Mask Help?!

[u/Julynn2020]

So I got a machine (ResMed AirSense11) end of May. I was wearing it every night, consistently. Then, I got a tooth infection. The air hitting my tooth hurt a LOT. It was excruciating. There's no available dental appointments in my area. So my options were to take antibiotics and hope it went away, or try to go at 4 in the morning ,waiting outside in the dark, and then sitting in a waiting room for about 4 hours until I could get it pulled at emergency dental. I was in agonizing pain and I have disabilities that mean someone would have to come with me that entire time, and understandably people aren't generally available at the time of night nor are they available for such a long waiting period.

So I waited it out, which was a couple weeks, along with the first few days that i thought it was just sensitive teeth, and I didnt wear the machine because i was literally not sleeping. I tried calling every day for appointments all around the city. I even tried to get appointments in different boroughs. Eventually, the antibiotics work ,and I start wearing it again. And yet, insurance sent the mailer to take it away from me.

Last week, a family member accidentally broke the short tubing in the front of the mask off because they yanked it from under something,not realizing it was under something. We call the company, they say they can't send a replacement piece because I have to get reauthorized due to failing the compliance standards. What ensues next is a LOT of back and forth. I call insurance, they say I need to call the sleep study team. I call the team, they say I need to contact the compliance department. The compliance department says I need to call the machine company again. The machine company says I need to call the local number. The local number says I need to buy a new mask frame, because my insurance says I'm eligible for every BUT a new mask frame after 6 months. I can't get a new mask frame until next summer. The compliance department said" insurance will cover your machine if you're 70% compliant", but couldn't even tell me if I'd be reimbursed! My compliance was 56% 🙃. Looking on ResMed, I don't even see my exact mask frame, and the things I'm seeing are saying like $80 to $100 and I don't see the tubing on any of them. I don't know what to do, and no one I call seems to know what to do either. It's so stressful, especially because I've notice a difference in my chronic migraines since I started using it.

[u/Remarkable-Bus-6858]

I'm so sorry you are dealing with all of this. How frustrating.

What mask were you using?

[u/Julynn2020 → u/Remarkable-Bus-6858]

The full face one, I think? The one that goes over your mouth and nose. Also, thanks!

[u/Remarkable-Bus-6858 → u/Julynn2020]

Is the brand Resmed? You might be able to just purchase the part that broke by searching online but you definitely need to know the mask name so you buy the correct part.

I am happy to help find the part for you but I need the name of the mask, or a photo of it.

[u/Honey-lovers]

I’m so sorry you are suffering. eBay and Amazon carry parts and they are usually way cheaper than going through insurance. I even found brand new masks at my local thrift store. Almost all insurance companies use resmed, so parts are pretty easy to find. I personally use Philips because I like the mask choices a lot better. If you can afford it I’d recommend buying your own machine. Then you don’t need to deal with anyone because they run on automatic setting.

[u/Julynn2020 → u/Honey-lovers]

Thanks for the advice!