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. Below we discuss the requirements necessary to qualify for oxygen supplies.
Does Medicare Cover Oxygen Therapy?
Yes, oxygen therapy, as well as oxygen therapy tank accessories, are covered under Part B. Oxygen equipment and all accessories are Durable Medical Equipment. Part B covers the rental and use of DME for beneficiaries to use within their homes. 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.
For Medicare to cover oxygen equipment and supplies, beneficiaries must have the following:
- Have a prescription from your doctor
- Have documentation from your doctor showing you have a lung disorder preventing you from receiving enough oxygen and that other measures have not been successful in improving your condition
- Proof of gas levels in your blood from your doctor
It’s more cost-effective to rent your oxygen equipment from a participating DME supplier. Your rental payments will be paid up to 3 years. After that, the supplier will still own the equipment. However, they must still supply oxygen to you for an additional 24 months. If you still need oxygen therapy after 5 years, you can renew your contact with the supplier or find a new one.
If you use an oxygen concentrator, your Part B benefits will cover the cost of servicing your equipment every 6 months once the 36-month rental window has ended.
Does Medicare Cover Portable Oxygen Concentrators?
While Medicare covers small liquid portable tanks, oxygen concentrators are not part of the coverage. Oxygen concentrator devices are much more expensive. This is why suppliers choose to cover the smaller portable oxygen tanks instead since it’s much more cost-effective. Medicare will only approve one payment for oxygen therapy.
How Much Does Oxygen Cost with Medicare?
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!
However, with Part B coverage, you’ll only be responsible for the 20% coinsurance. Unfortunately, this can still be too much for most beneficiaries to spend out of pocket. This is why many choose to enroll in a Medicare Supplement plan, to cover this coinsurance as well as other cost-sharing such as deductibles.
Does Medicare Cover Hyperbaric Oxygen Therapy?
Hyperbaric Oxygen Therapy 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 coverage for this therapy.
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 carrier to determine the coverage guidelines for oxygen therapy. The carrier is the one who sets how much they cover. So, they may cover it, but they may cover less than what Medicare would’ve covered.
Do Medicare Supplement Plans Cover Oxygen Therapy?
Yes, supplement plans help cover the 20% coinsurance that Medicare doesn’t cover. It also covers other cost-sharing in the form of deductibles Choosing Medigap means you choose peace of mind. For those wanting to protect retirement savings, a Medicare Supplement plan will do just that.
How to Get Coverage for Oxygen Therapy Under Medicare
If you’re new to Medicare, or not new and just looking for better coverage, we can help! Our services are completely free. Our job is to educate you on all your options so that you can make the best decision on your healthcare. Give us a call today. Can’t call in now? No worries, fill out our online rate comparison form and discover all options available in your area.