out billing rates, etc.

I may sound like I am complaining. I am not. Since my deductible is so high, I would be willing to pay cash out of my savings to maintain treatment.

All advice would be appreciated and thank you.

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Jul 31, 2012
Part 2 of 2
by: CpapHelpDesk

• Once you get your Sleep doctor on your side, I have seen many times the sleep center will call out to their preferred list of Home Medical Equipment companies and talk to them on your behalf. In turn these companies do not want to disappoint the Sleep Center/doctor because they get a lot business from them & will try to accommodate their request.

• Big city hospitals are especially geared to help people with financial hardships. Don’t be uncomfortable to inquire about potential help.

• Call & speak to the branch manager of the Home Medical Equipment Company and explain your situation. A good number of them will help you when you explain you have “Financial Hardship”. That’s the key phrase to use.

• Many Home Medical equipment companies will create a payment plan to pay the deductible that is acceptable to you.

• You could also reach out to the helpful people of the many CPAP forums for answers.

• Please Forgive me, I am not making light at all of your financial situation…Allow me to share with you what I do. I literally have a plastic container (like a piggy bank) in my room and every month I physically put a few dollars & all my loose change in there. When I have enough, that’s when I buy one of those “ridiculously over priced CPAP mask,” or cushion or what ever I need. I plan for it for I know I inevitably am going to need it. In essence I am creating a budget for it even though it is not a fixed dollar amount. I just make sure I put “something” in that plastic container every month. This may or may not be helpful to you. I am just sharing with you what I personally do. Just like you, I to have a very high deductible insurance plan but I also buy Masks to conduct tests & reviews for this website in order to be helpful. Every year this problem is going to surface, so might as well start saving your loose coins away for that.

• Go to Google and type CPAP. You will see tons of tiny advertisements of Home Medical Equipment companies that sell CPAP on the right hand side. All their websites will show you what’s out there in the market & their prices.

Please , please don’t give up. There is help out there. You have to be persistent .

Jul 31, 2012
by: CpapHelpDesk

Part 1 of 2
I have a couple of suggestions based on what others who have been in your (similar)shoes have done:

• Change the cushions only of the mask you like. It is so much cheaper than buying a brand new mask. (Assuming your mask frame & headgear is in fairly good condition)

• If your headgear is in bad shape, just replace that part only. Now if you have another type of CPAP mask lying around, see if you could use that headgear with your mask of choice.

• Explain to your Sleep Physician about your financial problem, and many of them will give you sample CPAP masks they have lying around. Ask them nicely about it & you will be shocked by many of their generosity.

• The cheapest way & the best way to clean the mask plus your CPAP tubing is with a mild dish detergent you have already in your kitchen.

• The best way to know about billing rates is to simply ask them. They will tell you. Also speak to your insurance and they can break it down more precisely how much they will cover. Same thing with any of the Home Medical equipment companies. By law they have to tell you how much your Copayment is going to be upfront.

• Especially big name hospitals in big cities have used CPAP units that people donate. They are generally older machines that work but the previous owner has moved on to a newer model and donated it with the expressed intent to give it to someone in need. You have to ask around & I guarantee you will find it. Don’t give up easily. You want to speak to the nurse practitioner or the person who actually sends the CPAP orders to Home Medical equipment companies or the doctor's assistant/secretary about it. Make it known to them about your dilemma.

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