Does Medicare Cover Oxygen Concentrators?

Medicare Part B (medical insurance) does cover oxygen concentrators and related oxygen equipment if your doctor prescribes them for use in your home.

Learn more about your oxygen therapy coverage options, including how equipment may be covered and exactly what components may be covered.

Does Medicare cover home oxygen equipment?

An oxygen concentrator and other oxygen equipment can qualify as durable medical equipment (DME) that is covered by Medicare Part B if you meet certain conditions.

Medicare covers oxygen equipment rentals for use in your home, including equipment such as:

• Systems that provide oxygen
• Containers that store oxygen
• Tubing, masks, mouthpieces and other supplies and accessories that deliver oxygen
• Servicing, maintenance and repairs of equipment and supplies

Medicare may also cover humidifiers if used along with your oxygen equipment.

How does Medicare cover oxygen equipment?

Medicare covers the rental of oxygen concentrators and other oxygen equipment for up to five years, as long as you continue to have a medical need for oxygen therapy.

If you have Medicare Part B, you will rent your oxygen concentrator from a DME supplier for 36 months (three years). After that period, your supplier will continue to provide coverage for an additional 24 months (two years).

If you need to continue using the equipment after five years, you will begin a new five-year contract with the same or different DME supplier.

If you own the oxygen equipment yourself, Medicare Part B will cover the cost of oxygen contents and supplies if all of the following apply:

• Your doctor determines that you are not getting enough oxygen
• Your doctor believes your health might improve with oxygen therapy
• Your arterial blood gas level falls within a certain range
• Other alternative treatments have been tried and failed

You will pay 20 percent of the Medicare-approved amount for the oxygen concentrator after you meet your Part B deductible (which is $198 per year in 2020).

Medicare.gov details some additional coverage rules for oxygen equipment under certain circumstances.

How are portable oxygen concentrators covered by Medicare?

Portable oxygen concentrators are covered by Medicare only if the DME supplier agrees to offer you a portable option.

Because portable concentrators are more expensive than stationary ones – and because Medicare’s reimbursement rate to the supplier is the same either way – many suppliers will only offer stationary oxygen concentrators to Medicare beneficiaries.

Does Medicare cover oxygen for COPD treatment?

If you have chronic obstructive pulmonary disease (COPD) and your doctor determines that oxygen therapy is medically necessary for you, Medicare will help cover your oxygen equipment.

Other health conditions that could require you to need medically necessary oxygen therapy can include:

• Cystic fibrosis
• Sleep apnea
• Late-stage heart failure
• Emphysema
• Severe asthma

As mentioned above, Medicare Part B will cover the rental of your oxygen concentrator and other equipment only if it is prescribed by your doctor for use in your home.

Medicare Advantage plans can cover oxygen concentrators

Medicare Advantage plans (Medicare Part C) cover all the same benefits as Original Medicare (Part A and Part B) and may also offer additional coverage for things like dental, vision, prescription drugs and more.

One of extra benefits that may be included in some Medicare Advantage plans is air conditioners for people who have asthma. If you have asthma and have a Medicare Advantage plan, you could potentially have both an oxygen concentrator and an air conditioner covered by your plan.

Call to speak with a licensed insurance agent today and learn more about how a Medicare Advantage plan could help fit your health care coverage needs.

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