Portable oxygen concentrators can be quite expensive and not everyone can easily afford them. So a common question many people have is, “Does Medicare cover a Portable Oxygen Concentrator?”
In this article, we answer this question in clear, plain English. You will also find the average costs of Portable Oxygen Concentrators.
Do Medicare Cover a Portable Oxygen Concentrator?
The short answer is yes; Medicare will cover the cost of Portable Oxygen Concentrators. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your Portable Oxygen Concentrators. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for the costs of a Portable Oxygen Concentrator. Medicare Part B covers a Portable Oxygen Concentrator cost because it is considered Durable Medical Equipment or known as DME.
However, Medicare Part B only covers the rental of a Portable Oxygen Concentrator. Medicare Part B will not cover the purchase of a portable oxygen concentrator.
For Medicare Part B to cover the rental of a portable oxygen concentrator, you have to meet certain criteria. The requirements consist of the following:
- Your healthcare provider says that you have severe lung disease or you’re not getting enough oxygen
- If oxygen therapy might improve your health
- Your arterial blood level falls within a specific range
- Other alternative treatments did not work
What Is Covered
If you meet the criteria, Medicare Part B will also cover the following equipment:
- Containers that store oxygen
- Tubing and other related oxygen accessories
- Humidifier (but only if it is used with the portable oxygen concentrator)
Medicare Part B will cover the rental of portable oxygen concentrators for five years as long as you need oxygen therapy. To start, you will rent the portable oxygen concentrator from your DME supplier for up to 36 months (3 years).
If you still need it after that period, your supplier is must provide oxygen equipment for another 24 months or 2 years. Within those five years, Medicare Part B will cover not only the monthly rental of portable oxygen concentrator but also the following:
- Tubing or mouthpiece
- Oxygen contents
- Machine maintenance
- Service and repairs of the Oxygen machine
Once the five-year period is over, you can start another 36-month payment period and a 5-year supplier obligation period. Medicare Part B will cover 80% of the costs.
Medicare Advantage plans (Medicare Part C) also provides coverage for portable oxygen concentrators as they cover everything Original Medicare covers.
One additional benefit you might receive from Medicare Part C, is that some plans also cover an air conditioner and a portable oxygen concentrator for those who have asthma. However, out-of-pocket costs will vary depending on the plan provided by the plan providers.
How Much Does Portable Oxygen Concentrators Cost?
Portable oxygen concentrators can cost from around $1800 to nearly $3400. Rental costs vary too. But, on average, you can expect the rental to cost around $35 a day or around $225 a week.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover wigs for cancer patients?