When I first started looking into solving my sleep and daily fatigue issues, after I did some research on the cost of CPAP medical equipment, I started by calling a local clinical sleep center. From what I had read, this is where a doctor would send me to be evaluated for my snoring issues and potential sleep apnea.
So I called the sleep study facility and asked, “What’s the price to do a sleep study?”
The answer I received to my pricing question was “I don’t know. We have to submit to your insurance.”
That response, which is so typical in the medical industry, is one of my biggest areas of frustration. I hear this response all the time because apparently, I’m the only person in the world that wants to know what things cost before getting into them.
I was just getting started and really wanted an approximate number before giving all my insurance details.
So, as I always do, I pushed by asking more questions. I asked, “Yeah, but ballpark, how much are we talking? A hundred dollars? Three hundred? A thousand? I’m just looking to get a feel for what I’m getting into here”.
But the response I still got back was “I’m sorry I can’t say, I need to run it through your insurance.”
Why not?!! Why is this so hard?!! Why are costs in the medial industry so convoluted and hidden?!!
Trying to stay calm, I decided to try again with the question, “OK… If I didn’t have insurance, how much would it cost for me to pay with cash?”
That simple reframe was enough to get the type of response I was looking to receive. The rep responded, “Well, the initial sleep study is $375 and the titration study is $500”.
GREAT! Thank you! We’re in the ballpark… let’s play ball!!!
Two Sleep Studies?
I dug further and by asking few more questions I learned that first, there is an overnight sleep study to first determine if you have sleep apnea, and then if tested positive, you are typically are brought back for a second “titration” study.
The second “titration” sleep study is for the powers-that-be to be able to set the sleep apnea correcting CPAP machine at the “optimal setting”, specifically for your level of condition. In other words, the “titration study” determines how hard the CPAP pressure unit needs to force air down your throat so that you don’t nearly choke yourself to death in your own sleep.
So at that point, it appeared that for me just get to the point of being able to buy a CPAP sleep machine I’d be out around $900.
Cripes!!! NINE HUNDRED DOLLARS… and that’s just the cost to have the medical privilege (prescription) of spending another $800 on the actual solution?! And that doesn’t even yet include the regularly need wear-and-tear replacement parts.
Now you might be thinking, “Yeah… but that’s without insurance? You should really go through your insurance. Because surely the $500 per month you pay for a financial bodyguard as protection against the medical industry will save you!”
And to you, I belly laugh with a guffaw, “Silly fool… I am self-employed with private insurance!”
My insurance will cover 80% of any medical procedures and equipment… but only after my $6,000 deductible.
So unless the entire procedure is over $6,000 for the year, my insurance is not going to help me any!
(Actually, that’s not totally true – there is some weird price lowering of about $20 on each night stay because of my insurance’s contracts with the provider. One associate I spoke with termed it the “unmet deductible price”)
With an estimate in the area of around $2,000 to solve my sleep and fatigues issues, I decided to think a while longer. I needed to really decide that it would be worth that big-ticket cost to possibly feel better (I’m pretty cheap).
In the meantime, I started looking into home sleep studies, learned about auto-titration CPAP machines that don’t require a “titration” study. I’ll discuss these further in more posts.
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