Like most kinds of medical equipment, oxygen concentrators are not free (or cheap). They make life easier for millions of people with breathing issues. That said, high rental and purchase costs make them too expensive for some (especially the uninsured). The high cost leaves many people asking the same question: are portable oxygen concentrators covered by Medicare?
You might be familiar with oxygen concentrators if you have asthma, COPD, lung cancer, or other breathing issues. These tanks deliver oxygen to patients who have trouble breathing or have low blood oxygen levels. Most oxygen tanks use a “pulse flow” mechanism that only delivers air when a patient inhales. This mechanism helps make them one of the most efficient methods for oxygen intake.
The Cost of Oxygen Concentrators
Let’s first look at the cost of oxygen tanks. Without any insurance, you can expect to pay between $1500 and $3500 to purchase a portable oxygen tank. Prices will also vary based on air capacity, battery life, and accessories, among other things.
You also have the option of renting a concentrator. Though prices vary by supplier, you can expect to pay as much as $35 per day without insurance. This may seem high, but rental fees usually include parts and repairs for as long as you have the device. Your supplier may or may not include these services if you choose to buy your tank.
Are Portable Oxygen Concentrators Covered by Medicare?
Yes, Medicare does cover portable oxygen concentrators. Medicare categorizes oxygen tanks as Durable Medical Equipment (DME). Therefore, Part B covers oxygen tanks as DME.
However, Medicare does not provide oxygen tanks for just anyone. You will have to meet ALL of the following criteria to get an oxygen concentrator through Medicare:
- A doctor must confirm that you either 1) have a severe lung disease or 2) are not getting enough oxygen
- A doctor must be able to show that oxygen therapy could have a positive effect on your health
- Your blood oxygen levels must fall below 60 mm Hg or fall within an unsafe range (as determined by your doctor)
- You must have tried alternative methods without seeing improvement in your condition
If you can meet all of these criteria, Part B will pay for the rental of an oxygen tank. You will pay 20% of the Medicare-approved amount, which may differ from the price set by the supplier. Thus, Medicare can save you up to 80% (or more) on the cost of an oxygen tank rental.
Agent TipPurchasing a Medicare Supplement (Medigap) plan or a Medicare Advantage Plan can help cover your out-of-pocket costs associated with your Oxygen Concentrator. Contact us at 800-208-4974 for a free plan comparison!
How Long Will Medicare Cover My Oxygen Concentrator?
The first rental period for an oxygen tank is 36 months (3 years). If your doctor determines that you still need the equipment after this period, Medicare will extend the period by 24 months. In short, Medicare will cover an oxygen concentrator rental for up to 5 years through a single supplier.
However, this doesn’t mean that you can only get Medicare to cover an oxygen tank for five years. Most people who need help getting oxygen suffer from chronic breathing issues. As a result, they might need an oxygen device for more than five years.
The five year period simply determines how long you must obtain your oxygen device through one supplier. If you still need a tank after the first five years, you can start a new period. When one period ends, you can choose to get your device through a different supplier for the next five years.
Thus, once the first 5-year period ends, a new one begins. During each five year period, Medicare requires the supplier to provide you with accessories, maintenance, and repairs (as needed). You won’t need to pay extra for any of these services, as they fall within the Medicare-approved amount.
What if I Buy My Own Tank?
Medicare will not pay for a device that you can keep. If you buy an oxygen tank on your own, you will have to cover the initial cost. You will also be responsible for the cost of repairs and replacement parts. However, if you meet the criteria for a Medicare-supplied tank, Medicare will cover the delivery of oxygen.
Learn More: How Much Will I Pay For Medicare in 2021?
Does Medicare cover the Inogen One?
The Inogen One is a brand of tanks that provides oxygen to patients at a fraction of the cost. According to Inogen, you can rent an Inogen One tank for as little as $2 per day. This comes out to just $700 per year. So, even if you don’t have Medicare, the Inogen One might be one of the most affordable options on the market.
Medicare Part B does cover the Inogen One as long as you meet the requirements for a prescribed oxygen tank. The Inogen One comes in three different forms: G3, G4, and G5. Each type varies in size and price. For more information on renting an Inogen One with or without Medicare, consult Inogen’s Pricing Guide.
Read more: Original Medicare Articles
Figuring out the Medicare requirements for oxygen tanks might feel daunting. You will have to meet certain criteria to qualify. In addition, the quality of your device and services can vary by supplier. So, let’s do a quick recap of all of the essential information in this guide:
- Are portable oxygen concentrators covered by Medicare? Yes, as long as a doctor prescribes it to you and you meet all of the requirements for oxygen equipment.
- Will Medicare cover the purchase of an oxygen concentrator? No. Medicare will only cover oxygen equipment rentals.
- How long will Medicare cover my equipment? Medicare will pay for 80% of the rental costs for up to 5 years at a time through one supplier. Once the 5-year period ends, a new period can begin with the same supplier or a new one.
- What will suppliers provide? Medicare requires suppliers to provide the tank, oxygen deliveries, replacement parts, and repairs.
- Does Medicare cover the Inogen One? Yes, as long as you meet the requirements for oxygen equipment outlined above.
- Consider purchasing a supplemental plan to help cover the 20% that Medicare does not pay for.
thumbIf you have any more questions about Medicare coverage or want to learn about cost-sharing Medigap options, call us at 800-208-4974 today!