About a year ago, I broke an incisor. It went downhill and eventually I broke down and went to the dentist. Upshot: an implant, a root canal and several fillings (OK-It HAD been a while!). While undergoing the bone graft in preparation for the implant (Cadaver bone==idea for a zombie story in that!), the dentist noticed I stopped breathing twice. So, he set me up for an in-home sleep test for sleep apnea. Results came back that I had severe apnea. So he made me an appointment for a consult.

Go in for the consult. Everything goes well=they have a copy of my test, my knowledge of biology helps the conversation along, etc. Sends a prescription for the C-PAP machine to the supply company. End of story (?).

Get a call several days later from some (presumably blonde) person at the supply co. Seems Medicare won't honor the prescription because I didn't have a (1) consultation, (2) sleep test and (3) another consultation==IN THAT ORDER! The Dentist observed my apnea, gave me the test and then I had a consult (out of order, according to Medicare). So I can either pay Medicare's share (Blue Cross is my primary care) or start the whole thing over. So today I get to take time off from work, go to the Dr and get told what I already know. Then take another sleep test (Tying up a machine and staff to tell me what we already know) and then another consult to tell me the results that I already know!

BTW: I was tested several years ago and was found to be "marginal" at that time!

You have it far better than anyone who has to buy their own insurance.

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Common sense isn't so common.

Mrs. PatriotX had to do the sleep study, or it would have been $2300 out-of-pocket. That was with expensive private insurance.

Fortunately, when the insurance-paid machine gave up the ghost, I found a company to provide a replacement for a nominal co-pay.


I hope you find the sort of relief she did from using the CPAP machine. Good luck with all of the annoying hoop-jumping, too.

I will go on Medicare next month. Around four years ago I was diagnosed with severe sleep apnea. I had not come anywhere near my deductible that year, and the prescribed CPAP machine cost me around $1500.00. I found out yesterday that the local medical supply company that sold me the CPAP and from whom I get my replacements masks, etc., did not get the medicare bid for next year (competitive bidding). They told me I would have to get a new prescription (i.e., see the sleep doc) every year for whatever medicare provider I use. The original sleep doc who diagnosed the sleep apnea and prescribed the CPAP machine has retired. The clinic is still in business, and should have my records. I just hope I am not required to go through another sleep study in order to get supplies or a new CPAP machine when needed. The CPAP machine has greatly improved the quality of my sleep.

Most people have a funny uncle, I'm pretty Uncle Sam is one of them.

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Back to back World War Champs.

The new sleep studies are done at home (unless they need to titrate or adjust the pressure). I did the old style (sleep at the lab) a few years ago. Now you take the machine home for the test.

I have come to believe that to work for the Government You have to be a complete Moron that is unable to make a decision if it is not spelled out in black and white and sitting in front of Them.
You would not believe what I have had to go through with the Ohio Workers Comp.System.or Social Security.

Do not confuse insurance with health care. Insurance is a contract the describes and mandates actions that the insurance company will pay for. The rules are described in the policy, the payments are described in the policy. Some things are not covered.
You have to see the doctor periodically to get the prescription renewed for the parts.

I'm still shaking my head at getting medical advice for a potentially life-threatening condition from a dentist . . .

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Wisdom comes thru fear . . .

Medicare calls the shots. You either play by their rules or don't play.

The term, “Uncle Sam” has a very misleading connotation of benevolence and good will intended towards you, like some caring uncle might have. So I find it appallingly difficult to refer to the great beast that resides in Washington DC as “Uncle Sam.” Yosemity Sam with both barrels roaring is more like it.

Might want to READ my post, DOCTOR (You ARE a doctor, correct? Otherwise who are you to criticize!) I was there for a surgical procedure; he noted I stopped breathing twice during the procedure; he ordered me a sleep test which was interpreted by a sleep specialist. No where did I ask for or get advice, other than I should see a sleep specialist based on the tests.

Not a criticism unless you're sensitive about reading a statement you don't like. I didn't name call or yell. I just described my thoughts. If your primary care physician ordered a root canal for an abscessed tooth, wouldn't you actually see the dentist first before just walking in and asking for a root canal? What if there's something else medically going on besides apnea?

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Wisdom comes thru fear . . .

Snippy, aren't we?
Lighten up- we didn't do it.



I'm confused on how the poor (presumably blonde) person at the supply company is the villain when Medicare fumbles.....
Maybe I lack understanding.

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Regards,
Lee Jarrett