Renting oxygen concentrators and their accessories are covered by Medicare Part B as durable medical equipment (DME). The device must be prescribed by a physician for use at home in order to be eligible.
Medicare does not cover any out-of-pocket costs and will never pay for the PURCHASE or temporary rental of an oxygen concentrator.
Does Medicare Cover Portable Oxygen Concentrators?
Medicare Part B will cover the following in terms of oxygen therapy:
- Systems that provide oxygen
- Containers that store oxygen
- Tubing and other necessary accessories
It’s crucial to keep in mind, though, that Medicare typically won’t pay for the purchase of oxygen equipment. It will instead pay for equipment rentals.
The accessories and oxygen will be covered by Medicare if you already own an oxygen concentrator.
Medicare Coverage Requirements for Oxygen Concentrators
Through your Medicare Part B benefits, all durable medical equipment is covered. Therefore, being a Part B beneficiary is the first requirement for eligibility for DME.
Oxygen equipment eligibility depends on meeting each of the following criteria:
- Your doctor certifies that your body does not get enough oxygen
- Oxygen therapy may improve your health
- Your arterial blood gas values are within a certain range, which varies depending on the diagnostic method used and your particular condition
- Alternative measures to treat your condition have failed
You need to use an Inogen-approved Medicare-approved durable medical equipment supplier in addition to the aforementioned requirements. On this page of Medicare.gov, you can locate a provider. Simply type in your zip code and click Go. For additional information, dial 1-800-MEDICARE.
Why Are Portable Oxygen Concentrators Popular?
Due to their portability, portability, and small size, portable oxygen concentrators are very common. Numerous portable oxygen concentrators weigh as little as 5 lbs. and are only 10 inches tall. That implies that you can take them wherever you go—shopping, visiting friends, going out to dinner, even catching a flight—by simply placing them in a carrying case.
Unlike gas or liquid oxygen delivery systems, portable oxygen concentrators don’t require regular refilling; instead, they run on batteries that must be changed out. They are a lot more practical than other delivery methods because of this. Having one close at hand is not an additional stressor because most units are also very user-friendly.
However, portable oxygen is not inexpensive; the majority of units range in price from $2000 to $3500.
You may be wondering if Medicare will cover a portable oxygen concentrator if you have been prescribed portable oxygen and are concerned about the cost. Sadly, the majority of the time, the answer is no.
What Does Medicare’s Oxygen Equipment Coverage Include?
A system to deliver the oxygen, storage containers for the oxygen, and oxygen-related extras like tubing are all covered by Medicare if you meet the requirements for the equipment. Medicare may also help with the cost of an oxygen humidifier if you need to use one with your machine.
Please be aware that Medicare Part B covers the oxygen contents and associated supplies if you own your own equipment AND meet the requirements listed above.
How Much Does Oxygen Equipment Cost?
Instead of a direct purchase, Medicare Part B covers renting oxygen equipment. Before Medicare starts contributing its part, you must first meet the Part B deductible. The Medicare Part B deductible in 2023 is $226.
You pay the standard Part B coinsurance of 20% of the Medicare-approved amount after you’ve reached your annual deductible, with Medicare picking up the remaining 80% of the cost.
Equipment types, suppliers, tank sizes, and other factors all affect how much it costs to rent oxygen equipment. However, if you don’t have health insurance, you can anticipate to pay about $140 per week for the rental of an oxygen concentrator.
When the portability factor is included, that cost increases significantly. On average, it costs $210 per week to rent a portable oxygen concentrator.
What Does Oxygen Equipment Rental Include?
A 36-month rental period is applied to Medicare oxygen equipment. The oxygen equipment and associated supplies must also be provided by medical equipment vendors for an additional 24 months, if necessary.
Your monthly rental includes the following oxygen accessories and services:
- Tubing or mouthpiece
- Oxygen contents, including liquid oxygen and oxygen concentrate
- Maintenance (i.e. servicing and repairs as needed) of the oxygen machine
Assuming you continue to require oxygen for medical reasons, medical suppliers are required to provide both the equipment and associated supplies for up to 5 years.
What Happens After 36 Months?
If you still require oxygen after renting the equipment for 36 months, your medical supplier is required to keep it in working order and provide supplies for a maximum of 5 years (this includes the initial 36 months). Additionally, the DME provider must continue delivering oxygen tanks or cylinders on a monthly basis, for which you are still responsible for the 20% coinsurance.
Even if you still have a medical need for oxygen, your current provider is no longer required to provide oxygen equipment after five years. Of course, if both of you agree, you can continue using this provider. You can start a new 36-month rental period and select a different supplier of durable medical equipment.
When is Home Oxygen Prescribed?
If you suffer from a medical condition that lowers blood oxygen levels, your doctor might advise you to use home oxygen. This is known as hypoxemia.
Symptoms of hypoxemia include:
- A pale or blueish tint to the lips and skin (known as cyanosis)
- Confusion
- Fast breathing or shortness of breath
- Increased heart rate
- Sweating with minimal exertion
A wide array of health conditions may cause hypoxemia, including:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Heart failure
- Lung disease
- Pneumonia
- Respiratory trauma
- Sleep apnea
Despite the fact that all of these problems may make it difficult for your body to get enough oxygen, a diagnosis of one of these conditions does not automatically entitle you to Medicare coverage. To ascertain the levels of blood oxygen, diagnostic testing is necessary. You won’t be authorized for oxygen unless those fall within the ranges set by the Centers for Medicare and Medicaid Services (CMS).
How Do Doctors Diagnose Hypoxemia?
Tests to measure your oxygen saturation levels should be ordered if your doctor suspects you have hypoxemia. Blood gas testing and breathing drills could be part of this. Attaching a pulse oximeter to your finger and checking oxygen saturation is the least invasive testing technique. Contrarily, blood must be drawn for blood gas analysis.
Your doctor will probably suggest medical oxygen therapy if your oxygen levels fall to 88 to 93 percent.
Final Thoughts
If any of the above-mentioned hypoxemia symptoms sound familiar, consult your doctor. Your Medicare benefits will assist in defraying the cost of medical oxygen whether you have Original Medicare (Parts A and B) or a Medicare Advantage plan.
Try our Find a Plan tool to locate the Medicare plan that best suits your requirements and financial situation. Entering your zip code will get you started quickly and easily.
FAQs
How Do You Qualify for a Portable Oxygen Machine?
1. Get a physical examination from a doctor.
2. You should have a medical record proving your need for oxygen therapy.
3. Demonstrate lowered arterial blood gas oxygen saturation.
4. Get a prescription from a licensed medical professional.
How Much is An Oxygen Concentrator Portable?
Portable oxygen concentrators cost between $4,000 and $4,500 from the manufacturer, although you can often find them in the range of $2,500 to $4,000 from online retailers such as the and others, such as Oxygen Concentrator Store.
Do You Need a Prescription for a Portable Oxygen Concentrator?
Oxygen concentrators are class II medical devices according to the US Food & Drug Administration (FDA). This implies that you cannot buy one without a legitimate prescription from a medical professional who has attained board certification.
Can I Get An Inogen on Medicare?
For beneficiaries who meet the requirements of Medicare, portable oxygen concentrators, including Inogen, are covered. Inogen is covered by Medicare Part B as durable medical equipment.