Insurance and Respirators

[Noah Barfield]

Hi all,

I'm in the process of looking at a positive pressure respirator mask (i.e. a Trend Air Stream, a 3M Air Shield, etc.). As someone who has asthma and who has struggled with pneumonia in the past, I began wondering if this mask is something that would qualify as a medically "necessary" item. Has anyone here ever had one recommended or prescribed by a doctor? If so, did your medical insurance cover the cost?

I figured this was one of those "it never hurts to ask" type of questions.

Noah

[Tom Winship]

Noah, that would make too much sense, IMHO. They will wait and pay for the equipment to treat not prevent.

[Robert McGowen]

It seems to me that it would depend on your profession. If you are a professional turner and not wearing the protection is effecting your livelihood and health, maybe. If you just feel like voluntarily exposing yourself to this hazard just for fun, I would say you are out of luck. Also, remember the doctor writes a prescription, but the insurance company usually determines what equipment you need. Even with a prescription for dust protection from a doctor, you could end up with a $10 box of dusk masks from the insurance company!

[Noah Barfield]

I agree--medical insurance practices can be pretty screwy. I just got off the phone with my flex-spending program. If I submit a medical necessity form, I can probably get a respirator reimbursed through them.

Second question--My local Woodcraft only carries the Trend Airstream Pro. I've had the chance to try it on (it's a bit snug), but the battery was dead. Last night at my local woodturners' meeting, I spoke with someone about his respirator. He recommended not buying the Trend Airstream due to vibration noise. Given that I don't have the opportunity to try on respirators in my area, how should I go about picking one out?

Noah

[Paul Heely]

I bought my 3M Airstream from Airware America, they also sell the Trend and Trend Pro. Their website says that if you are dissatisfied for any reason you can return what you ordered. That might be one way to try one risk free. Try giving them a call. They are great to deal with.

[Roger Chandler]

I like my Trend Airshield Pro............It does what I need it to do.........prevents dust in my lungs and sinuses. I have had pnuemonia 3 times already and almost died in 2006............Mine has been a great investment........I use when sanding especially, and I have an overhead air cleaner and a dust collector..............I think I have it covered about as good as I can.

[Brian Tymchak]

Hi all,

.. I began wondering if this mask is something that would qualify as a medically "necessary" item. Has anyone here ever had one recommended or prescribed by a doctor? If so, did your medical insurance cover the cost?





My insurance wouldn't cover orthotics, which I need to walk for more than 100 yards, because "durable" medical devices are not covered on my employers plan. Based on my experience, I'd bet you would have some difficulty getting your mask covered. My orthotics at least count towards my deductible, but that really adds up to nothing, as I have only once in all my years exceeded the deductible. Also, since your mask would be used for you to participate in your hobby (making an assumption), IMHO, the "necessary" part of "medically necessary" is on thin ice.

Sorry to take the pessimistic view..

[Ken Fitzgerald]

If you are a professional woodworker, have no other marketable talents and a doctor wrote a prescription you might convince an insurance company to pay for the respirator.

However, if you are a hobbiest like most of us, I doubt they will pay for it.

Would you expect an health insurance company to pay for a parachute if you took that hobby up?

[Jason Roehl]

Heh-heh...a parachute is "medically necessary". That's a good one, Ken.

[David DeCristoforo]

Based on my experience with insurance companies in general, I would guess hahahahahahahahahahahahahahahahah!!!

Those guys don't make their money by paying for stuff. They make it by not paying. Safest to assume they would not pay.

[Bernie Weishapl]

I have the Airstream AS-400 with HEPA filter on the advice of my Doctor. I have problems with bronchitis which she said could turn into emphysema. She told me she wouldn't/couldn't prescribe one but she strongly and firmly recommended I get one. She said it is what the grain elevator uses. She said she couldn't get it thru insurance because it wasn't something I HAD to do. She said if that is how I made my money maybe. The paper face filters I had been using were not doing the job. I have no issues with mine now for over 1 1/2 yrs. There are some days I wear it all day long for 7 to 8 hrs with no discomfort at all. I just put a new filter in it and you wouldn't believe how much sanding dust was in the old one. Oh and haven't had a bout with bronchitis since I got it.

[Noah Barfield]

Thank you to everyone who weighed in. I appreciate the recommendations on the respirators too. I'll let you know how it all turns out.

Noah

[Ryan Baker]

Insurance won't pay for it, but they might raise your rates after you inform them that you are increasing your risk through voluntary activity.

No doubt the 3M Airstream is the system to have, if you can scare up the funds. I will probably switch to that some day.

I use the Trend Airshield Pro. It is a good device, and does a pretty good job of filtering. I don't have any vibration issues at all. Noise from the fan is not bad. Noise from the air blowing out past my ears is a bigger disturbance to me. It is a bit cumbersome and top-heavy, though you will get pretty used to it after a bit (and adjusting the fit changes the comfort a lot). If you are leaning over for many hours you will feel the effects of the top weight. The batteries easily last over 8 hours new, but take almost twice that to charge. An extra battery and the stand-alone charger will keep you running without any down time.

[Jim Burr]

I checked with my Pulmonologist and he said it won't fly anymore. 30 years ago, it would have, but a usual the system was abused and things like hot tubs and wine chillers (both used to be prescribed in the 70's) are out the door. Insurance companies now view prevention to be the responsibility of the end user.
I have been using my Trend Airshield Pro almost daily and notice much less coughing and inflammation in my upper airway.

[Noah Barfield]

Hi all--just a quick follow up. As many of you noted, insurance was not willing to pay for the respirator. However, I was able to use my flex spending account to pay for it (as an unreimbursed medical expense). So, it did wind up coming out of pocket, but I was able to save a little (i.e. taxes) via the flex spending program.

Noah