When you’re relying on Original Medicare for insurance coverage, you may wonder what services and supplies it includes, especially if you depend on certain equipment like oxygen. Oxygen equipment may be covered, depending on whether you have Original Medicare or Medicare Advantage. For example, Medicare Part B will cover the rental or purchase of oxygen equipment, but only under certain conditions:
If your doctor determines that oxygen therapy may improve your health
If your arterial blood gas level falls in a certain range
If your doctor determines you are not getting enough oxygen
If other treatments have failed
In this article, we’ll explore what oxygen equipment and supplies are covered by Original Medicare, the general cost of oxygen equipment and supplies and whether Medicare Advantage offers the same coverage as Original Medicare for oxygen equipment.
What oxygen equipment and supplies are covered by Original Medicare?
Original Medicare includes Part A and Part B. Medicare Part B, which acts as outpatient medical insurance, covers the rental or purchase of durable medical equipment, including oxygen equipment, when prescribed by a doctor for use in your home. This includes oxygen concentrators, portable oxygen systems and accessories such as tubing and supplies.
If you have Original Medicare and need to use oxygen, you can rent oxygen equipment from a supplier for 36 months. After 36 months, your supplier must continue to provide oxygen equipment and related supplies for an additional 24 months. They must provide equipment and supplies for up to a total of 5 years, as long as you continue to have a medical need for oxygen. The monthly rental payments to the supplier cover not only your oxygen equipment, but also any oxygen accessories and services like:
Tubing or a mouthpiece
Oxygen contents
Oxygen machine maintenance
Oxygen machine servicing
Oxygen machine repairs
Alternatively, Medicare Part A, which acts as hospital insurance, will also pay for oxygen therapy if it’s part of your treatment during an inpatient hospital stay.
Does Medicare Advantage cover oxygen equipment?
Medicare Advantage, also known as Medicare Part C, is a type of health insurance plan offered by private insurance companies. Medicare Advantage plans provide the same coverage as Original Medicare. However, coverage details will vary depending on your specific plan. If you require oxygen equipment and are considering enrolling in a Medicare Advantage plan, it’s important to carefully review the plan's coverage for durable medical equipment, including oxygen equipment.
How much does oxygen equipment cost?
The cost of oxygen equipment can vary depending on several factors, including the type of equipment, whether you choose to rent or purchase the equipment and your Medicare plan. On average, without Original Medicare coverage, the weekly cost of renting a portable oxygen concentrator starts at about $150, while purchasing the equipment typically starts at $1,000 for a used device and $2,000 for a new one. With Original Medicare coverage or a Medicare Advantage plan, you pay your Part B deductible ($226 in 2023) and then 20% of the Medicare-approved amount after deductible.
You’ll want to contact suppliers or medical equipment providers to get specific pricing information based on your needs and location. It’s also important to review your Medicare Advantage plan or private insurance coverage to understand if there are any additional costs or limitations associated with oxygen equipment.
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