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Cluster Headache Help and Support >> Medications, Treatments, Therapies >> How do you get your O2...
(Message started by: Gator on Mar 26th, 2008, 12:37pm)

Title: How do you get your O2...
Post by Gator on Mar 26th, 2008, 12:37pm
paid for by insurance?

Does your insurance company work with your provider?

Do you pay up front and then submit a claim?

If you do submit a claim, do you have to file a claim for the rental of oxygen cylinders and then a separate claim for the refill of cylinders?


Title: Re: How do you get your O2...
Post by Ray on Mar 26th, 2008, 12:43pm

on 03/26/08 at 12:37:23, Gator wrote:
paid for by insurance?

Does your insurance company work with your provider?

Do you pay up front and then submit a claim?

If you do submit a claim, do you have to file a claim for the rental of oxygen cylinders and then a separate claim for the refill of cylinders?


My insurance needed to pre-approve the oxygen use, but they [eventually] did.

My insurance receives an invoice from the provider and pays them directly, although I will probably have to go through the pre-approval and a new prescription for it annually.

Ray

Title: Re: How do you get your O2...
Post by brewcrew on Mar 26th, 2008, 12:55pm
My PCP sent a prescription to Apria for O2, 15lpm through a non-rebreather mask as needed for cluster headaches back in 1996. Since that time all I've ever had to do is call Apria and tell them how many and what size and they deliver it, no questions asked. Durable medical goods (which includes O2) is covered 100% by my insurance. I have never paid a penny for O2 (except monthly premiums, of course).

I am one of the fortunate ones.

Title: Re: How do you get your O2...
Post by Guiseppi on Mar 26th, 2008, 1:12pm
Amazingly enough, since I am with kaiser, they pay for it. I have my own demand regulator, although they originally delivered me one with my outfit. I also use Apria. Once a year my neuro has to renew the prescription, I keep 4-8 bottles on hand on or off cycle. I call everytime I'm up to 3 empties, they pick up the empties, drop off fulls.

Guiseppi

Title: Re: How do you get your O2...
Post by E-Double on Mar 26th, 2008, 1:42pm
from plants  :D

Title: Re: How do you get your O2...
Post by Karla on Mar 26th, 2008, 1:42pm
While I was on O2.  My HMO approved it no problem.  They supplier submited claims to the HMO and I never saw a bill.  It was so nice.

Title: Re: How do you get your O2...
Post by DennisM1045 on Mar 26th, 2008, 3:54pm
My supplier just needed a script.  It took a bit of work to get the right mask and regulator.  

They bill direct to my insurance Blue Cross Blue Shield.

-Dennis-

Title: Re: How do you get your O2...
Post by vietvet2tours on Mar 26th, 2008, 4:06pm
Welders Supply

Title: Re: How do you get your O2...
Post by midwestbeth on Mar 26th, 2008, 4:07pm
My insurance does cover a portion of 02 cost, but it was a pita.  Now I get welders 02 and pay the same cost that my insurance was charging me, only I do not have to call, order, wait for delivery, ect......

Beth

Title: Re: How do you get your O2...
Post by brewcrew on Mar 26th, 2008, 4:07pm

on 03/26/08 at 13:42:02, E-Double wrote:
from plants  :D

http://www.netzeitung.de/img/0088/166288.jpg

Title: Re: How do you get your O2...
Post by Linda_Howell on Mar 26th, 2008, 5:12pm


You wouldn't be SMOKING any of those plants now would you, Eric?

Back to Mike's question.

  It was costing me a LOT more per tank to have the Ins, co. in on it, so I made a deal with my supplier (Apria) to leave them out of it entirely and I would pay cash.

 I pay 10 per e-tank and I bring it to the supplier for swapping out the tanks  instead of having them deliver it.

Linda

Title: Re: How do you get your O2...
Post by superhawk2300 on Mar 26th, 2008, 6:59pm
What Bill said - Aprila. Except that while I do not pay for the 02 itself i pay monthy to rent the regulator. Kinda sneaky. Perhaps I'd be better off buying one but it isn't a lot I guess - 17 bucks or something.

Title: Re: How do you get your O2...
Post by jon019 on Mar 26th, 2008, 9:45pm

on 03/26/08 at 17:12:07, Linda_Howell wrote:
Back to Mike's question.

  It was costing me a LOT more per tank to have the Ins, co. in on it, so I made a deal with my supplier (Apria) to leave them out of it entirely and I would pay cash.

 I pay 10 per e-tank and I bring it to the supplier for swapping out the tanks  instead of having them deliver it.

Linda


Yup, sounds like me. For years I did same (and paid same amount and did my own refill runs). Then insurance FINALLY ok'ed and I switched. Been a year now, and it looks like I should opt out of that scam. They cover 60% of "reasonable" charges. Turns out it would be cheaper to just go it alone.

BTW, I use Lincare and the folks at the O2 shop I use are golden (well, except for the mgr, who raised my cash rate to $14 and insisted I use insurance). May switch to Apria.

Regards,

Jon

Title: Re: How do you get your O2...
Post by KatzPurr on Mar 26th, 2008, 11:16pm
I went to my neuro on Tues. He gave me a script and I brought it to a local medical supply store. They were not able to take my insurance (Aetna), but were so helpful because they faxed the paperwork to another supplier and I was approved. I'm supposed to have my O2 delivered tomorrow. I sure hope that it works.

Title: Re: How do you get your O2...
Post by Gator on Mar 27th, 2008, 11:59pm

on 03/26/08 at 17:12:07, Linda_Howell wrote:
You wouldn't be SMOKING any of those plants now would you, Eric?

Back to Mike's question.

  It was costing me a LOT more per tank to have the Ins, co. in on it, so I made a deal with my supplier (Apria) to leave them out of it entirely and I would pay cash.

 I pay 10 per e-tank and I bring it to the supplier for swapping out the tanks  instead of having them deliver it.

Linda


When your insurance was "paying" did you submit a claim for every tank (or group of tanks you received) or one claim a month for all tanks or did the supplier bill you monthly for what insurance wouldn't pay?  How did that work?



Edited to add:  I do use oxygen, but I go the welder's O2 route.  Not having insurance, it's a lot cheaper than going through a medical supplier and it's actually even cheaper than what I would have paid through my last insurance company.

Title: Re: How do you get your O2...
Post by slacker032 on Mar 28th, 2008, 12:46am

on 03/26/08 at 17:12:07, Linda_Howell wrote:
It was costing me a LOT more per tank to have the Ins, co. in on it, so I made a deal with my supplier (Apria) to leave them out of it entirely and I would pay cash.

 I pay 10 per e-tank and I bring it to the supplier for swapping out the tanks  instead of having them deliver it.

Linda




I do the same except I'm paying Lincare $15 per tank.  Maybe I should give Apria a call.

Title: Re: How do you get your O2...
Post by Kitty1973 on Mar 28th, 2008, 2:27am
In my area we only have Lincare.  I pay $15 per tank.  I have no insurance, soooooooo.  

I just got my first tank today!!  The only problem is that the tank will only go to 8lpm.  That is what the Dr. prescribed.   I now have to wait until Monday to call the Dr. and tell her that I needed 12-15 Lpm.  

I did use it once today, at the 8 Lpm.  It helped alot, but I had to stay on it for 25 minutes before I felt any relief.  I quit after 30 minutes.  The attack wasn't completely gone, but it wasn't a KIP 10 anymore.  I would say it knocked it down to a KIP 5.  It eventually left, after 30 minutes of pacing.

Kitty

Title: Re: How do you get your O2...
Post by BMoneeTheMoneeMan on Mar 28th, 2008, 2:59am
I have several regulators and I use E tanks and M tanks.  It is a flat rate per month for unlimited use of O2.  The DME company wants to charge $80-something per month, but the insurance will only pay $30, so thats what they charge.  Of the $30 monthly cost, my co-pay was $6.  Now that I dropped my insurance, I have to pay the full $30 per month......thats worked out to about $1 a tank this month.




Title: Re: How do you get your O2...
Post by Linda_Howell on Mar 28th, 2008, 12:00pm

 
Quote:
When your insurance was "paying" did you submit a claim for every tank (or group of tanks you received) or one claim a month for all tanks or did the supplier bill you monthly for what insurance wouldn't pay?  How did that work?


A claim was submitted for every group of tanks I recieved.   They charged my Ins. Co. 42.00  PER TANK.  Ins. would only pay 10.00 and I was stuck with 32.00

That is why I decided to leave Ins. out of it.  I also had to sit down with the manager, bat my eyelashes, tell them my tale of woe and we then came up with the deal I have now of 10 per e-tank-cash.

Title: Re: How do you get your O2...
Post by jon019 on Mar 28th, 2008, 8:09pm

on 03/28/08 at 12:00:53, Linda_Howell wrote:
 

A claim was submitted for every group of tanks I recieved.   They charged my Ins. Co. 42.00  PER TANK.  Ins. would only pay 10.00 and I was stuck with 32.00

That is why I decided to leave Ins. out of it.  I also had to sit down with the manager, bat my eyelashes, tell them my tale of woe and we then came up with the deal I have now of 10 per e-tank-cash.


Gator, THANKS for this thread. I may need to be proactive before I get screwed.

Linda,

Something strange going on here and I am starting to get worried and/or pissed.

For years I did the same $10/tank cash deal. Submitted claims (myself) to insurance which (gleefully it seemed) DENIED each and every one. Got nothing but circular arguments from them, but at least got the satisfaction of making them do the paperwork. Then something changed (no idea what) and they said they required a letter from my doctor to cover O2 (for THIS condition as they put it).

My neuro at the time was great and was delighted to write such (even did it in front of me). Seems the key phrase, that finally got me coverage was "INTRACTABLE headaches".

Coincidentaly, my not so friendly neighborhood Lincare O2 shop mgr had raised my cash rate to $14.50 (and was a little nasty about it (???)). That's what they billed to insurance UNTIL recently. NOW they bill $43.50 ea and I have yet to see the first insurance statement post that (there's the worry). AND, Lincare required I fill out ANOTHER insurance billing permission form. I read it but now I'm gonna reread it more carefully.

I did talk to the Lincare billing dept and got a convoluted and confusing "don't worry about it"
explaination. Why would two completely separate O2 companies, nearly simultaneously raise their billing rate to a RIDICULOUS and nearly identical level? What's going on? I'm ALMOST feeling some sympathy for the insurance co.

I may need your eyelashes, as mine definitely won't cut it with this yutz.

Regards

Jon

Title: Re: How do you get your O2...
Post by Gator on Mar 28th, 2008, 10:51pm

on 03/28/08 at 12:00:53, Linda_Howell wrote:
A claim was submitted for every group of tanks I recieved.   They charged my Ins. Co. 42.00  PER TANK.  Ins. would only pay 10.00 and I was stuck with 32.00

That is why I decided to leave Ins. out of it.  I also had to sit down with the manager, bat my eyelashes, tell them my tale of woe and we then came up with the deal I have now of 10 per e-tank-cash.



$42 per E tank?!?  Sheesh!  No way in hell I could have afforded the $32 insurance didn't pay for.  

When I had Community Care Insurance, I paid nothing for my O2.  The local medical supplier came to the house and swapped out as many tanks as I needed.  I usually kept a huge K tank for the house and 3 E-tanks for traveling about. When I got fired, because of clusters, I went under my wife's insurance - Aetna.  The closest supplier I could use was 45 miles away and then I would have had to pay a per tank co-pay of like $17.50 or something like that.  That's when I said screw it and went to a local steel supply house and leased a K tank for a little over $50 per year and $22.50 refills.

Title: Re: How do you get your O2...
Post by Kitty1973 on Mar 29th, 2008, 10:11am
This may not be the case for everyone, but the Lincare that I go through told me that they have assistance programs to help those who are uninsured/under-insured pay for their O2.  Right now I have to pay $15.00 cash per E tank because my paperwork isn't processed yet.  They told me it would take about 2 weeks to get it processed.  

I had to ask them about assistance programs, they didn't volunteer the info, but they were very nice to me about it.  They were pretty helpful to me 2.  

I don't know what price I will have to pay yet, that will not be determined til after the paperwork is processed.  They did tell me that many people get it totally free though.  I kinda think I will too, because there are 2 adults and 2 children in my home, and we get a monthly income of about  $1000.00.  Our countable bills include a $300.00 mortgage payment and a $100.00 car payment, along with utilities and food expenses.  

I hope this helps someone.

Kitty

Title: Re: How do you get your O2...
Post by CostaRicaKris on Mar 29th, 2008, 5:18pm
I have Kaiser and Apria trades out my empties for full tanks whenever I need them. I pay $6.08 a month no matter how many tanks I use. I'm currently looking at switching jobs, so I guess I'll have to keep this in mind. I sure can't afford $32 per tank, not with my southern California mortgage.

Title: Re: How do you get your O2...
Post by Linda_Howell on Mar 30th, 2008, 1:37pm


Quote:
I may need your eyelashes, as mine definitely won't cut it with this yutz.


Try Walgreens Jon.  They sell them there.

Seriously, I don't blame you one little bit for being pi$$ed.  I have Apria now but for years it was Lincare who made that deal for 10.00 per e-tank with me.  Then 2 years ago...a new yahoo took over the mangr. position and I go waltzing in to swap out my tanks as usual, and get this "sorry, as of the first of the year our policy has changed and cash pays will now be 23.00"   I told him where to stick his new policy.

I immediately went over to Apria..told them everything and they made me the same deal I'd been having before with Lincare.  

Linda

Title: Re: How do you get your O2...
Post by Racer1_NC on Mar 30th, 2008, 1:46pm

on 03/26/08 at 12:37:23, Gator wrote:
paid for by insurance?

Yes.


Quote:
Does your insurance company work with your provider?

Provider files with insurance, I get a bill for the balance.




Title: Re: How do you get your O2...
Post by puppylove41 on Mar 30th, 2008, 3:43pm
My hubby started going to a VA specialist in Delaware and he ordered the O2 for him he has a H tank and 6 e tanks and also one that plugs in and makes its own O2 but that one only goes to 10 so if he needs more he puts on the H tank and we pays nothing. He is 10% disable from Navy and we never used thier doctors till his boss let him go b/c of the headaches and no job no insurance so I guess it all worked out we found a better doctor for him.

Title: Re: How do you get your O2...
Post by danm on Apr 15th, 2008, 9:47am
www.apria.com

Insurance needed approval from my neuro and now I get them delivered and have never seen a bill.  Apria in my area, northern NJ, is great.  Call and order and they deliver it within 1-2 days.

Title: Re: How do you get your O2...
Post by Melissa on Apr 15th, 2008, 10:38am
It's RX'd by my GP and then Walgreens bills my insurance and we pay the out of pocket 20% that Humana does not cover.

We never pay any money up front.

Oh, and I usually request 3 tanks and a regulator (I have the mask).  They do offer home delivery as an option, but I find that I am uncomfortable waiting on someone else to bring me my O2, so I usually drop off and pick-up myself.

Title: Re: How do you get your O2...
Post by purpleydog on Apr 15th, 2008, 6:02pm

on 03/26/08 at 18:59:40, superhawk2300 wrote:
What Bill said - Aprila. Except that while I do not pay for the 02 itself i pay monthy to rent the regulator. Kinda sneaky. Perhaps I'd be better off buying one but it isn't a lot I guess - 17 bucks or something.


You CAN get a regulator cheaper by buying it. At $17.00 per month rental, that's $84.00 per year. What size tanks do you use? I picked up a couple off ebay a couple years ago, to fit an M or H tank. They are both being used, but I paid $25.00 each for them. Let me know what size tanks you have, I'll do a little research for you.

We have O2 delivered by a local home health care company, don't know the name, but it's not Apria. We have two O2 generators, when used together, they put out about 18 LPM. We also have an M tank, and keep 4 full E tanks at all times for traveling. Courtesy of the VA. They even supplied a high flow rate regulator, and repaired one of our own regs, at no charge. They come by every other Monday, unless we are running low and call them. They regularly give us non-rebreather masks, and the mask part is softer plastic, it conforms to your face easier, and is gentler on the edges.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               

Title: Re: How do you get your O2...
Post by brewcrew on Apr 15th, 2008, 10:08pm

on 04/15/08 at 18:02:05, purpleydog wrote:
You CAN get a regulator cheaper by buying it. At $17.00 per month rental, that's $84.00 per year.

It's even worse than that. It's $204 per year.

Title: Re: How do you get your O2...
Post by purpleydog on Apr 15th, 2008, 10:23pm

on 04/15/08 at 22:08:26, brewcrew wrote:
It's even worse than that. It's $204 per year.


::) Um, thanks. My math skills are pretty much non-existent today.   [smiley=ops.gif]

Title: Re: How do you get your O2...
Post by brewcrew on Apr 15th, 2008, 10:26pm

on 04/15/08 at 22:23:09, purpleydog wrote:
::) Um, thanks. My math skills are pretty much non-existent today.   [smiley=ops.gif]

My only point was that it's less of bargain than originally thought - not to criticize your math skills, Chris. That would be like the pot calling the kettle black. And I do it for a living! ;;D

Title: Re: How do you get your O2...
Post by CostaRicaKris on Apr 15th, 2008, 10:56pm

on 04/15/08 at 22:26:59, brewcrew wrote:
That would be like the pot calling the kettle black. And I do it for a living! ;;D


Is there money in that? What are the hours?

Title: Re: How do you get your O2...
Post by brewcrew on Apr 15th, 2008, 11:02pm
24/7/365, sister.

Title: Re: How do you get your O2...
Post by purpleydog on Apr 15th, 2008, 11:05pm

on 04/15/08 at 22:26:59, brewcrew wrote:
My only point was that it's less of bargain than originally thought - not to criticize your math skills, Chris. That would be like the pot calling the kettle black. And I do it for a living! ;;D


I know, Bill, no worries. It's true, I had no math skills at work today, and it took me 15 minutes to convert  the price on a 20' long piece of steel tubing into the price per inch. Than I had to ask someone to check it for me. Just one of those days LOL. :o

And I do it for a living too!!   ;;D

CRKris, lot's of positions open for calling the kettle black, however, there's no money in it, unless you are a politician. ;)

Title: Re: How do you get your O2...
Post by CostaRicaKris on Apr 16th, 2008, 1:06am

on 04/15/08 at 23:02:30, brewcrew wrote:
24/7/365, sister.


Ha! You da man Brew

Title: Re: How do you get your O2...
Post by CostaRicaKris on Apr 16th, 2008, 1:08am

on 04/15/08 at 23:05:12, purpleydog wrote:
CRKris, lot's of positions open for calling the kettle black, however, there's no money in it, unless you are a politician. ;)


No thank you. I don't want in that business. :-X

Title: Re: How do you get your O2...
Post by bnewman on Apr 23rd, 2008, 11:09pm
This might sound crazy but  I go to the local hardware store and rent a big tank for 45.00 per year and swap it when it runs low. We use to have a home oxygen business and they say it's not and diffrence in between medical oxygen and regular oxygen.In fact I have taken the tanks to be filled and they come out of the same big tank.. So for anyone who does not have insurance there is a cheap out.. You can talk to a medical supply company about buying a regulator or ask at the local hospital if they have any old ones laying around.. I took 2 broke one and made 1 good one... Where theres a will theres a way... ;)



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