Medicare's New Rules for Paying for Oxygen Equipment

Just like with most laws for how medical coverage works, these laws are subject to change. The newest set of medicare rules started on January 1, 2009. Don't worry – you will still be able to get your oxygen equipment covered, and the rules that changed have only resulted in minor changes.

Changes in How Medicare Pays for Oxygen Equipment

The old law used to state that after the first 36 months of your medicare coverage, you would own your oxygen equipment. That would mean that if medicare helped you pay for a stationary oxygen concentrator, after 36 months you would be the owner of that oxygen concentrator. Once you no longer require the concentrator, or if you get a different one, you would need to return it to the medical supplier.

Your supplier is also required to send you the additional supplies you need, and do the necessary repairs or replacements for an additional 2 years after this first 36 month period. This time period comprises the mandatory 5 year contract between medicare, your medical supplier, and you.

What Medicare Covers, and What You Will Have to Pay

For the first 36 months of coverage (the “rental” period), medicare will cover 80% of all costs for your oxygen therapy equipment, and you will need to pay the medicare part B deductible, as well as 20% of the rental amount.

After the 36 Month Rental Period

As long as you still need the oxygen equipment, medicare will continue to cover it for the next years, or for however long you need it. Medicare will also cover delivery of oxygen if you use refillable tanks.

Benefits of Not Owning the Equipment after 36 Months

One thing that is beneficial under the new law for oxygen therapy patients, is that the supplier will still be fully responsible for servicing and any necessary repairs to the equipment after the first 36 months, and medicare will be billed for these services. If the equipment needs to be replaced, this is the responsibility of the medical supplier, and the patient not incur any out-of-pocket expenses.

What Happens at the End of the Five-Year Contract

Just as with all contracts, you will be free to choose a new medical supplier if you feel the need. Before the end of the 5-year period, your medical supplier will give you a heads up, so you can choose to get replacement equipment or switch suppliers.

One Moving or Traveling

If you are moving or traveling over a long period of time during the first 36 months, ask your supplier if they can help you find a supplier that can help you in your new location. If you are moving or traveling long term after the first 36 months, your current supplier will be responsible for making sure you are still getting what you need from them in your new location. They just won't be able to change the type of equipment they send you.

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