Are Philips Respironics Concentrators Covered by Medicare?

A Philips Respironics portable oxygen concentrator (POC) is an perfect option for those who want to travel and move around their community with ease. These concentrators are small, compact, lightweight, and easy to take with you wherever you want to go. However, many people who would like to purchase a Philips Respironics portable oxygen concentrator want to know: does Medicare cover these units? While it seems that there should be a simple "yes" or "no" answer to this question there typically isn't.

Medicare and Supplemental Oxygen: How it Works

Medicare Part B covers most durable medical equipment, and some concentrators from Philips Respironics fall into this category. So, it is possible that Medicare would pay for you to have a Respironics portable oxygen concentrator.

If you have Original Medicare, you pay 20% of the Medicare-approved amount after meeting your Part B deductible for whatever Medicare has approved for you to have to meet your oxygen needs. This might include a home unit, oxygen tanks for travel, or possibly a portable oxygen concentrator.

It’s also important to note that you must meet certain health-related measures for Medicare to cover the delivery of oxygen and equipment to you, such as:
  • Your doctor says you have a severe lung disease
  • Your doctor says you aren’t getting enough oxygen
  • Your health might improve with oxygen therapy
  • Your arterial blood gas level falls below a certain range
  • Other alternative treatments have failed
Medicare does not cover the purchase of any oxygen equipment. Instead, they cover the cost of the rental of oxygen equipment by paying an oxygen equipment supplier a fee each month for providing you with oxygen. Your oxygen needs help to determine what oxygen equipment the supplier provides you with.

If you require supplemental oxygen only at night, they will provide you with a stationary, home concentrator. These units are typically 30-50 lbs and there are no requirements on size, noise level, or energy efficiency that these units need to meet. They simply need to provide you with the supplemental oxygen that you need.

If you require supplemental oxygen 24/7, the oxygen equipment supplier will also provide you with a portable option. Unfortunately, this portable solution is often bulky, medical-grade oxygen tanks. Sometimes, they will provide you with a portable oxygen concentrator as your mobile solution.

Why Medicare often Does Not Pay for Portable Oxygen Concentrators

The reason that most people aren’t able to get a Medicare-covered portable oxygen concentrator is that in 2013, Medicare cut its reimbursement rates by 50%. This meant that the cost of providing a portable oxygen concentrator was now more than what oxygen suppliers were being reimbursed for.

Therefore, these suppliers simply do not offer portable oxygen concentrators to patients very often because they aren't being paid back for them by Medicare. However, the best way to find out if Medicare will pay for a Philips Respironics POC is to call your oxygen supplier and ask if they will.

You can also give us a call to talk more about Medicare and portable oxygen concentrators. We would be happy to help answer any questions that you have.

So, What are My Options?

This issue with Medicare often leaves people thinking that they are going to be unable to afford a portable oxygen concentrator and that they should continue using the oxygen tanks that their supplier provided them as their portable option.

However, this option doesn't work for everyone. Oxygen tanks are bulky and aren't meant to accompany you when you travel. Not to mention, if you are paying out-of-pocket for refills, costs can add up quickly!

So, while you may be able to get these traditional solutions more easily through Medicare, Philips Respironics POCs offer many advantages over these traditional solutions:

  • The portable concentrator units are small and light enough to carry around daily, giving you the freedom to travel wherever you want.
  • There are no refills to worry about with portable oxygen concentrators.
  • The units run on batteries, which are easy to charge and change.
  • Philips Respironics portable oxygen concentrators are FAA approved for use on flights.
  • Cleaning the unit is simple and easy.
It's clear to see why many people still want a portable oxygen concentrator. Don’t worry, there are many ways to save money on one!

How You Can Save Money on a Philips Portable Oxygen Concentrator

The best ways to cut costs so that you can have a portable oxygen concentrator of your own are:

Key Takeaways

Portable oxygen concentrators offer many benefits over the traditional solution of an oxygen tank. However, they are typically not covered by Medicare. But there are multiple ways to save money so you can have a portable oxygen concentrator of your own and have the freedom you deserve to travel wherever you want.

Have More Questions?

Give us a call at 877.774.9271 and we would be happy to review Medicare coverage for oxygen concentrators with you.

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