New positive airway pressure (PAP) technologies are entering the market, and I am interested in trying a new product. Will my insurance pay for another PAP device?
Many payors will consider replacement of a PAP device after five years of use. However, if your condition has changed, resulting in a need for a different pressure or features that your current machine does not have, your health insurance carrier will often upgrade the equipment at an earlier date. The insurance company may require a “letter of medical necessity” that a new device is required. Contact your HME and your physician about a letter of medical necessity. My HME provider put me on an autotitrating device for a short time to help determine the optimum CPAP pressure I should receive. I really liked the autoPAP. It was more comfortable than the CPAP device the HME set me up on. How can I convince my physician and insurance payor to allow the HME to give me the autoPAP back? Due to the additional features of APAP devices, they are more expensive. Some payors will allow the patient to pay the difference between the CPAP and the APAP device. In some cases the insurance company can
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