Hi saw ENT this morning and he wrote a script for Auto-Pap with cflex and humidifier. Apria DME provider, just called back to set appointment for fitting on Monday!!!  But, they say Medicare will not cover this,,,that they will only cover straight Cpap with cflex!!! Im not sure its a issue for me, as Ive only used CPAP the nite of my sleep study!!! But I do understand the mechanics of Cflex and did want that !!!!

But my question is has anyone had Auto covered by Medicare ?????? Thanks,,,,Dan

[quote="LittleRedTruck"]Hi saw ENT this morning and he wrote a script for Auto-Pap with cflex and humidifier. Apria DME provider, just called back to set appointment for fitting on Monday!!!  But, they say Medicare will not cover this,,,that they will only cover straight Cpap with cflex!!! Im not sure its a issue for me, as Ive only used CPAP the nite of my sleep study!!! But I do understand the mechanics of Cflex and did want that !!!!

But my question is has anyone had Auto covered by Medicare ?????? Thanks,,,,Dan[/quote  

Hi I'm new to this board and new using the CPAP...used it 2 nights so far.  My primary insurance is Medicare.  My sleep doctor sent me to LinCare DME.  I got the Respironics REMstart Auto with C-Flex and Respironics REMstar Heated Humidifier.  The paperwork for Medicare said "rented".  So I don't see why it wouldn't be covered by Apria DME as well.

Hi Dan:

Your question has 2 answers. Technically Medicare does not cover "Auto Cpap" only basic units. Medicare does not have a billing code for an auto but your company should provide you this auto and bill for the basic. Most DME companies will do this.

If you really want to get an auto, I would suggest you call the company that is going to provide you with this unit and tell them that your doctor ordered an auto unit, not a basic one. If they give you a tough time, just tell them you will contact your doctor and tell him/her that they are refusing to provide you with the unit your doctor prescribed you. They probably will give in. If they don't, there are a lot of other companies out there that may provide it.

The reason most companies don't provide auto units because they cost about $100. more than basic units and they get paid the same amount regardless of the type of unit. However many companies do provide them as a "marketing tool" for their referrals.

Let us know how you make out. All the best!

James

Took my initial sleep study 12/2 and still no thearpy!!!!! But,, I am closer !!!!  Im taking a second sleep study 1/17 with the purpose of determining if BiPap will help my severe Central Apnea !!!! If its substantiated by a sleep study,,its my understanding that Medicare will even cover a BiPap,,the most expensive type machine!!! So a week from tonite,,,,I  will be suffering on a bed made of Portland cement,,,wishing it were over!   .......Dan

Medicare will cover the bipap. Best of luck!

James