I found your site tonight and know that it will be helpful. I'm wondering if this post may help someone else who runs into this issue and also if you have any thoughts, comments, or suggestions.
I have had clinical insomnia (verified by a sleep study in 1999 but I didn't need it to know that I was in trouble!). Had daytime sleepiness to the point of falling asleep while driving, having to pull over and fall asleep within 30 seconds and space out for an hour, depression, weight gain, falling asleep while talking to people, etc. With medication (Trazadone) I managed to get to sleep much easier.
In April of this year I went back for another sleep study with a phenomenal doctor, Harvard grad, up on all the newest research. She diagnosed me with sleep apnea caused by a slightly smaller than normal airway. I had 24 pauses in breathing during the study. She related that although my numbers were not alarming, she had seen people's lives changed through using a C-Pap at my levels. "Why not?" I thought.
After a month's use (which my previous insurance covered at 100%) the following occurred: 1) the general anxiety that I carried for years, day in and day out, despite therapy, exercise, etc., suddenly evaporated! In it's place was a person I didn't recognize - someone who could handle life's struggles and pressures with relative ease, 2) I was able to lose weight in a way that I never had before, 3) the heart arrythmia that showed up 14 months ago never bothered me, 3) and the depression I have battled for decades became 80% better!
I was thrilled! Then I was forced to change insurances to a rather restrictive state medicaid plan. I am self-employed and a funding which helped me pay my premiums disappeared and I was not able to pay the $550.00 a month it was going to cost me to continue with an excellent and outstanding insurance.
Here's the rub. The new insurance decided that my "clinical numbers" did not match their criteria. Despite the doctor's appeal, they upheld their denial. Now, I am on the hook for the last 2-month's rental cost ($240.00) and will have to give it back.
I am understandably confused and angry. As a previously state certified Emergency Medical Technician it was drilled into me that you "treat the patient not the machine." Despite the significant improvement in my mood, general health, and affect, I am being denied an essential service. And in it's stead, I will need to return to the sleep study doctor, follow-up with my PCP, and probably need another sleep study in the future. All of this will cost the insurance company more than 3 times the cost of my current machine.
Any thoughts or comments to help me during this very confusing time?