Will My Insurance Cover My Oxygen Concentrator Costs?

When individuals with COPD are recently prescribed oxygen therapy, usually one of their first concerns is cost.  Oxygen therapy equipment can be fairly expensive and many patients are unaware of insurance benefits available to them.

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Oxygen is considered a medical treatment and must be prescribed by a physician in order for you to receive it.  Some patients need only occasional, short-term oxygen therapy while others require continuous long-term oxygen therapy.  One of the most popular oxygen delivery systems is the oxygen concentrator.  Oxygen concentrators come in a variety of sizes providing solutions for both home and travel.  Almost 80% of Medicare home oxygen patients use oxygen concentrators daily.

Most insurance plans, including Medicare and Medicaid, will cover most of the cost provided your test results show that you require oxygen therapy. Private insurance coverage varies from company to company, so it is important to check with your provider to see if your policy provides coverage.

If you would like Free Help to see what your insurance will cover for a portable oxygen concentrator, take a moment now to answer a few questions.  Our staff can quickly decipher your insurance policy and help you receive your equipment at the lowest possible cost to you.

Oxygen Therapy Patient Wearing CannulaMedicare’s Medical Guidelines for Home Oxygen Therapy varies from state to state.  Most oxygen concentrators produce oxygen that is generally between 87% and 95% pure.  Medicare requires the purity to be greater than 85%.  Since the Medicare monthly fee schedule allowance for portable oxygen concentrators varies from state to state, you should visit their website to see the guidelines for the state you reside in.

Medicare Example
To illustrate how Medicare coverage for oxygen therapy works, let’s look at the state of South Carolina as an example.  Medicare will help pay for oxygen therapy equipment under the following conditions:

  • Your doctor confirms that you have lung disease and that oxygen therapy might improve your condition
  • Your arterial blood gas level falls within a certain range
  • Other alternative methods have been tried and were not effective for you

If you meet these conditions, Medicare will help pay for:

  • Oxygen supply systems (including oxygen concentrators)
  • Oxygen storage containers
  • Oxygen contents
  • Supplies for the delivery of oxygen, such as tubing

Eligibility for Medicare coverage for oxygen therapy requires your test results must show you have a measured blood oxygen of 55 millimeters of mercury (mmHg) or less, or a saturation of 88%.  If your measured blood oxygen is between 56 and 59 mmHg and your saturation is 89%, you can still meet the reimbursement requirements only if you exhibit one of the following symptoms:

If you are eligible, Medicare will pick up 80% of the cost and you or your supplemental insurance must pay the remaining 20% of the Medicare-approved amount.  You must also pay an annual deductible of $131.00 for services and supplies before Medicare coverage begins.  There are 2 exclusions for coverage of portable oxygen systems:

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  1. If oxygen is provided for use during sleep only
  2. If portable oxygen is used only as a backup to a permanent oxygen system

Even if you don’t meet Medicare requirements for coverage or don’t have private insurance and are worried about paying the remaining 20% of costs, don’t dismay.  This website sells oxygen concentrators and offers innovative payment plan options.  If qualified, you can spread out your payments for up to a year, interest free!  To find out how inexpensive and easy it can be to have your new portale oxygen concentrator, fill out the FREE CONSULTATION form, and the staff here at OxygenConcentrators.org will contact you with options.

The FAA ruling and the improved technology of portable oxygen concentrators makes airline travel not only possible for oxygen therapy patients, it makes it easy and without the stigma attached to bulky oxygen cylinders.  Many POC’s, like the Inogen One and SeQual Eclipse, are also battery operated.  For further information on how to safely travel with portable oxygen concentrator batteries, please visit the Department of Transportation (DOT) website.

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