If your COPD or other lung condition is severe enough, your doctor will prescribe the use of medical oxygen therapy. Medicare, which covers necessary medications and supplies to people over the age of 65, or in some cases, under the age of 65, will cover the costs if you are eligible. With COPD, you will definitely need oxygen therapy to stay healthy, just as any other kind of medicine works. There are a few other requirements you will need to meet to have your oxygen therapy supplies covered under medicare.
What are the Medicare Requirements?
When your doctor determines that you need medical oxygen therapy to function in day-to-day life, he or she will write you a prescription for all the things you will need. You will need prescriptions for all of the supplies you need, this includes the oxygen concentrator as well as all of the filters, batteries and tubing, to purchase them and have them covered by medicare.
Medicare will request your medical records, to make sure you physician has specifically documented your need for medical oxygen therapy. Your condition must be well-documented for them to approve your claim.
Your medical supply company must have the order from your doctor, before they can bill medicare, and the order has to be kept on file in case medicare requests it in the future.
Medicare covers the supplies you need to use medical oxygen therapy in your home, on an ongoing basis. The need for its use on an ongoing basis must be extensively documented in your medical records. This is based on severity of your condition, and whether or not oxygen therapy on an ongoing basis will help to improve your condition.
The severity of COPD is measured by your arterial blood gas test and oxygen saturation percentage. Your PaO2 (measured by the ABG test) must be less than or equal to 55 mg Hg, and oxygen saturation level of 88% or less while you are awake.
Other methods of improving your condition must have been attempted to improve your condition, first. Alternatively, other methods may have been considered and expressed to be ineffective by your doctor. This must be documented as such in your medical records.
Will Oxygen Therapy Help Me?
It's important to get necessary oxygen therapy. Not only will it make you feel better, but oxygen therapy use for at least 15 hours a day can increase the survival rate for those with moderate to severe COPD. It will also help prevent heart failure, which is caused by a long term deficiency of oxygen in the blood.
What Will Medicare Cover?
On Medicare Part B, they will help cover the following: Oxygen refills, oxygen concentrators, oxygen tanks and other storage systems, nasal cannulas, masks, tubing and portable oxygen concentrators.
However, Medicare will not cover portable oxygen concentrators which will only be used during sleep, or a portable oxygen concentrator that will be used as a backup to your stationary oxygen concentrator.