Cough Assist Machine - follow up

[dkcarl62]

Seasons Greetings everyone!

Follow up to my 10-14-15 post. In that post, I described that I was prescribed a cough assist machine for reasons that were unclear. I don't have a problem with phlegm, don't cough, don't have mucus, and the best reason the RT could come up with for WHY I have it was that it will help me to acclimate to the machine for when I do need it. The machine was delivered in Sept and billed to my private insurance.

After reading lgelb's (Laurie) excellent feedback on this topic, I decided to pack up and shelve the devise.

So I thought I owned the machine. Come to find out, my insurance is billed every month for $600 - a RENTAL FEE. My insurance is paying for a machine every month that is sitting in my closet. Its becoming a lot clearer now why I have a machine I don't need.

Deb

 

[Atsugi]

Wow. Just wow.

 

[dkcarl62]

On the other hand, my Medicare Part D provider Silverscripts just informed me that Baclofen is not in my formulary. (Medicare is a whole new ballgame for me in 2016). I now have to request a special coverage determination called an "exception". I have a machine I don't need and can't get the pills I do. At least life isn't boring.

 

[JimInVA]

We had our CoughAssist much before we needed it. But on the day that we first did need it, my PALS was able to recover from a terrible instance that would otherwise have taken her life. That was 9 months ago and we've used the CoughAssist many times since. Regardless of where we are... home... work... travel... it is never more than a moment away. I'm glad that you have no need for it at this time. But I am also glad, that when you do, it is ready to pull out of the closet and provide for the unexpected need.

Our best to you and yours...

Jim & Darcey

 

[Clearwater AL]

Deb, if you haven't already... call your Neuro and tell him/her about the Baclofen problem. Just a suggestion... have him/her do a hand written prescription for the Baclofen. Scan it and Email it to your Part D provider or copy it and send it in by mail. Also, as you may know, and mention to your Part D provider... you can not just stop taking Baclofen! Most of all if you have been taking it for a long period of time. But... that also depends on the daily dosage you take... 5 or 10MGs isn't critical but if you're up to 20 or 30 MGs three times a day definitely not.

 

[bigmark1954]

The home medical industry has become predatory to the Health INS, and for that matter people needing medical equipment.
It really chaps my a$$, because it is reflected in the premiums we pay.
I was prescribed a Cough Assist unit on my last clinic, but I decided against it. Five months has gone by, and now I think I might actually need it.
I have had my BiPap for about a year and the rental fees have paid for the machine twice (on a Resmed unit costing 1100.-1200.00 purchase price).
I have an 02 concentrator and the home medical company is raping Blue Cross on that as well.
I have pointed this dynamic out to Blue Cross a few times and they don't seem to have an issue.

Hang on to your BiPap because it will be harder to get it back a second time.

 

[lgelb]

Mark & all,

Just a reminder that you don't have to rent PAPs via your insurance co's DME and pay more in rent than it costs to buy. You can use the same Rx to buy on sites like second wind.

 

[dkcarl62]

Laurie, do I understand you to say that insurance (Medicare) will cover the cost of the purchase of a cough assist machine? In all fairness, the monthly rental does include all supplies and 24/7 support. I can't assess the value of that when I don't use the machine, but it could be worth the cost to rent.

Al, I did contact my neuro thru the patient portal and am awaiting a response. I uploaded the letter I received and contact info for my provider. I asked for direction about what to do next. Haven't heard back, but its the holiday season.

Deb

 

[lgelb]

Sorry for confusion. PAP refers to BiPAP not the C Assist. The cost for buying a CA outright is more variable as supply is less plentiful on the secondary mkt. Either way, if you go through Medicare, you are subject to capped rental depending on the item. I was talking about buying one's own BiPAP, so not using Medicare or other insurance.