Does Medicare Cover Home Oxygen?

Medicare covers different kinds of Durable Medical Equipment (DME) in different ways. Depending on the type of equipment:

• You may need to rent the equipment.
• You may need to buy the equipment.
• You may be able to choose whether to rent or buy the equipment.
• Some items become your property after you’ve made a certain number of rental payments.

Medicare helps pay for:

• Systems that give oxygen.
• Containers that store oxygen.
• Tubing and related supplies for the delivery of oxygen and oxygen contents.

You must meet all these conditions:

• Your doctor or other health care provider says you aren’t getting enough oxygen.
• Your health might improve with oxygen therapy.
• Your arterial blood gas level falls within a certain range.

You may also be eligible if you have certain conditions (like cluster headaches) that aren't related to arterial blood gas levels.

• Make sure your doctors and DME suppliers are enrolled in Medicare and will accept assignment. Medicare will only pay for DME items if you get them from suppliers who are enrolled in Medicare. It’s also important to ask your suppliers if they participate in Medicare or will accept assignment of your claims before you get DME.
• Your health care provider may decide that your oxygen equipment no longer works for you. If so, your provider may contact the oxygen supplier with a new order for different equipment. The oxygen supplier must provide you with equipment that fits your needs, including your mobility needs both inside and outside your home.
• Your supplier can’t change the type of equipment you get each month unless your doctor orders a change.
• Your supplier must give you the amount of oxygen you need each month. If you’re running low on oxygen tank refills, contact your supplier immediately and ask them to deliver more oxygen.

• After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.
• If you have Medicare and use oxygen, you’ll rent oxygen equipment from a supplier for 36 months. What happens if my oxygen supplier goes out of business or leaves the program during my rental period?
• The monthly rental payments cover your oxygen equipment, all refills of tanks or cylinders if you use gaseous or liquid oxygen, and any supplies, accessories, and services necessary for use of the oxygen and oxygen equipment, like::
• Tubing or a mouthpiece
• Any other necessary supplies and accessories, including a trans-tracheal oxygen catheter (if needed)
• Any oxygen equipment maintenance and servicing necessary for the equipment to function properly whenever it's needed
• After Medicare makes rental payments for 36 months, payment for the oxygen equipment ends. However, Medicare will continue to pay your supplier to give you oxygen and oxygen equipment for long as you need it up to 5 years after you started using the equipment. What if my supplier refuses to continue providing my liquid oxygen, oxygen equipment, or related services as required by law?
• If you use either an oxygen concentrator or equipment used to fill portable tanks in your home, you may have to pay coinsurance every 6 months for maintenance and servicing of the equipment. If you have to pay for this service, you’ll begin to pay coinsurance 6 months after the 36-month period ends. The supplier can’t charge you for this service unless they come to your home to inspect and service the equipment.
• If you use oxygen and oxygen equipment for 5 years or more, the supplier of the equipment is no longer obligated to continue giving you oxygen and oxygen equipment. If you still need oxygen and oxygen equipment after 5 years, you must get new equipment and Medicare will begin a new 36-month period of payment for the oxygen and oxygen equipment. There is no limit to the number of times you can get replacement oxygen equipment you need, but every 5 years you must obtain new equipment from a supplier (it doesn’t need to be the same supplier you used before, but it can be).