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Re: Substitute cpap for auto cpap?

Posted by Kahalu'u Bob on April 25, 2003 at 15:47:30:

In Reply to: Substitute cpap for auto cpap? posted by Slim Appelbaum on April 24, 2003 at 23:03:45:

I'm not sure I understand the situtation, because I'm not sure why she is "elegible" for a cpap without charge. Assuming that it is because you have insurance coverage of some sort, I would fight for an autocpap if that is her doctor's prescription. The decision regarding appropriate treatment should be between your wife and your doctor.

As D.H. and I have discussed at some length below, I recognize that insurance companies can be arbitrary in some of their decisions and procedures. But I am not sure they can arbitrarily refuse to provide equipment that has been prescribed, if it is otherwise within the scope of their coverage obligation.

The problem I see more often on this forum is that doctors are relucant to prescribe an autocpap. If her doctor thinks it is necessary and appropriate, I would suggest pushing the insurance company to cover it. If you are unsuccessful with the insurance company's internal appeal procedures, your state insurance commissioner's office may have an expedited appeal process. You might call their offices and inquire.

If her eligibility for a free cpap has nothing to do with insurance, please forgive me for rambling on!

Good luck!

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