Does Medicare cover home oxygen?

What does Medicare cover for home oxygen?

Medicare Part B covers oxygen and oxygen equipment for use in your home as durable medical equipment (DME). Medicare helps pay for:

• Systems that give oxygen
• Containers that store oxygen
• Tubing and related supplies for delivering oxygen and oxygen contents
• Oxygen accessories, including oxygen humidifiers

Who qualifies for Medicare home oxygen coverage?

You qualify when you meet all of the conditions below. You may also be eligible if you have certain conditions, like cluster headaches, that aren't related to arterial blood gas levels.

• 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

What oxygen test results does Medicare use?

Under CMS's national coverage policy for home oxygen, your treating practitioner must order and evaluate a clinical test, usually an arterial blood gas test, though an ear or pulse oximetry reading is also acceptable, taken when you need the oxygen. Your oxygen equipment supplier can't do the qualifying test. Results that qualify include:

• An oxygen saturation at or below 88%, or an arterial oxygen level (PO2) at or below 55 mm Hg, at rest while breathing room air
• Readings at those levels only during sleep, which covers oxygen for use during sleep (portable oxygen isn't covered in that case)
• Readings at those levels only during exercise, which covers oxygen during exercise if the oxygen improves your low reading
• An arterial oxygen level of 56 to 59 mm Hg or a saturation of 89%, if you also have swelling that suggests congestive heart failure, pulmonary hypertension or cor pulmonale, or erythrocythemia with a hematocrit over 56%

What do I pay for home oxygen?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount. You rent oxygen equipment from a supplier for 36 months, and the monthly rental payments cover the equipment, all refills of tanks or cylinders if you use gaseous or liquid oxygen, needed supplies and accessories like tubing, a mouthpiece or a trans-tracheal oxygen catheter, and the maintenance and servicing the equipment needs to work properly.

If you use an oxygen concentrator or equipment that fills portable tanks at home, you may have to pay coinsurance every 6 months for maintenance and servicing, starting 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.

What happens after 36 months or 5 years of oxygen?

After Medicare makes rental payments for 36 months, payment for the oxygen equipment ends, but Medicare continues to pay your supplier to give you oxygen and oxygen equipment for as long as you need it, up to 5 years after you started using the equipment.

After 5 years, the supplier no longer has to keep giving you oxygen and equipment. If you still need oxygen, you must get new equipment, and Medicare begins a new 36-month payment period. There's no limit to the number of times you can get replacement oxygen equipment, and the new equipment can come from the same supplier or a different one.

Does Medicare cover oxygen when I travel?

Medicare won't pay for any oxygen related to air travel, and your oxygen supplier isn't required to give you an airline-approved portable oxygen concentrator, though you may be able to rent one from your supplier. If you travel away from home for several weeks or months, or move, during the 36-month rental period, ask your current supplier to help you find a supplier in the new area or use Medicare.gov's supplier directory. After the 36-month period, your supplier is generally responsible for making sure you have oxygen and equipment in the new area.