Medicare coverage for oxygen therapy is available when your doctor prescribes it to treat a lung or respiratory condition. Oxygen therapy can serve as a source of relief for those with severe asthma, COPD, emphysema, or other respiratory diseases.
Medicare covers oxygen therapy in a hospital or at home when you meet specific guidelines. Do you have a doctor’s prescription for oxygen?
Below we discuss the requirements necessary to qualify for oxygen supplies.
Medicare Oxygen Guidelines 2020
Many people with respiratory conditions benefit from being “on oxygen” all the time. However, there are stipulations for oxygen therapy coverage through Medicare.
For Medicare to cover oxygen equipment and supplies, beneficiaries must adhere to the following:
- Must be eligible for Medicare
- Get diagnosis and treatment of illness by a physician
- Meet all regulatory and statutory requirements
Once you meet the requirements, contact a local Medicare oxygen supplier to order your goods.
Does Medicare Pay for Oxygen
Medicare covers storage containers for oxygen, tubing, other oxygen accessories, and units that provide oxygen. Also, if the oxygen machine works with a humidifier, this may have coverage.
Does Medicare Cover Oxygen for COPD
Chronic obstructive pulmonary disease (COPD) is a disease within the lungs that is quite common; this disease makes it hard for individuals to breathe.
If you suffer from COPD, Medicare covers a few types of therapies. Further, these therapies may include at-home oxygen use, continuous positive airway pressure devices, and pulmonary recovery.
Does Medicare Pay for A Portable Oxygen Concentrator
Oxygen tanks can be large and quite cumbersome. That’s where a portable oxygen concentrator can come in handy.
However, an oxygen concentrator is a mobile device that operates its flow of oxygen through pulse dosage.
While Medicare potentially covers portable tanks, oxygen concentrators are not part of the coverage.
Oxygen concentrator devices are much more expensive. Although, if a beneficiary prefers a concentrator, they’ll have to purchase this themselves.
Medicare provides monthly rental benefits for oxygen therapy, and it’s much more cost-effective to supply oxygen tanks.
How Much Does Oxygen Cost
Typically, canned oxygen with a concentration of around 95%, runs at about $50 per unit. Canned oxygen could be costly if you were to rely on the constant use of an oxygen machine.
Costs could quickly escalate to more than $1,160 per day and more than $426,000 per year!
Oxygen Covered by Medicare
There are three forms of oxygen available:
- Oxygen concentrator – Not covered
- Liquid oxygen – Covered
- Compressed oxygen gas – Covered
Given all the criteria is met, the following items have coverage by Medicare for oxygen tank use:
- Storage vessels
- Oxygen contents
- Tubing and other necessary accessories
- Devices for providing oxygen
Medicare Coverage for Oxygen Therapy Tanks
Medicare covers the rental of oxygen tanks and all its accessories. Although the equipment is DME and requires a prescription from your doctor.
Also, this form of oxygen therapy proves to have a considerable impact on people’s health and well-being.
How Long Will Medicare Pay for Oxygen
You can rent oxygen equipment from medical suppliers for up to 36 months. Once you’ve met the 36-month mark, the supplier has to continue providing all oxygen equipment for another 24 months.
Medicare Coverage for Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is a form of therapy where your whole body gets exposed to oxygen through increased atmospheric pressure. The oxygen distributes through a chamber.
Medicare usually includes HBOT, most private insurers, and Medicaid. However, HBOT may not be safe in treating some health conditions.
Part B covers HBOT for several of the following ailments:
- Gas embolism
- Acute carbon monoxide intoxication
- Severe peripheral arterial insufficiency
Beneficiaries can expect to pay 20% of the approved amount, and they may have to pay the Part B deductible as well.
Does Medicare Pay for Oxygen in A Skilled Nursing Facility
There are tons of different types of medical equipment that beneficiaries use within skilled nursing facilities.
Oxygen therapy devices also qualify as DME. Part B benefits will cover the use of oxygen equipment for usage within a member’s home.
However, hospitals and nursing homes don’t qualify as “home.” Long-term care facilities do qualify as a “home,” oxygen, and equipment don’t have coverage.
Who Pays for Oxygen in A Nursing Home
Nursing homes don’t qualify as a “home” setting. Therefore, Part B benefits won’t cover the use of DME within this setting.
Choosing to go with a Medicare Advantage Plan may open the doors to obtain coverage of oxygen equipment within a nursing home.
However, the best option is to contact Advantage plans beforehand to ensure coverage of all oxygen equipment is covered.
Will Medicare Advantage Offer Coverage for Oxygen Therapy
Advantage Plans must cover the same health services and equipment that Medicare includes. Fortunately, oxygen falls within this category.
However, costs associated with coverage may vary since these plans are through private insurance companies.
The best bet is to contact the policy itself to determine the coverage guidelines for oxygen therapy.
Medicare Supplement Coverage for Oxygen Therapy
Medigap plans can make oxygen coverage a cost-effective way to go. Members must pay their monthly premium but can expect much lower healthcare costs because of this coverage.
The Supplement Plan helps cover the 20% coinsurance costs that members would otherwise pay. Also, when you choose a Medigap plan, you have access to all the doctors, specialists, and suppliers across the nation that accept Medicare.
Choosing Medigap means you choose peace of mind. For those wanting to protect a retirement egg, contact an agent at the number above.
Can’t call in now? No worries, fill out an online rate comparison form, and discover the best Medicare Supplement policies in your area.
Our agents represent the top carriers in the nation. Also, they’re experts in the Medicare industry willing to help you with the process at no additional cost to you.