Sunday, August 27, 2017

Medicare Won't Pay for CPAP

It doesn't matter if you have used a CPAP for sleep apnea for years. Unless you can convince Medicare you need the machine, they won't pay for your CPAP.

Your doctor says you need a CPAP.

The AASM (American Academy of Sleep Medicine) says you have OSA (Obstructive Sleep Apnea).

But until Medicare says you need a CPAP, they won't pay for it.

Until 2013, getting Medicare Part B to cover the cost of a CPAP was not a problem. But in 2009 the Obama administration ordered the IAG to review claim payments by Medicare to determine ways to eliminate waste, fraud and abuse.

The IAG study, released in June of 2013, said the following.

"beneficiaries receiving CPAP treatment may have received more supplies than were medically necessary"

Emphasis added.

The report further stated,

Even though the report showed that the number of supplies did not exceed the recommended replacement schedule it also stated that if someone DID receive more supplies than necessary that would be wasteful spending.

Let that sink in for a moment.

Medicare is always looking for ways to save money. Problem is, their way is to shift more of the cost of care to folks who can least afford to pay.

Most Medicare beneficiaries have pre-paid for their benefits over many year via FICA payroll taxes. Now that we have reached the age where we have earned a right to collect, DC is finding ways to deny us access to Medicare benefits.

For more information on the challenges of getting Medicare to cover the cost of your care, read Does Medicare Pay for CPAP?

#CPAP #Medicare #Apnea #OSA

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