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I was diagnosed with obstructive sleep apnea quite a few years ago. I was told that i do not get any deep sleep therefore my body never recoups (so to say) or reenergizes. My insurance company at the time denied my getting a CPAP. I was also referred to an ENT to get my uvula trimmed. Since all of that I have had ear issues & found out I had 2 uvulas & that problem has been taken care of . I am still tired all the time. I figure i still have apnea. what can i do?
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Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Trimming your uvula does not treat obstructive sleep apnea. It's odd that you're insurance company denied CPAP when you had obstructive sleep apnea based on a sleep study. Was your AHI over 5? If so, if you have excessive daytime sleepiness, then you meet the coverage criteria set by Medicare (and what insurance companies also usually follow). You should follow-up with your sleep doctor and re-evaluate your condition. Maybe get another study to see if you still have sleep apnea.
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Permalink Reply by Barbara on
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Like i said it was quite a few years ago. I since have moved & am now living in the poconos in Pa. I even wrote the insurance company a nasty letter at the time - of course with no response. I can't even get the results because it was so long ago.
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I did have a 2 night sleep study done in the mid to late 90s '- the first night i just slept. the 2nd night they had me sleep with a CPCP on. it was the best night's sleep I had had in a long time! i don't know what the issue was with the insurance company at the time. they said it was not medically necessary. My husband & i are self employed & don't have the greatest health insurance ... not sure if it would be covered or not.
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Yep. I do. Have a new sleep study. And assuming it again diagnoses OSA, have the sleep doctor write the script and get a copy of the doctor's dictated results AND the full scored data summary report w/condensed graphs from BOTH studies. Keep them safe for your records. Take copies to local DME suppliers, explain you have no insurance coverage and discuss what equipment they will provide AND AT WHAT COST. Some will sell at "insurance" rates, others will insist on charging full "billable" amounts. Then go online and check prices for the equipment you need and want. If you have good luck w/the mask from your titration study that would be the first mask I'd buy.
Since you will be new to all this, if you can't find a local DME supplier willing to provide you w/a CPAP at a reasonable price you can afford, buy the CPAP you want from an online DME supplier, including the integrated humidifier, but not the mask. Pay the higher price at the local DME supplier who offers you the most lenient mask exchange policy. Once you know your needed pressure setting THE RIGHT MASK becomes THEY KEY to successful CPAP therapy. And finding the right mask isn't always easy! Some have gone thru as many as a dozen masks before they found a comfortable, relatively leak free mask that works for them. Once you find THE right mask for you, then if you want to save money and the local suppliers won't work w/you on price, buy the mask that you know works for you online as well. It is too expensive buying masks online until you know which mask works for you as they are non-returnable via online suppliers.
Understand one thing about shopping for CPAP equipment online: Resmed, Respironics and Fisher & Paykel instituted MAP (minimum advertised pricing) policies against the online DME suppliers. So the price you see advertised for the xPAPs are NOT necessarily the price you would be charged. Usually you must either call the online supplier's toll-free number, or check out a "code" or add the item to your shopping cart (doesn't commit you to the purchase at that time) to find what your true charge for that device might be. I don't believe they are utilizing MAP for masks, etc. just the xPAPs and integrated humidifiers.
If prices are still too high for you you could try cpapauction.com for a lightly used xPAP and get some really great buys. But be sure you know your "prices" before you shop any auction.
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Permalink Reply by sleepycarol on
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Until 2007 our insurance did not cover sleep studies or treatment of such. When I had told my doctor that I probably needed a sleep study she said contact the insurance company to see if their policy had changed. It was and so the rest is history.
So it could have been possible that 10 years ago -- insurance did cover the study for you but possibly not the treatment of sleep apnea IF you didn't have it severe enough or other comorbid issues as well.
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