Does Medicare Cover Portable Oxygen Concentrators?
Medicare Part B will cover the rental of oxygen concentrators and accessories as durable medical equipment (DME). To qualify, a doctor needs to prescribe the equipment for use in the home.
However, keep in mind that vendors do not have to offer you a portable unit; rather, they may only offer a stationary one.
To quickly learn the basics of portable oxygen coverage with medicare, watch our short video.
Medicare Part B Oxygen Coverage
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 important to note, however, that Medicare usually won’t cover the purchase of oxygen equipment. Instead, it will cover equipment rentals.
If you already own an oxygen concentrator, then Medicare will pay for the accessories and oxygen.
Eligibility
To be eligible for Medicare coverage of oxygen therapy, all of the following must apply:
- Your doctor must affirm that you aren’t getting enough oxygen.
- Your doctor must affirm that your health might improve from oxygen.
- Your arterial blood gas level must fall within a specific range.
- You must have tried alternative treatments, and they have failed.
Your doctor must also prescribe the need for an oxygen concentrator.
Portable Oxygen Costs with Medicare
After you meet your Medicare Part B deductible ($226 in 2023), you’ll pay 20% coinsurance of the Medicare-approved amount for oxygen equipment.
So if you begin renting an oxygen concentrator and it costs $200 per week, you'll most likely end up paying $40 per week, and Medicare will pay the rest after you've met your deductible.
Why Are Portable Oxygen Concentrators Popular?
Portable oxygen concentrators are popular because they’re small, light, and convenient to use. Many portable oxygen concentrators weigh as little as 5 lbs and are less than 10 inches high. That means you can easily put them in a carrying case and take them with you as you go shopping, visit friends, go out to dinner, or even catch a flight.
Portable oxygen concentrators require batteries that must be changed regularly, but they don’t need refilling the way gas or liquid oxygen delivery systems do. That makes them much more convenient than other delivery systems. Most units are very user-friendly too, so it’s not an extra stressor to have one close at hand.
However, portable oxygen doesn’t come cheap, with most units costing somewhere between $2000 – $3500.
If you’ve been prescribed portable oxygen and are worried about the cost, you might be wondering if Medicare will pay for a portable oxygen concentrator. Unfortunately in most cases, the answer is no.
I Need A Portable Oxygen Concentrator – Now What?
If you’re set on getting a portable oxygen concentrator, you’ll need to buy from a private supplier, and you’ll need to fund the purchase yourself. Online stores are good places to start.
You’ll need a prescription to buy an oxygen concentrator. This is to make sure you’re getting the right amount of oxygen delivered in the right way. Your physician will be able to advise you about whether you need a pulse flow or continuous dose oxygen concentrator and how much oxygen it needs to provide for you in liters per minute (LPM.)
A reputable store will want to know about your prescription and needs before selling you a portable oxygen concentrator. It’s always worth talking to their customer service department first to make sure you’re choosing a machine that suits your needs.
How to Save on the Cost of a Portable Oxygen Concentrator
Many stores have a financing option so you can spread the cost of buying a portable oxygen concentrator. As we always say, do double-check the small print before signing up for a financing option.
Some manufacturers sell reconditioned or second-hand portable concentrators, which cost a bit less than new ones. This can be a good way to save money; however, do check with them to find out how they ready the machines for sale and what tests they do to make sure they’re in good working order.
Another money-saving option is to rent an oxygen concentrator. This is a good choice if you only need it for a short time, such as after surgery or for traveling on an airplane (make sure the one you rent is FAA approved.) Renting can work out more expensive than buying in the long term though, so it’s not a good option for longer-term use.
It’s also smart to compare prices. Online stores do vary a bit in how much they charge, so comparing suppliers can save a bit of money. It’s also a good idea to see which accessories are included in the price. If you’re getting batteries and spare cannulae included, it can work out cheaper than buying them separately.
Unfortunately, Medicare doesn’t generally cover portable oxygen concentrators. However, they do cover some oxygen therapy if you cannot afford to buy it privately. If you can afford to buy privately, there are ways you can save a bit on a portable concentrator as outlined above.