I have been reading these boards and see that a lot of people have more than one mask.  I am wondering about the payment of these masks.  Does your insurance cover them?  I know this varies a lot and I will check about my coverage, but I am wondering if there is a standard?  Do you buy them online or through the company who provided your CPAP machine (what's that called DE? what does that stand for?).  If you buy them online, can you exchange if the mask you chose doesn't fit?  

My swift nasal pillows mask is now more comfortable (took 4 nights of using for that to happen).  I am still having to play with the fit a lot.  I have been reading that it might be helpful to have a different type of mask for times when I am congested.  I prefer buying cute handbags to masks, but I want to have what works well for me.

~Rondi~

Well, I can speak for myself.  My DME (not sure exactly but it's durable medical supplier) has given me 3 masks now.  The first 2 I had problems with so they are happy to give me another  until I am ok with it.  So right now I have 2 masks that don't fit well and rub my nose so they are no good.  I am presuming my ins. is covering these masks because I haven't received a bill from them.  As for the future, I believe they cover a new mask every 3 months as well as tubing.  Actually, I should call them and find out.  I know if your ins. does cover it it's best to buy online but I have no clue if you can exchange it.  

LOL, yeah, who'd have thought we'd be buying MASKS!!!??!!!!

After 6 weeks with my Swift, I too am thinking about trying another - maybe the Breeze or the Headrest.  I'm looking for something better for switching sides during the night.   My DME said she didn't think the insurance co. would cover a new mask so quickly, but she'd try.  She did say they frequently need to be replaced in 3 months and I had the sense that the insurance would cover that.  

I have to say, I love the humor and attitudes of most everyone on this list.  Sharing laughs about shopping for masks and all the rest really does make it easier to manage the experience.  But I'm still with you, Rondi, I'd rather be shopping for handbags.  

Wendy, what mask are you using now?


_________________
Barb

I have John Deere insurance and it covers:
100% of all sleep studies
All but a $25 co-pay when I see the Sleep Specialist
100% of all CPAP equipment
100% of all masks, with unlimited replacements (in other words, not just every 3 months)

I just ordered a new Fisher & Paykel FlexiFit Series HC405 to replace the one I broke.  Yes, I broke it.  So I bought another from CPAP Station.  They sell them for $52.  I'd go through insurance but I'd use more time and money processing it than with it is worth.  

I like these mask because they fit well and nice seal around the nose.  Quiet too.  No wind sounds from the mask.  

Woody

Barb, I'm using the Respironics Profile Lite mask.

Wendy

Hi Rondi:

Most insurances will pay for mask replacement every 3 months. Some, including some Blue Cross insurances will pay for them more frequently.  Many insurances follow the Medicare guidelines.

If you are comfortable with a certain mask you should probably stick with that one. Too often many cpap users will try the latest mask on the market and never get acustomed to one mask.

Before you buy one on-line, check with your insurance company or the DME company you got it from. They will verify your insurance coverage. And masks are non-returnable because they are a single patient use item. If the mask is defective, most companies will stand by their mask warranty.

Best of luck,
James

CpapMD wrote:

Hi Rondi:

Most insurances will pay for mask replacement every 3 months. Some, including some Blue Cross insurances will pay for them more frequently.  Many insurances follow the Medicare guidelines.

My experience with Blue Cross (Ontario) has been the opposite.  They will cover NOTHING.  I was told that if the machine were for oxygen then it would be covered.  They told me CPAP is for air and that is not covered.  Tried to explain about air/oxygen levels to no avail.  I pay for my own private coverage (no coverage at work) and I get nothing.  Time to look for a new insurance company.

Wendi,

I'm a newbie considering this mask. What are its pro's? Con's?