Does Medicare Cover Oxygen Equipment & Accessories?
Medicare covers the rental of oxygen equipment and accessories for home use as long as your doctor prescribes it and you meet certain requirements. You will still have to pay your Medicare Part B deductible and 20 percent of the Medicare-approved cost for the equipment and supplies.
Medicare Coverage for Home Oxygen Equipment and Supplies
Medicare considers home oxygen equipment and accessories to be durable medical equipment (DME), which it covers. Medicare Part B medical insurance will cover oxygen equipment and accessories used in your home if your doctor determines that the supplies are medically necessary and you meet certain other criteria.
- Oxygen therapy may improve your health
- Your arterial blood gas level — the levels of oxygen and carbon dioxide in your blood and your blood acidity — falls into a specific range
- Your doctor determines you have a severe lung condition or you are not getting enough oxygen
- Other alternatives have failed
To qualify for Medicare coverage, you must have Medicare Part B or a Medicare Advantage plan. Medicare Advantage plans are required by law to cover everything Medicare Part A and Part B covers.
What Is Your Cost for Oxygen Equipment and Supplies?
Under Medicare, you will rent your oxygen equipment from a supplier for 36 months. During this time, you will be responsible for your Medicare Part B deductible and 20 percent of the Medicare-approved cost of the monthly rental.
After the initial 36-month rental period ends, your supplier must continue providing you with oxygen equipment, supplies and regular maintenance for another 24 months, free of charge — as long as the equipment remains a medical necessity.
Five years after starting oxygen therapy, you will have to decide how to continue, as a new 36-month rental period will begin. Several factors will determine your out-of-pocket expenses going forward — including the use of alternative insurance, if you choose to rent or buy the equipment and what your doctor or supplier charges.
What Equipment and Accessories Are Covered by Medicare?
If you meet all the requirements, Medicare Part B will pay for specific equipment needed to provide oxygen therapy in your home.
- Medical-grade oxygen
- Systems that provide oxygen (such as home oxygen concentrators)
- Containers that store oxygen (such as oxygen tanks used to move around the home)
- Tubing or mouthpieces
- Oxygen machine maintenance
- Oxygen machine servicing
- Oxygen machine repairs
- A humidifier (if it is used with your oxygen machine)
Medicare will also cover equipment and supplies for continuous positive airway pressure (CPAP) therapy. CPAP machines, tubing and face masks are used to treat sleep apnea and similar conditions.
Does Medicare Cover Portable Oxygen Concentrators?
Medicare typically covers portable oxygen concentrators only in very specific cases.
While Medicare provides billing codes for the devices, it usually does not cover enough of the cost for oxygen suppliers to want to offer portable oxygen concentrators as an option for Medicare beneficiaries.
Most suppliers will instead offer an older, larger home oxygen concentrator along with several oxygen tanks you can use when you move around your house.
Oxygen tanks and oxygen concentrators are two different types of medical equipment that both provide oxygen to people who can’t get enough oxygen on their own.
Oxygen tanks have a specific amount of pressurized oxygen, delivered through a tube to your nose.
Oxygen concentrators collect oxygen from the air around them. They concentrate the oxygen before delivering it to the user. The advantage of a portable oxygen concentrator is that it doesn’t run out of oxygen.
5 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2020, August). Medicare Coverage of Durable Medical Equipment & Other Devices. Retrieved from https://www.medicare.gov/Pubs/pdf/11045-Medicare-Coverage-of-DME.PDF
- Liberty Medical. (n.d.). Will Medicare Pay for My Portable Oxygen Concentrator? Retrieved from https://traveloxygen.com/poc-blog/will-medicare-pay-for-portable-oxygen-concentrator/
- Smith, H. (n.d.). Oxygen Tanks vs. Oxygen Concentrators: 5 Tips to Help You Choose. Retrieved from https://www.rehabmart.com/post/oxygen-tanks-vs-oxygen-concentrators-x-tips-to-help-you-choose
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Getting Oxygen Equipment & Supplies in Certain Situations. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-b-covers/getting-oxygen-equipment-supplies-in-certain-situations
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Oxygen Equipment & Accessories. Retrieved from https://www.medicare.gov/coverage/oxygen-equipment-accessories