PAP Resmed upgrades

UPGRADES: As of 8/27/24

ResMed P30i insurance upgrades are as follows:

Aetna: $15 e a . f or t h e P i ll o w s (A 7033) /$ 45 for the Frame (A7034) / $15 f or t h eH G (A 7035) (H GON L Y -$ 28)
BCBS: $11 e a . f or t h e P i ll o w s (A 7033) /$ 32 for the Frame (A7034) / $12 f or t h eH G (A 7035) (H GON L Y -$ 23)
Medicare CBA: $7 e a . f or t h e P i ll o w s (A 7033) /$ 21 for the Frame (A7034) / $15 f or t h eH G (A 7035) (H GON L Y -$ 18)
Medicare Rural: No upgrades

ResMed F20 AirFit Insurance Upgrades are as follows:

Aetna: $15.21 f ore a c h c u s hi o n (A 7031) /$ 36.64 for the Frame (A7030) / $10.00 f or t h eH G (A 7035) ($ 30 if HG ONLY)
BCBS: $7.37 f ore a c h c u s hi o n (A 7031) /$ 16.30 for the Frame (A7030) / $5.00 f or t h eH G (A 7035) ($ 25 if HG ONLY)
Medicare CBA: No Upgrade except if they want only HG, then $20.00 HG upgrade
Medicare Rural: No upgrades

ResMed P10 Insurance Upgrades are as follows:

Aetna: $8.54 f ore a c h p i ll o w (A 7033) /$ 24.22 for the Frame (A7034) / $10.00 f or t h eH G (A 7035) ($ 28 if HG ONLY)
BCBS: $4.73 f ore a c h p i ll o w (A 7033) /$ 11.48 for the Frame (A7034) / $5.00 f or t h eH G (A 7035) ($ 23 if HG ONLY)
Medicare CBA: No upgrade except if want only HG, then $18 HG upgrade
Medicare Rural: No upgrades

ResMed N20 Insurance Upgrades are as follows:

Aetna: $8.08 f ore a c h c u s hi o n (A 7032) /$ 24.22 for the Frame (A7034) / $10.00 f or t h eH G (A 7035) ($ 24 if HG ONLY)
BCBS: $3.78 f ore a c h c u s hi o n (A 7032) /$ 11.48 for the frame (A7034) / $5.00 f or t h eH G (A 7035) ($ 19 if HG ONLY)
Medicare CBA: No Upgrade except if they want only HG, then $14 HG upgrade
Medicare Rural: No upgrades

AETNA BENEFICIARIES: As of 3/18/24 The patient will need to pay the difference between the cost of the equipment and the reimbursement of AETNA. AETNA does not consider what the product costs us. AutoCPAPS have gone up $50 a s w e ll, an d A ETN A ha s n o t a dd resse d t hi s . P a p ser v i ce f or A e t nab e n e f i c ia r i es w i ll in c l u d e t h e f o ll o w in gu p c ha r g es : R es M e d A i rse n se 10 or 11 A u t o Cp a p :$ 350 OOP ResMed Aircurve 10 or 11 AutoBipap: $550 OOPR es M e d A i rc u r v e 11 A S V :$ 2350 OOP ResMed heated hose: $16 additional OOP ResMed non-heated hose does not have an OOP All other ResMed Resupply will have an OOP for the beneficiary.

WHAT CAN BE SUPPLIED THAT IS COVERED BY AETNA ALLOWABLE: Philips Dreamwear UTN & FFM products can be dispensed on AETNA with no additional charges to the patient.(this does not include remaining deductible or co-pay). AMARA VIEW UPGRADES:

Please transition any patients that are still using the Amara view over to the Dreamwear FFM. The Amaraview cost us $10 more per cushion and they are basically the same thing. If your patient wants to stay with the Amaraview they will have to pay an upgrade. WHAT CAN BE SUPPLIED THAT IS COVERED BY AETNA ALLOWABLE: Philips Dreamwear UTN & FFM products can be dispensed on AETNA with no additional charges to the patient.(this does not include remaining deductible or co-pay). AMARA VIEW UPGRADES:

Medicare patients will pay $10 p erc u s hi o n (A 7031) BCBSp a t i e n t s w i llp a y$ 15 per cushion (A7031) Aetna patients will pay $20 per cushion (A7031

Regarding the Philips Dreamwisp for Aetna Patients: $13 u p g r a d eo n e a c h c u s hi o n, (A 7032) .$ 10 upgrade on the frame, (A7034). $10 upgrade on the headgear, (A7035)

Choice Medical

Explorer

UPGRADES: As of 8/27/24

ResMed P30i insurance upgrades are as follows:

ResMed F20 AirFit Insurance Upgrades are as follows:

ResMed P10 Insurance Upgrades are as follows:

ResMed N20 Insurance Upgrades are as follows:

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