Apparently, Breathing While Sleeping Requires Paperwork

I have used a CPAP machine for years.

For those unfamiliar, a CPAP machine is essentially a bedside appliance whose sole purpose is to keep you from quietly suffocating in your sleep. It is not glamorous. Nobody posts glamorous CPAP selfies.

Years ago, when I was first diagnosed with sleep apnea, I didn’t have medical insurance. So I did what many uninsured people do: I became resourceful.

I bought my CPAP machine online. Then another one. Then another one. Over the years, I purchased four machines and supplies myself because, frankly, breathing seemed important.

Recently, however, I discovered something surprising. Insurance covers CPAP machines. I know. I had somehow missed this exciting development.

Unfortunately, insurance does not simply hand you a machine and say, “Congratulations on your commitment to oxygen. Sleep well.”

No. There are hoops. Many hoops. Olympic-level hoops.

First came the sleep study.

It had been about fifteen years since my last one, so honestly, this was probably reasonable. Still, I had forgotten what sleep studies involve. You spend the night while a stranger watches you sleep. This happens twice. One night without a CPAP machine. One night with one.

Fortunately, mine took place in a hospital instead of some office park building, which somehow felt less like I might wake up in the middle of the night and discover I’d accidentally joined an experimental documentary.

After the study, my doctor sent the prescription and results to a local medical supply company.

Then came the first phone call.

“Hi! Your doctor referred you to us for a new CPAP machine. Is now a convenient time to answer some questions?”

It was. We went through their list.

Then came the sentence I would soon hear so often that it began to feel less like information and more like a spiritual mantra:

“We are not in network for your insurance. Your discount would be X%. If we were in network, your discount would be Y%. Would you like to continue?”

Well. I didn’t know. Because that entirely depended upon one very important question: How much money are we talking about here?

For this, I needed to be transferred to another person.

Person B explained that when insurance is involved, CPAP machines are generally rent-to-own. The first payment would be around $1,100. Then eleven more payments of roughly $117.

I paused.

I had purchased multiple CPAP machines online over the years. I happen to know approximately what they cost.

So I asked, carefully:

“What would this machine cost if I just bought it outright?”

“Oh, about $1,000.”

My eyebrows nearly relocated to my hairline.

Let me see if I understand. If I pay cash, the machine costs around $1,000. But if insurance becomes involved, suddenly we are entering luxury automobile financing territory?

This felt suspicious. Still, I remained open-minded. Perhaps there was some hidden brilliance I simply failed to understand.

About a week and a half later came the second call.

Again, I was informed:

“We are not in network for your insurance. Your discount would be X%. If we were in network, your discount would be Y%.”

At this point I began to suspect that everyone in the office had attended the same dramatic arts program.

This time, I learned the process: First, insurance approval. Then, an appointment to try on masks for sizing. Fine. Good. We were making progress.

A week later came Call Number Three.

You already know how it started.

“We are not in network for your insurance. Your discount would be X%. If we were in network—”

Yes. I remembered. At this point I could probably have delivered the speech myself.

This time, I revisited the pricing issue.

I explained that I had previously purchased CPAP machines online and was struggling to understand why any rational human being would voluntarily spend over $2,000 for something worth half that amount.

She explained that people often like using insurance for masks and hoses later. Because apparently if you do not begin your relationship with a CPAP provider by overpaying dramatically, you lose future hose privileges.

I asked her if she knew how many masks and hoses one could buy for a thousand dollars. Because I do.

This conversation was going about as smoothly as oil and water sharing a bathtub.

At one point, I asked if I could simply come in and look at the masks.

“Sure,” she said. “Drop by.”

Wonderful. We dropped by. Turns out I could look at the masks. Trying them on, however, required an appointment. This would have been useful information before driving over there.

Still, the trip was not a complete loss. I finally learned where my confusion had begun. Unlike doctors’ offices and pharmacies—which politely tell you only your portion of the bill—this company had been quoting the total amount: insurance payment plus patient payment combined. My actual financial responsibility was far lower. This was, admittedly, better.

Encouraged, I waited a week for them to call again, which they didn't, so I called them to schedule my appointment.

“So sorry,” I was told. “There’s only one person here who schedules appointments, and she’s off today.” No offer to take my name. No suggestion that someone call me back.

No:

Would you like me to leave her a message?

Nothing.

Now, I’m not always quick to catch subtle hints. Sometimes life needs to wave a large fluorescent sign directly in front of me.

But after being told three separate times that they were not in network, repeatedly reminded of percentages, sent through a pricing labyrinth, invited to look at masks but not touch masks, and then gently blocked from scheduling an appointment altogether…

It slowly dawned on me. Perhaps they did not actually want my business. Perhaps, in the kindest and most bureaucratic way possible, they were encouraging me to find someplace else.

Someplace… in network.

So I did.

The new company made exactly two phone calls. One to gather information. One to schedule an appointment.

Easy peasy lemon squeezy.

And now I have a new CPAP machine.

Apparently, all it took was finding a medical supplier that seemed genuinely enthusiastic about my continued nighttime breathing.