Chronic Obstructive Pulmonary Disease (COPD) can make everyday activities feel exhausting, but oxygen therapy can provide much-needed relief. Many seniors and individuals with COPD qualify for an oxygen concentrator through Medicare, but navigating the process can be confusing. Here’s how to secure an oxygen concentrator with Medicare coverage and breathe easier today.

Understanding the Need for Oxygen Therapy

COPD is a progressive lung disease that makes it difficult to breathe. As lung function declines, oxygen therapy can help maintain energy levels, reduce breathlessness, and improve overall quality of life. Oxygen concentrators are a preferred solution for many COPD patients, as they provide a continuous supply of oxygen without the need for bulky oxygen tanks.

Medicare recognizes the importance of oxygen therapy and provides coverage for those who meet specific medical criteria. However, securing an oxygen concentrator through Medicare requires understanding the eligibility requirements and following the right steps.

Medicare Coverage for Oxygen Concentrators

Medicare categorizes oxygen concentrators as durable medical equipment (DME), meaning they are covered under Medicare Part B when deemed medically necessary. Here’s what’s included in Medicare’s oxygen therapy coverage:

• Oxygen concentrators and other oxygen delivery systems
• Tubing and related oxygen supplies
• Ongoing maintenance and servicing of equipment

However, Medicare does not cover the purchase of an oxygen concentrator outright. Instead, it funds a rental agreement through an approved supplier for up to 36 months, followed by continued coverage for maintenance.

Who Qualifies for Medicare-Covered Oxygen Therapy?

To qualify for an oxygen concentrator through Medicare, you must meet the following criteria:

✔ A diagnosed lung disease like COPD, emphysema, or pulmonary fibrosis
✔ Blood oxygen levels that fall below Medicare’s threshold, confirmed through arterial blood gas (ABG) testing or pulse oximetry
✔ A prescription from a Medicare-approved doctor stating that oxygen therapy is necessary
✔ Demonstrated need for oxygen therapy at home and not just in a clinical setting

Once a healthcare provider confirms that oxygen therapy is required, Medicare will help cover the cost through a participating durable medical equipment (DME) supplier.

How to Apply for an Oxygen Concentrator Through Medicare

Follow these steps to ensure smooth approval and coverage for your oxygen concentrator:

1️⃣ Schedule a Doctor’s Appointment – Your physician will assess your oxygen levels and determine if you meet Medicare’s medical necessity criteria. They will provide a prescription for oxygen therapy if you qualify.

2️⃣ Complete Required Testing – Medicare requires oxygen saturation testing while at rest, during activity, and while sleeping. A doctor may conduct an arterial blood gas (ABG) test to measure oxygen levels more precisely.

3️⃣ Find a Medicare-Approved DME Supplier – Medicare only covers oxygen concentrators rented through approved durable medical equipment (DME) providers. Use Medicare’s official supplier directory to locate one in your area.

4️⃣ Submit Paperwork and Get Approved – Your supplier will coordinate with Medicare to process your oxygen therapy coverage. Once approved, you’ll begin renting an oxygen concentrator under Medicare’s 5-year payment plan.

How Much Will You Pay Out-of-Pocket?

Medicare Part B covers 80% of the rental cost of an oxygen concentrator. You are responsible for the remaining 20% co-pay, unless you have supplemental insurance or Medicare Advantage (Part C), which may cover the full cost.

Additionally, some Medicare Advantage plans offer extra benefits, including portable oxygen concentrators. It’s worth checking with your plan provider to explore additional coverage options.

Are Portable Oxygen Concentrators Covered by Medicare?

Traditional stationary oxygen concentrators are fully covered under Medicare’s rental plan. However, portable oxygen concentrators (POCs), which provide greater mobility, are not always covered. Medicare considers POCs a luxury item, and beneficiaries may need to pay out-of-pocket or explore alternative funding sources.

Some options include:

• Supplemental insurance plans that cover medical equipment
• Nonprofit organizations that assist with oxygen therapy costs
• Manufacturer financing programs to help spread out payments

Alternatives for Those Who Don’t Qualify for Medicare Coverage

If you don’t meet Medicare’s requirements, there are still ways to obtain an affordable oxygen concentrator:

• Look for refurbished or second-hand units through medical supply stores
• Seek out financial assistance programs from COPD support organizations
• Consider rental options from independent suppliers offering budget-friendly plans

Breathe Easier with the Right Oxygen Therapy

COPD doesn’t have to limit your quality of life. With Medicare assistance, you may be able to secure an oxygen concentrator at little to no cost. If you or a loved one needs oxygen therapy, speak to a Medicare-approved doctor today to begin the process of obtaining coverage.