A CPAP machine can help some get better sleep, but insurers don’t make it easy: NPR

Filed Under: Costs, Health plans, Patients

“Last March, Tony Schmidt discovered something unsettling about the machine that helps him breathe at night,” Marshall Allen of ProPublica writes over at NPR’s Shots blog. “Without his knowledge, it was spying on him. From his bedside, the device was tracking when he was using it and sending the information not just to his doctor, but to the maker of the machine, to the medical supply company that provided it and to his health insurer. Schmidt, an information technology specialist from Carrollton, Texas, was shocked. ‘I had no idea they were sending my information across the wire.’ Schmidt, 59, has sleep apnea, a disorder that causes worrisome breaks in his breathing at night. Like millions of people, he relies on a continuous positive airway pressure, or CPAP, machine that streams warm air into his nose while he sleeps, keeping his airway open. Without it, Schmidt would wake up hundreds of times a night; then, during the day, he’d nod off at work, sometimes while driving and even as he sat on the toilet. ‘I couldn’t keep a job,’ he recalls. ‘I couldn’t stay awake.’ The CPAP, he says, saved his career, maybe even his life.   As many CPAP users discover, the life-altering device comes with caveats: Health insurance companies are often tracking whether patients use them. If they aren’t, the insurers might not cover the machines or the supplies that go with them. And, faced with the popularity of CPAPs — which can cost $400 to $800 — and their need for replacement filters, face masks and hoses, health insurers have deployed a host of tactics that can make the therapy more expensive or even price it out of reach.  Patients have been required to rent CPAPs at rates that total much more than the retail price of the devices, or they’ve discovered that the supplies would be substantially cheaper if they didn’t have insurance at all. Experts who study health care costs say insurers’ CPAP strategies are part of the industry’s playbook of shifting the costs of widely used therapies, devices and tests to unsuspecting patients. ‘The doctors and providers are not in control of medicine anymore,’ says Harry Lawrence, owner of Advanced Oxy-Med Services, a New York company that provides CPAP supplies. ‘It’s strictly the insurance companies. They call the shots.'” Marshall Allen, “A CPAP Machine Can Help Some Get Better Sleep But Insurers Don’t Make It Easy,” Shots, Health News, NPR.