Some older adults need oxygen therapy. This can be because of sleep apnea, COPD, a heart condition, or asthma. It might be because of an infection, or temporarily while recovering from surgery.
Your physician will prescribe a portable oxygen concentrator if you have low blood oxygen levels and they feel oxygen therapy will help you. Oxygen therapy happens in three main ways:
Oxygen gas: This is a compressed gas system, consisting of an oxygen tank that is either used in the home or small enough to take outside.
Oxygen liquid: This is a refillable system, which can be given in a tank small enough to take outside the home.
Oxygen concentrators: These draw in the surrounding air and remove nitrogen to make it more oxygen-rich. They can either be stationary (for use in the home) or portable (small enough to carry around).
Does Medicare Cover Portable Oxygen Concentrators?
The situation with Medicare and portable oxygen concentrators is a little complicated. Medicare does provide support for durable medical equipment (DME), including items such as home hospital beds and wheelchairs.
People sometimes think that because oxygen therapy counts as a DME, Medicare will cover a portable oxygen concentrator. However, that’s not the case.
When it comes to oxygen equipment, what actually happens is that your equipment supplier has a contract with Medicare. Medicare pays them a certain amount per equipment rental, as under Medicare rules oxygen delivery is rented, not bought. The fact is that back in 2013 Medicare reduced the rental payment they give for portable oxygen concentrators by almost 50%. As a result, most medical supply companies simply cannot afford to supply portable oxygen concentrators, as Medicare doesn’t pay them enough.
That’s why you’ll most likely be told: “Medicare doesn’t cover portable oxygen concentrators.”
Will Medicare Pay For Any Type Of Oxygen Therapy?
Does this mean Medicare won’t pay for any oxygen therapy? No. In many cases, Medicare will cover the rental cost of an oxygen tank or sometimes liquid oxygen. In some rare cases, it might cover a stationary oxygen concentrator. Medicare will cover oxygen therapy if:
- Your doctor says you have a severe lung disease or you’re not getting enough oxygen.
- Your health might improve with oxygen therapy.
- Your arterial blood gas level falls within a certain range.
- Other alternative measures have failed.
If these conditions are met and your physician provides the necessary proof to back it up, Medicare will cover:
- Systems that provide oxygen.
- Containers that store oxygen.
- Tubing and related oxygen accessories for the delivery of oxygen.
You’ll enter into a 36-month rental contract with the supplier, during which the supplier must maintain the equipment and provide any spare parts or accessories as needed.
Your costs will vary depending on your exact insurance.
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 5lbs 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 cannula 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 privately. If you can afford to buy privately, there are ways you can save a bit on a portable concentrator as outlined above.