Does Medicare Cover Oxygen? Exploring Coverage and Payment Options

Introduction

If you or a loved one use oxygen supplies and equipment, you may be wondering if Medicare covers any of the associated costs. Medicare offers some coverage for oxygen supplies and equipment, but it is important to understand exactly what is covered and how to know if your supplies or equipment qualify for coverage. This article will provide an overview of Medicare coverage for oxygen supplies and equipment and explore the cost and payment options available.

Exploring Medicare Coverage for Oxygen Supplies and Equipment

Medicare Part B covers certain types of oxygen supplies and equipment, including oxygen tanks, tubing, and masks. It also covers portable oxygen concentrators, which are machines that turn ambient air into oxygen and deliver it through tubing directly to the user. However, Medicare does not cover oxygen tents, stationary oxygen concentrators, or liquid oxygen systems.

In order to determine if your oxygen supplies and equipment are covered by Medicare, you must first make sure they are considered “durable medical equipment” (DME). DME is defined as any medical equipment used to serve a medical purpose in the home and can be reused, such as wheelchairs, hospital beds, walkers, and oxygen supplies. If your supplies and equipment meet this definition, they may be eligible for coverage under Medicare Part B.

Understanding the Cost of Oxygen Supplies and Equipment with Medicare

Once you have determined that your oxygen supplies and equipment are considered DME and are eligible for coverage under Medicare Part B, you should review the cost of these supplies and equipment with Medicare. Medicare covers 80% of the approved amount for DME, so you will be responsible for the remaining 20%. The approved amount is the amount Medicare determines to be reasonable for the particular item being purchased.

It is important to note that if you use a supplier that does not accept assignment from Medicare, you may be responsible for higher costs. Suppliers that accept assignment agree to accept the approved amount as payment in full. Therefore, it is recommended that you use a Medicare-approved supplier whenever possible.

In addition to the cost of the oxygen supplies and equipment, Medicare also covers rental fees for oxygen equipment. The rental fees are covered for up to 36 months and after that, Medicare will pay for the purchase of the equipment. However, you will be responsible for any additional costs above the approved amount.

The benefits of Medicare coverage for oxygen supplies and equipment include access to quality products and services and protection against unexpected high costs. Additionally, Medicare covers the cost of oxygen maintenance and repair, which can help you save money in the long run.

Steps to Take When Your Oxygen Supplies are Not Covered by Medicare

If your oxygen supplies and equipment are not covered by Medicare, there are still payment options available to you. You may want to compare Medicare coverage for oxygen supplies to other insurance options, such as private health insurance or Medicaid. Some private health insurance plans may offer more comprehensive coverage for oxygen supplies and equipment than Medicare does.

You may also want to explore other payment options, such as using a credit card or taking out a loan. Additionally, many oxygen suppliers offer payment plans that allow you to spread out the cost of the supplies and equipment over time. Finally, you may be able to get financial assistance from charitable organizations or other sources.

Conclusion

In summary, Medicare Part B covers certain types of oxygen supplies and equipment, including oxygen tanks, tubing, and masks, as well as portable oxygen concentrators. To determine if your oxygen supplies and equipment are covered, you must make sure they are considered “durable medical equipment” (DME). Medicare covers 80% of the approved amount for DME, and you are responsible for the remaining 20%. If your oxygen supplies and equipment are not covered by Medicare, you may want to compare Medicare coverage to other insurance options or explore other payment options.

By understanding the coverage and payment options for oxygen supplies and equipment, you can make informed decisions about your healthcare needs. With the right information and resources, you can ensure you or your loved one get the oxygen supplies and equipment you need at a price you can afford.