CPAP Machine Needed at Night, but I Need to Claim Insurance for This

  • A letter from your respiratory physician confirming a sleep study has been undertaken and a CPAP is required.

  • A letter from a sleep consultant to the manufacturing company stating the need for a CPAP device.

  • A copy of your sleep study confirming the need for a CPAP device.

Bupa said I need one of those three, which one is easier to get?

and please tell me where I can get them if possible.

Lives in Sydney, ashfield 2131

Comments

  • +3

    how do you know you need a CPAP machine? did you get a sleep study done?

    • I have very bad snoring, I have a very low blood oxygen level when I wake up.

      • +10

        While these can certainly be indicators, they cannot make a formal diagnosis of sleep apnea and certainly not enough to support an insurance claim.

        I dislike how sleep apnea is defined but it has a strict definition/measurement (ahi, events per hour, etc). Snoring and low oxygen level measurements are just possible symptoms - you could have other conditions which cause the same symptoms (e.g., nasal obstruction).

        In short, get a sleep study done to get a formal diagnosis. You will get much better support from the medical system that way. CPAP is the gold standard but not everyone can handle it.

        Good luck with everything.

  • +8
    • Go to your closest GP now and get a referral for sleep studies.
    • Call RPA (Closest to ashfield that can do) to book your schedule.
    • Wait for the result and send to BUPA.
  • Middle one will be the easiest, as it doesn't require a sleep study - it seems to imply the agent trying to sell the machines can write you a letter (? "Dear Bupa I would like to get my commission, xoxo").

    Contact a CPAP seller and tell them what BUPA told you - they've probably done it before and can guide you further.

    • +1

      It says FROM the sleep consultant TO the manufacturer.

      • +1

        Aha, well spotted. Sleep studies it is!

        • so what can I DO?

          • +1

            @Kawaii: …get a sleep study?

            You might want to talk to BUPA about how much you're going to get back on that CPAP unit, btw - you might be pretty disappointed.

            • @GrueHunter: They say 85% of the cost.

              which is $1415

              I can get $1000 back

  • +2

    They're all basically the same thing, you need a sleep study done and someone to recommend you go on CPAP.

    • where to do it? is it complex?

      • +2

        Google for "respiratory clinics near me" or "sleep clinics near me". Or better yet, go ask your GP, they need to write the referral and will have a list of places you can do it.

        It's easy to get done, you get a referral from your GP, book an evening at the clinic, go in after dinner, they wire you up and you go to sleep. They boot you out at about 5am and you go home. Some places can be done from home but I'd do it in a clinic, the wires can come off over night and they'll just fix it for you there.

        For me I asked to go on a waitlist for cancellations and got in within about a week. It took a month to see the specialist to get the recommendation though. Then I went to CPAP Victoria, rented a machine that automatically adjusts the pressure to get a good measurement then bought a fixed pressure one about a month later (it was much cheaper. Also I found the automatic one kept adjusting too high and waking me up).

        There's also other causes of snoring beyond sleep apnea so a test is a really good idea. Diagnosing yourself is always a bad idea, plus you need the help knowing how bad your sleep apnea is (you might not need to go the CPAP route) and help setting up and wearing the headgear. If you walk into a CPAP store they won't sell to you without a referral anyway.

  • +4

    A letter from a sleep consultant to the manufacturing company stating the need for a CPAP device.

    Most likely this will require a sleep study. You can't really diagnose sleep apnoea without one. My partner indicated i stopped breathing at night and would gasp for air.
    Still got a sleep study done. Turned out i only had mild sleep apnoea, 1 visit to the ENT later and day surgery and i sleep far better than before (without the need for a CPAP).

    Personally, go to your GP, they'll refer you to get a sleep study done, then assess the results and go from there.
    You might be better off with surgery, never know.

    • im kinda fat

      • +2

        If you can, try to fit exercise and dieting in your regime, much better to treat the cause than the symptom.
        You really don't want to be on cpap unless you need to.
        Even though it helps your breathing, the pressures can also be harmful to the alveoli, and can get conditions such as barotrauma. Obviously there is a need for it, but yours might be curable if you try and lose the weight.

        • Completely agree
          If it is weight induced then I'd strongly suggest going down the weightloss path
          Chances are your oxygen levels are already low and reducing the burden on the body would probably be the priority

          Else if you're really desperate to get one without a prescription you could always to go gumtree/marketplace.
          They're a fair few on there.

  • +2

    Start with your GP…. /end

    • -2

      Did not visit GP b4, i got no GP

      • +3

        Then get one?

        Go to your local GP office and see if they're accepting new patients.

        • thanks

      • maybe wented and gotted yaself one

  • Figured out what to do, thankks guys !

  • You need to get the sleep study done as it will give you the settings for a CPAP machine. Unless you want to shell out extra for an APAP machine. But the sleep study is crucial.

    I got it done and it turned out I had severe sleep apnea. Good times. Ironically now if I don't get a good 7-8 hours sleep with the machine, I'm MORE tired now than before the machine. Guess I got used to no sleep over the years. Also my blood pressure dropped within a few days of starting CPAP, which meant my blood pressure medication was rolled back.

  • Your first step should be to get a diagnosis as to why you snore, for example it my be a deviated septum in which case a CPAP is likely a waste of money.
    Go and see an ENT specialist.
    For my part, I also used to snore quite heavily and suffered low blood oxygen due to a deviated sepum. Purchased a simple pair of nasal dilators for about $5.00 on Aliexpress. Stick them in at bedtime and no further issues.

  • +1

    Looks like some people here have done sleep study.
    Curious, what was the trigger that made you do it?

    • Snore like a freight train, father and brother both have sleep apnea, high blood pressure.

      • I snore every now and then (apparently!) , so I wonder if I need to do it..
        How does it improve your sleep afterwards?
        How much does it cost you out of pocket?

        Thanks

        • +1

          Light snoring might not be a sign of sleep apnea. Mine was heavy snoring, with periods of stop breathing and then gasping.

          Ironically I can get more tired now if I don't get my sleep, my body was just used to shit sleep before the CPAP, now it demands sleep, LOL.

          Costs were GP visit (my GP doesn't bulk bill), at home test was free, then had to do a lab one because I knocked some of the at home machine sensors off, but that was also free. Then had to do another in lab sleep test to find the machine settings, also free.

          I bought the more expensive Resmed Autoset machine, which was $1545 with mask. Then got $1000 back from PHI.

          My sleep apnea is severe, and if I didn't sort it out, I am at risk of other problems. But I am also overweight and I'm working on it.

          My sleep study found I was averaging 31.6 events an hour, my lowest blood oxygen was 84%, and I was getting periods of stop breathing in excess of a minute. Good times.

  • Use the find feature on this company and you can do a Sleep Study at your home, instead of a private hospital, and you might even get bulk billed.

    https://www.sleepservices.com.au/locations/

  • The vast majority of private health insurance policies exclude CPAP machines. Check your exclusions.

  • There is a Private Sleep Clinic in Ashfield which I have attended.
    I have also done several sleep studies at the WoolcottI Institute in Glebe. Leading Slerp Study Centre in Australia. Very nice place, parking, fab staff and lovely ensuite hotel type rooms. The Clinic also provide respiratory, dental, cardio etc specialists.
    I think this might be the one for you, and only 5 km from home.
    Good luck!!

    • Thanks for the advice

  • If you do get one, and anyone else that has one, make sure you cont your electricity supplier and advise them you use a life saving device.
    If anyone is on a pension, you can claim a electricity rebate from Centerlink $164.00 this year.

    • I’m not on a pension.

  • Shouldn't you be asking your health provider, and if you know so much about them, shouldn't you at least know where to obtain?

  • There are sleep studies offered that are in home and bulk billed. They are then assessed and you get a written report and the prescribed treatment (including settings). Note, no dealer is going to sell a device without this prescription either.

    Your only problem is BUPA tends to have preferred practitioners. Whether this applies or not for sleep studies, you would need to ask.

  • I got referred by my doctor to Western Sydney Respiratory Institute (since i'm at Blacktown)

    Waited 2/3 weeks for an appointment there, and he then arranged an in home sleep study.

    Dude then came round to my house a week later, and strapped me up like the 6 billion dollar man, and monitored all my shit overnight.

    Went back today to get the results - i stop breathing 91times an hour (apparently 30 or more is serious) - so now I am also in the market for one of these CPAP machines.

    I don't however have private health, so i'll end up forking out for one myself.

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