Medicare Portable Oxygen Coverage Guidelines

Medicare may also help cover oxygen and supplies if you own oxygen therapy equipment.

Medicare portable oxygen coverage guidelines.

Your supplier must provide equipment and supplies for up to a total of 5 years as long as you have a medical need for oxygen. Medicare s oxygen coverage criteria divides beneficiaries into three coverage groups group i. Coverage and payment related to covid 19 medicare original medicare. If you travel by plane your oxygen supplier isn t required to give you an airline approved portable oxygen concentrator and medicare won t pay for any oxygen related to air travel.

Arterial po2 is 55 mm hg or less or saturation is 88 or less group ii. Dme includes a wide range of medical equipment including oxygen supplies such as the systems storage containers tubing and associated accessories needed to transport the oxygen. If you have medicare and use oxygen you ll rent oxygen equipment from a supplier for 36 months. Medicare part b which includes a variety of outpatient services covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them.

Dependent edema suggesting congestive heart failure or pulmonary hypertension or cor pulmonale or. Also rentals are available through online companies that work with most airlines. Medicare covers 80 of the costs of oxygen equipment rental after a person has met the yearly deductible. Medicare part b medical insurance includes coverage for medically necessary services and supplies including benefits for durable medical equipment dme.

After 36 months your supplier must continue to provide oxygen equipment and related supplies for an additional 24 months. However the portable oxygen benefit can be satisfied with small liquid tanks larger gaseous tanks or a portable oxygen concentrator. Yes your medicare oxygen benefit covers the cost of portable oxygen. No medicare will not cover a portable oxygen concentrator in addition to the oxygen tanks you most likely already receive.

They don t pay more money for more equipment. Oxygen therapy can serve as a source of relief for those with severe asthma copd emphysema or other respiratory diseases. Medicare s coverage criteria were influenced by the patient population and results of the nott study. For medicare to consider paying for oxygen therapy the beneficiary must meet one of the following background on medicare s oxygen coverage group 1 an arterial po2 at or below 55 mm hg or an arterial oxygen saturation at or below 88.

Requirements for medicare coverage. Medicare covers oxygen therapy in a hospital or at home when you meet specific guidelines. Arterial po2 is 56 59 mm hg or saturation is 89 and. Medicare coverage for oxygen therapy is available when your doctor prescribes it to treat a lung or respiratory condition.

However there are several prerequisites that may determine specific coverage.