Key takeaways

  • Medicare Part B covers oxygen therapy, including portable oxygen concentrators, if deemed medically necessary by a doctor.
  • Under Medicare, you can rent oxygen equipment from an approved supplier, paying monthly for the first 36 months, which covers maintenance and repairs.
  • After the rental period, Medicare may continue covering maintenance, and after 5 years, you can get new equipment, starting a new rental period.

Medicare provides coverage for oxygen therapy, including portable oxygen concentrators, under Part B. A doctor must consider oxygen therapy medically necessary for you to qualify for it.

Medicare covers oxygen equipment under its durable medical equipment (DME) benefit. You can rent the equipment from a Medicare-approved supplier and pay a monthly rental fee.

Oxygen concentrators pull oxygen from the air and condense it, allowing you to breathe in higher oxygen concentrations than you’d typically breathe. Portable oxygen concentrators are smaller models than the stationary versions.

To qualify for oxygen therapy under Medicare, a doctor must certify that it’s “reasonable and necessary” for your treatment.

Medicare outlines detailed coverage criteria and testing specifications in its Local Coverage Determination (LCD) for oxygen and oxygen equipment. The criteria involve measurements of arterial PO2 (the amount of oxygen dissolved in your blood) and arterial oxygen saturation.

Medicare can cover a portable oxygen system, such as a portable oxygen concentrator, if you can walk around and a healthcare professional performs your blood gas study while you’re awake or exercising.

Doctors may recommend oxygen therapy to treat a range of conditions, including:

  • chronic obstructive pulmonary disease (COPD)
  • pneumonia
  • asthma
  • heart failure
  • cystic fibrosis
  • sleep apnea

There are various out-of-pocket costs for oxygen therapy under Medicare. Medicare Part B has a monthly premium of $185 and a $257 annual deductible. If you receive coverage for a portable oxygen concentrator, you must pay a 20% coinsurance on the cost of the equipment after meeting your deductible.

You must make monthly payments for the first 36 months that you have your equipment. These payments can cover all necessary accessories, maintenance, and repairs.

However, you may need to pay coinsurance on home visits to repair or service your equipment.

Under Medicare rules, rented oxygen equipment has a useful lifetime of 5 years. As a member, you must make monthly rental payments for the first 36 months of use, regardless of whether you use stationary or portable equipment.

If you meet the criteria for a portable oxygen system, you need to pay for it separately (and in addition to) your stationary system.

After 36 months, you may make no more payments for the rest of the equipment’s useful lifetime. Medicare covers the cost of maintenance and servicing of the equipment every 6 months for months 37 to 60.

After 5 years, beneficiaries can get new equipment, which starts a new 36-month rental period. Alternatively, they may continue using their current equipment. Whether the rental company retains the title to the equipment or transfers it to your beneficiary may affect whether Medicare continues covering its maintenance.

Find a Medicare-approved equipment provider using Medicare’s search tool.