You are At Risk for Being Billed for

Your Device and Supplies!

At your equipment set-up appointment, you were informed that following the first 90 days of treatment, your insurance plan requires a re-evaluation to continue paying for your PAP and supplies.  During the first 90 days of treatment, your insurance plan requires you to: 

  1. Use your PAP device for 4 or more hours per night for 70% of the nights (at least 21 days) during a consecutive 30-day period.

  2. Make and attend a follow up appointment with your treating physician. Your insurance plan requires that you attend a follow up appointment with your doctor to discuss your PAP therapy within the first 90 days, between the 31st and 90th day from the start of use of the CPAP or BiPAP equipment. It is your responsibility to make and keep this appointment.

Currently you are not meeting these requirements and are at risk that your insurance plan will not continue to pay for your machine or supplies.

What if you do not meet your insurance plan’s compliance requirements by day 90?

You have a few options:

  1. You can requalify to continue your therapy by scheduling and attending a doctor’s appointment to discuss your PAP usage, then complete a repeat sleep study in a sleep lab.

  2. You can purchase your machine outright by completing an Advance Beneficiary Notice (ABN) form. You will be financially responsible for supplies as well.

  3. You can call your local branch and arrange to return the device.

If you have any additional questions please contact call the Patient Success Team, Monday-Friday, 9am-5pm E.T., at patientsuccess@metromed.com or call us at 1-855-216-5974.