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findjoshua
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Question about Oxygen and Insurance
« on: Nov 30th, 2005, 8:07pm »
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HaPPily my doctor has prescribed O2 for me FINALLY!  Also I got verapamil.  My question though is about insurance and O2.  In ppl's experience here, did their insurance cover the oxygen?  I stopped in a place on the way home and they told me a tank was $350.  Now, my insurance is Cigna, and they're closed until tomorrow for questions, so the impatient side of me is wanting to know if anyone has any experience with being reimbursed for this or if $350 is RIDICULOUS or par for the course.
.
This site has been a lifesaver after too long of doing the cluster thing alone.  
.
Thanks to all who reply and even those who just read Smiley
 
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Re: Question about Oxygen and Insurance
« Reply #1 on: Nov 30th, 2005, 8:16pm »
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Congrats, Joshua. O2 is great for us.
 
I have Aetna open access HMO. I pay $5 copay to take up to 5 E tanks home, with a non-rebreather mask and one regulator, and one cart with wheels for the tank. Then I pay $5 copay every time I refill the tanks. If I refill one or 5 tanks, it's always $5 bucks.
 
I got it easy. I've read many posts here where people complain about insurance and O2.
 
keep us posted!
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Re: Question about Oxygen and Insurance
« Reply #2 on: Dec 1st, 2005, 12:41am »
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1. If insurance covers it, your golden.
2. If not covered, you have to get it on your own, as economically as possible.
3. If you can't afford it, you get to whine a lot.
 
Some insurance companies are pretty cool about it, and you get what you need. Mine told me to Piss Off. I've had to procure my own stuff, but that's beside the point.
 
CH is a long term curse. O2 is a front line defense, so take a long term approach to having it on hand, insured or not.
 
Never buy or pay your medical supply company $350 forf a filthy E tank. I bought MM tanks (3,500 liters, 80# weight) for about $200 new. Got an E tank on EBay cheapish, and use is solely for it's portability. Found a cool device (again, on EBay) to transfer O2 from a large tank to the E tank. And this doesn't even get into the realm of welding O2. There are all kinds of ways to whip this O2 dilemna, where bigger IS better. It's good to be impatient; it's the first step to Satisfaction Guarenteed or Triple Your Money Back.
 
Actually, the first step is to go buy a Clustermasx. After that, all you need is a regulator (I got a box full, most or which are for sale) and the proper TANKS.
 
You're welcome.
RJ
« Last Edit: Dec 1st, 2005, 7:37am by Mr. Happy » IP Logged

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Re: Question about Oxygen and Insurance
« Reply #3 on: Dec 1st, 2005, 8:03am »
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The store I went to yesterday says they don't deal with insurance, that I have to pay and then get reimbursed.  I will try to find a place that actually does the whole thing and I only pay the co-pay.  regular drug stores wouldn't be able to do this right? I need to go to some medical supplies places I would guess.
.
I just ordered the Clustermasx so I have it whenever.
>
Thanks,
Joshua
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Re: Question about Oxygen and Insurance
« Reply #4 on: Dec 1st, 2005, 8:23am »
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YAY!  They pay 100%  It's being delivered Monday at 4pm Smiley  The bad news ( i think ) is that it's only 5 to 7 litres/min.  Hopefully it will still work and the next time I get the prescription I'll have to ask for more.
.
Joshua
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Re: Question about Oxygen and Insurance
« Reply #5 on: Dec 1st, 2005, 8:27am »
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5-7 LPM won't work, or if it does it will take 30 minutes. You'll never know if the O2 killed the headache, or if just went away. Believe me, bro, you need at least 10 LPM, 12-15 is better. If you can't find a regulator, call PM Mr. Happy and buy one of his. Or go on e-bay. It's only $20 or so.
 
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Re: Question about Oxygen and Insurance
« Reply #6 on: Dec 1st, 2005, 8:34am »
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Ok, the purpose of a regulator just hit me.  So with a regulator I can up the litres per min. of my tank to more acceptable amount?  
Wow...  Grin
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Re: Question about Oxygen and Insurance
« Reply #7 on: Dec 1st, 2005, 8:37am »
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Bingo. The regulator controls the flow of the O2 out of the tank and into the mask. The higher the LPM setting on it, the more O2 you breath in. However, the higher the setting, the faster you will use up your tank. You should get more than one tank so you never run out.
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Re: Question about Oxygen and Insurance
« Reply #8 on: Dec 1st, 2005, 8:47am »
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Just got off the phone with them.  Have to find out what the deal is on refills, etc.  Turns out it comes with a regulator they said, so I should be able to adjust to what I need.  I may order another just in case.
>
This is like the most anticipated delivery in years.. what does THAT say!?  lol.
 
Joshua
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Re: Question about Oxygen and Insurance
« Reply #9 on: Dec 1st, 2005, 6:33pm »
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Josh,
 
You should be able to call your Doc and have his office call the 02 supplier. They will then be able to give you a higher 15 lpm regulator. Don't forget the non-rebreather and the moisture cup too.
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Re: Question about Oxygen and Insurance
« Reply #10 on: Dec 1st, 2005, 7:49pm »
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OK, I've got my clustermasx, and mr. Happy's regulator, all I need to do is get my tank.  My doc is let's just say, not forthcoming, so I'm going to bypass him and go somwhere else.  I've got a friend who is a welder.  I think I can get tanks from him.  How big a tank should I get?  In liters?  
 
I need all the info I can get.
 
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Re: Question about Oxygen and Insurance
« Reply #11 on: Dec 1st, 2005, 9:52pm »
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Commercial O2 folks don't do the H, E, etc, tank classifications, nor do they use liters (US.)
#2 tank is equivalent to an H tank. 7,000+ liters/250+ ft3, 130#
#4 tank is equivalent to an MM tank. 3,500 liters/125 ft3 75#
#7 tank is close to an E tank with 550 liters/20 ft3 20#
 
The #2 or H tank is a pisscutter to handle.....heavy when loaded.
The #4 or MM tank is still heavy at 75#, but manageable.
 
No matter what welding O2 tank you get, it will (or SHOULD) have a 540 adaptor. The size of the tank isn't as important as the immediate availability of refills. Ya just don't wanna run out on a Saturday afternoon. Scratch that. Ya just don't wanna run out.
 
How much wood would a wood chuck chuck.....
RJ
« Last Edit: Dec 1st, 2005, 9:57pm by Mr. Happy » IP Logged

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Re: Question about Oxygen and Insurance
« Reply #12 on: Dec 1st, 2005, 10:36pm »
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on Dec 1st, 2005, 8:23am, findjoshua wrote:
The bad news ( i think ) is that it's only 5 to 7 litres/min.
 
Turns out it comes with a regulator they said, so I should be able to adjust to what I need.  I may order another just in case.  

 
The prescription usually has the Lpm on it.  If it is low-flow you can see about changing that with a new script or just asking for a high flow regulator from the supply company.  The person I talked at the supply company happen to be familar with clusters and obliged with a high-flow regulator even though the script said 8Lpm, but don't count on that.      
  In any case, the regulators Hap can help with will achieve the 15Lpm, which I also have so a second "E" tanks is set up and ready when the one being used is half full.  No middle of the night changeovers.  Getting high-flow won't be a problem.  
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Re: Question about Oxygen and Insurance
« Reply #13 on: Dec 2nd, 2005, 12:07am »
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http://www.chhelp.org/mhni.html
 
 
From the newsletter Headliner, 2004, Issue 33, published by the Michigan Head-Pain & Neurological Institute.  Reprinted with permission.
 
 
"High Oxygen Flow Rates for Cluster Headache"
      by Todd D. Rozen, M.D., Neurologist
 
 
As discussed in previous issues of the Headliner, cluster headache patients require effective abortive therapy due to the extreme intensity of their pain. The two most effective cluster abortives are injectable sumatriptan and inhaled oxygen. However, since a large percentage of cluster sufferers are cigarette smokers and at high risk for coronary artery disease, many cannot be treated with the various triptan medications. In these cases, oxygen therapy becomes the preferred option.
 
Oxygen, the safest of all cluster therapies, is usually prescribed based on a landmark study by Dr. Lee Kudrow. In this study, patients were instructed to use 100% oxygen via a nonrebreather face mask at 7-10 liters/minute. Although usually effective, a certain subset of cluster patients do not achieve relief from this treatment. The author hypothesized that treating patients with higher flow rates of oxygen, up to 15 liters/minute, might provide relief to those sufferers who had not responded to standard oxygen therapy regimens.
 
Because MHNI has many intractable cluster patients, it was decided that a higher dose of oxygen therapy would be utilized in a few patients. Several important cases recently reported in the medical literature, found this therapy to be quite effective in patients who previously did not respond to lower dose oxygen inhalation.  
 
MHNI's experience indicates patients who do not respond to the standard flow rates should be given the opportunity to use up to 15 liters/minute. However, prior to initiating this therapy, patients must obtain clearance from their primary care physician since serious lung disease and other conditions can make oxygen therapy unsafe or inappropriate. In addition, such oxygen therapy should not be used for more than a maximum of 10-20 minutes at a single setting.
 
The basis by which oxygen turns off a cluster headache is unknown at this time. Oxygen's constrictive effect on cerebral blood vessels may play a significant role.  
 
Further study and a larger sample size is needed to provide conclusive evidence regarding the usefulness of high oxygen flow rates for difficult-to-treat cluster headache patients.
 
 
 
Headliner is published and privately distributed by the Michigan Head-Pain & Neurological Institute for informational use by our patients and friends. Rights to reproduction belong exclusively to Michigan Head-Pain & Neurological Institute. For additional copies or further information contact:
Jeffrey Pingel, Ph.D., or Scott Madden, Editors, Headliner
Michigan Head-Pain & Neurological Institute
3120 Professional Drive, Ann Arbor, MI 48104  
 
 
Last modified: 2004
 
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Re: Question about Oxygen and Insurance
« Reply #14 on: Dec 2nd, 2005, 8:58am »
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RJ
 
Thanks.  That was exactly the info I needed to get to my welder friend.  Now, let's see if he can help me.  Otherwise, I'll be all ready to rock and roll with masx and regulator, but no juice  Undecided
 
I gotta find a more accessible doc.
 
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Re: Question about Oxygen and Insurance
« Reply #15 on: Dec 2nd, 2005, 9:15am »
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In my case the PPO pays for the O2 with no problems but the O2 company was no help when I was trying to get extra tanks and a higher flow regulator.  When I mentioned this to the delivery guy he went back in his truck and got me a 15 lpm regulator, a couple of NRB masks, extra tubing, and more E tanks ( I keep 10 on hand)  Cheesy
 
If your having your O2 delivered talk to the driver, mine is my best friend now.
 
PS: any xmas gift suggestions for him?
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Re: Question about Oxygen and Insurance
« Reply #16 on: Dec 2nd, 2005, 9:46am »
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You're going to run into 2 different types of setups.  Many medical oxygen tanks come with a straight valve and a yoke type regulator that slips over the valve:
 
medical tank
http://www.portablenebs.com/oxygenproducts.htm
medical regulator
http://www.specialty-medical.com/page/SM/CTGY/oxygen-regulators
 
The other setup, the industrial one, comes with a pipe thread valve and the regulator screws on with a compression type fitting.  I think this is what Happy's regulator does.
 
You can't mix the two.
 
I'm with Blue Shield of California and they cover the complete cost of the tanks, regulator and mask.  I usually get 4 "E" tanks and an 8 lpm regulator with a non-rebreathing mask.  This setup completely knocks out an attack in 10 minutes and holds the pain to 3-5 during that 10 minutes (BTW - I'm 6'4", 230 lbs.)
 
If they didn't cover the cost, my med supply charges $20 to refill an E tank.  At $300+ it sounds like they are selling you the tank not just the O2 inside.
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Re: Question about Oxygen and Insurance
« Reply #17 on: Dec 2nd, 2005, 11:11am »
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on Dec 2nd, 2005, 9:46am, Bob P wrote:
You're going to run into 2 different types of setups.
You can't mix the two.

540 or 870. 540 or 870. 540 or 870.
 

 
Cylinder 870
 

 
540 or 870.
RJ
« Last Edit: Dec 2nd, 2005, 11:35am by Mr. Happy » IP Logged

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Re: Question about Oxygen and Insurance
« Reply #18 on: Dec 2nd, 2005, 12:04pm »
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Hey, you're a real fart smeller Hap.  I'm gonna have to break down and get one of them turbo hookas with the tiparillo mouthpiece for my next go round.
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Re: Question about Oxygen and Insurance
« Reply #19 on: Dec 2nd, 2005, 6:55pm »
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on Dec 2nd, 2005, 12:04pm, Bob P wrote:
Hey, you're a real fart smeller Hap. I'm gonna have to break down and get one of them turbo hookas with the tiparillo mouthpiece for my next go round.

 
Gotta love Hap not giving any credit to the Dude that taught his ass.....LOL Grin
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Re: Question about Oxygen and Insurance
« Reply #20 on: Dec 2nd, 2005, 7:04pm »
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Got a bid in on E-Bay right now, an 870 that goes to 24lpm and 3 non-rebreathers.
 
I know who the king of the chrome blow controller makers is Jonny.
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Re: Question about Oxygen and Insurance
« Reply #21 on: Dec 2nd, 2005, 8:00pm »
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Um Bob, blow and jonny should never be said in the same sentence. Grin (No matter what the meaning)
 
Thank you.....LMAO
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Re: Question about Oxygen and Insurance
« Reply #22 on: Dec 4th, 2005, 8:42pm »
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on Dec 2nd, 2005, 7:04pm, Bob P wrote:
Got a bid in on E-Bay right now, an 870 that goes to 24lpm and 3 non-rebreathers.
I know who the king of the chrome blow controller makers is Jonny.

No doubt about it......Jonny's been blowing the O2 horn since I can remember, and longer.
 
Don't go too crazy on the bidding for that particular 25 lpm/masks offer; that dude has a lot of them, and constantly gets premium price. You should be able to score a 25 lpm for $25 (del'd) or less if yer patient. Here's another one to keep your eye on. Once in a blue moon you can come across a cylinder style 870 that will take a bubbler AND put out 25 lpm.
 
Some of these hosers kill you with S&H charges.
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Re: Question about Oxygen and Insurance
« Reply #23 on: Dec 4th, 2005, 8:53pm »
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25 lpm????? wow!
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Re: Question about Oxygen and Insurance
« Reply #24 on: Dec 4th, 2005, 10:12pm »
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I have four #2 tanks, three #4 tanks, and five E tanks.....and I have still run out of 02. The ability to refill quickly....and the ability to remember to refill is paramount.  If you need to, in a pinch, you can just use the welding regulator on a welding tank.....it blows like a SOB.  Just remember to turn it down, and a bubbler won't fit on it.
 
Thankfully RJ sent me a nice little regulator that goes over 15lpm and fits on my welding tanks....I can't suck enough air at 15lpm or less.
 
Right now I'm stuck in Houston without any 02 for three days.  I'm just a little bit paranoid right now.
 
Roxy  Cool
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