Does Medicare Pay for an Oxygen Concentrator?

This video is the first in a three-part series to help oxygen therapy patients better understand the ins and outs of oxygen therapy and Medicare. Today’s session is called: Just the facts Regarding Medicare Guidelines and Coverage for Oxygen Concentrators.

Does Medicare Pay for Oxygen?

Facts around Medicare Coverage of Oxygen Video

If you are a Medicare beneficiary AND your doctor prescribes supplemental oxygen for you, oxygen therapy equipment IS covered by Medicare. The only question is WHAT equipment has to be provided, and we will cover that a little later. Rest assured, Medicare beneficiaries have coverage for supplemental oxygen.
The needs of a Medicare beneficiary who requires supplemental coverage will be categorized as either needing oxygen only nocturnally (at night when sleeping) or needing supplemental oxygen 24 hours per day. This is important because the type of equipment provided is different for nocturnal only patients or 24 hour per day patients.
Medicare coverage for supplemental oxygen is via a long term rental program. Medicare pays your local provider a monthly “fee” for providing (or renting) you the oxygen equipment needed. This includes having the equipment delivered to your home and regular (usually monthly) supplies of cannulas.

The Medicare provider is responsible for making sure the equipment is in good working order and that it meets the requirements prescribed by your doctor. It is worth noting; Medicare will NEVER pay for the purchase of equipment - the only way Medicare will cover oxygen therapy equipment is via this long term monthly rental program. Since this is our most frequent question and the source of much confusion, I am going to say this one more time. Medicare coverage is ALWAYS via a monthly rental program where a durable medical equipment provider or DME provides your equipment on a rental basis. Medicare will never cover the purchase of oxygen therapy equipment.
A patient needing oxygen only nocturnally will be provided a home or stationary concentrator. A home concentrator is typically a 30 - 50 lb piece of equipment. Here is a range of home concentrators. Unfortunately, there is no requirement on the weight, size, noise level or energy efficiency of the equipment so there can be quite a range. The only requirement, of course, is that it provides medical grade oxygen that meets your medical needs. Any of these models could be provided.
A patient needing oxygen 24 hours per day will be given both a home or stationary concentrator as just described AND a portable solution. By definition, a portable oxygen solution allows a patient to leave home and be mobile. The most common portable solution is tanks. The medical grade oxygen tanks are either delivered to the patients home, or a patient may be provided with a home concentrator that has a “filling” device attached so a patient can fill their tanks at home. A less common solution that is being provided is portable oxygen concentrators. Portable oxygen concentrators provide a patient with mobility because they can operate on AC power (plug it into the wall anywhere ), DC power (plug it into the cigarette lighter in your car) or batteries. Here is a variety of portable oxygen concentrators.
The equipment provided by a Medicare Provider (sometimes also called a durable medical equipment provider or local provider) MUST meet your medical needs. It does not need to be a specific brand, type or solution. Specifically, one of our most frequently asked questions is I have tanks and would like a portable oxygen concentrator, does my provider need to give me one? The answer to this question is NO.

To recap the video:

Medicare does cover supplemental oxygen therapy if prescribed by your physician.
The equipment for patients only needing oxygen nocturnally is a home or stationary concentrator.
Patients needing oxygen 24 hours per day will be provided both a home concentrator and a portable solution.
A portable solution can be either oxygen tanks or a portable oxygen concentrator.
Medicare coverage for supplemental oxygen is via a monthly rental program where the equipment is provided by a Medicare or Durable Medical Equipment provider. Medicare will never cover the purchase of oxygen therapy equipment.
Patients can select their Medicare provider (like you can select your doctor), but a provider is not required to provide a specific brand or portable solution.

We hope this helps provide you with a few clear facts on Medicare and supplemental oxygen coverage. There are two additional videos on Medicare coverage. If you still have questions on Medicare coverage, please feel free to call us and let the Oxygen expert you are working with know that you would like to speak with our Insurance Expert and we’ll be happy to try to answer your questions.