What is Oxygen Therapy and How to Get Treatment at Home?

Medicare Benefits Solutions
Feb 4, 2022

People who have breathing disorders like asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, lung disease, pneumonia, or sleep apnea can have trouble absorbing enough oxygen when they breathe. Getting oxygen therapy at home can be a key to helping improve their quality of life. Your healthcare provider may prescribe oxygen therapy if you’re experiencing wheezing, coughing, shortness of breath, shallow breathing, a fast heart rate, or rapid breathing. 

Since oxygen therapy can be vital for giving you some relief from these symptoms in certain situations, it’s vital for Medicare recipients to know if their Medicare benefits will cover the cost of oxygen should you ever need it. 

Medicare Coverage and Oxygen Therapy

Medicare puts oxygen therapy, such as Inogen One G4 portable oxygen concentrators, under the durable medical equipment category. It falls under Part B, and Medicare will help with payment for the necessary equipment, oxygen, supplies, and the delivery of the system if you meet the following: 

• Your doctor prescribes home oxygen
• Your doctor proves that you’re not getting enough oxygen due to a lung disease
• Your arterial blood gasses fall into a certain range
• Oxygen therapy can improve your overall health
• You have previously tried other treatment options with no relief

If any Medicare recipients qualify, the coverage includes the oxygen systems, storage containers, accessories, and tubing that is necessary to deliver the oxygen. If you have to use a humidifier with your oxygen machine, Medicare may cover the cost of this piece of equipment too. You will have to pay 20% of the Medicare-approved amount for this system, and you’ll also pay the deductible for Part B. 

Obtaining Oxygen Therapy Equipment

If your doctor prescribes oxygen and you’re someone with Part B coverage, you can rent the equipment for 36 months from a supplier. When the 36 months are over, and if you still need oxygen, the supplier will allow you to rent the equipment for a further 24 months. If your medical need goes beyond this time, the supplier has to provide you with the supplies and equipment for up to five years. 

The monthly oxygen treatment equipment rental plan includes: 

• Machine maintenance
• Machine repairs and service
• Oxygen contents
• Oxygen equipment
• Tubing and the mouthpiece

If you have oxygen equipment of your own, Medicare coverage will pay for any delivery supplies and the oxygen contents. You will have to pay 20% of the Medicare-approved amount with the deductible for Part B. If you have oxygen therapy for an extended time, you have to consider a few special circumstances. If you move to a new location and get a new supplier, you won’t lose your coverage. However, you will have to inform Medicare and your doctor of the changes. 

Medicare Benefits and Oxygen Supply Costs

Getting an exact quote for oxygen therapy at home is difficult because the price fluctuates based on the machine type, location, and accessories you need. However, the average cost for a weekly rental in the United States is roughly $210 for a portable oxygen concentrator. This price excludes the tubing or other accessories you may need. On a daily basis, it’s roughly $35.00. 

If you are dealing with COPD or another breathing disorder your doctor may prescribe supplemental oxygen therapy to help boost how much oxygen is in your blood. Research shows that using this therapy for some medical conditions reduces the stress levels on your heart, improves brain function, improves your exercise tolerance, and can improve your overall quality of life.