Medicare covers portable oxygen equipment, but only if your doctor prescribes it for a medical reason and you meet specific requirements

Medicare Part B pays for oxygen equipment and supplies when a doctor determines you need them to treat a chronic lung condition like COPD, pulmonary fibrosis, or severe asthma. Portable oxygen — the kind you can carry with you — falls under this coverage, but Medicare does not pay for all types or all the time. The equipment must be prescribed by your doctor, ordered through a Medicare-approved supplier, and used in your home. If you buy oxygen equipment on your own or use a non-approved supplier, Medicare will not reimburse you.

The amount Medicare pays depends on whether you rent or buy the equipment. For most people, Medicare covers 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent. Some people with a Medigap or Medicare Advantage plan may have different out-of-pocket costs.

Key Takeaways

  • Your doctor must order portable oxygen equipment and document that you have a chronic lung condition that requires it.
  • You must use a Medicare-approved durable medical equipment (DME) supplier, which you can find through Medicare.gov or by calling 1-800-MEDICARE.
  • Medicare covers the equipment itself, tubing, masks, and replacement supplies, but you pay 20 percent of the approved cost after meeting your deductible.
  • Portable oxygen concentrators and liquid oxygen systems are covered, but coverage rules differ slightly between renting and buying.
  • If your doctor stops prescribing oxygen or you no longer need it, Medicare coverage ends and you must return the equipment to the supplier.

What types of portable oxygen does Medicare cover

Medicare covers three main types of portable oxygen systems: portable oxygen concentrators, liquid oxygen systems, and compressed oxygen tanks. A portable oxygen concentrator is an electric device about the size of a small suitcase that pulls oxygen from the air and concentrates it for you to breathe. Liquid oxygen systems store oxygen in liquid form in a small portable tank that you refill from a larger tank at home. Compressed oxygen tanks are metal cylinders filled with oxygen gas that you carry with you.

Each type has different practical limits. Portable concentrators need to be plugged in or run on batteries, so they work best if you stay within range of a power source or carry extra batteries. Liquid oxygen is lighter and more portable than compressed tanks but requires regular refilling. Compressed tanks are heavy and bulky but do not need electricity or refilling as often.

Your doctor will recommend which type makes sense for your condition and how much oxygen you need per minute. Medicare will only cover the type your doctor prescribes. If you want a different type later, your doctor must write a new prescription and explain why the change is medically necessary.

How to start the process with Medicare

The first step is a conversation with your doctor. Tell your doctor you have trouble breathing or that your current oxygen setup is not working for you. Your doctor will do a blood oxygen test (called a pulse oximetry or arterial blood gas test) to measure how much oxygen is in your blood. If the test shows your oxygen level is too low, your doctor will write a prescription for oxygen and specify how many liters per minute you need and when you should use it.

Once you have a prescription, you need to find a Medicare-approved DME supplier — a company licensed to rent or sell medical equipment to Medicare patients. You can search for suppliers in your area on Medicare.gov by going to the "Supplier Directory" or by calling 1-800-MEDICARE and asking for a list. When you contact a supplier, have your prescription and Medicare number ready. The supplier will verify your coverage, explain your costs, and arrange delivery and setup of the equipment.

The supplier handles most of the paperwork with Medicare. You will receive a written notice from Medicare explaining what is covered and what you owe. Read this notice carefully. If something looks wrong — for example, if Medicare says you do not meet the requirements — you have the right to appeal.

Renting versus buying portable oxygen equipment

Medicare covers both renting and buying, but the rules are different. When you rent equipment, you pay a monthly rental fee. Medicare pays 80 percent of the approved rental amount; you pay 20 percent. After you have rented for 36 months, the equipment becomes yours and rental payments stop. This is called the "rental-to-purchase" option and is the most common path for Medicare patients.

If you buy equipment outright, Medicare pays 80 percent of the approved purchase price in one payment. You pay 20 percent upfront. Buying makes sense if you want to own the equipment when ready or if you have a Medigap plan that covers your 20 percent share. However, you are responsible for repairs and replacement parts after purchase.

The approved amount Medicare uses to calculate your cost is set by Medicare, not by the supplier's price tag. If a supplier charges more than the approved amount, you do not pay the difference — the supplier writes it off. This is called "accepting assignment." All Medicare-approved suppliers must accept assignment, so shop around and compare what different suppliers charge you out of pocket, not their list prices.

What Medicare covers and what you pay for

Medicare covers the oxygen equipment itself, the tubing and masks you use to receive oxygen, and replacement supplies like filters and cannulas. It also covers a backup system so you have equipment at home and a portable unit to take with you. Repairs and maintenance are covered as long as you are renting; if you bought the equipment, repairs may or may not be covered depending on what broke.

Medicare does not cover oxygen itself — the actual gas. Some suppliers include oxygen in their rental fee; others charge separately. Ask your supplier whether oxygen is included in the monthly cost or billed separately. If billed separately, that charge is not covered by Medicare and you pay the full amount.

Medicare also does not cover accessories like carrying cases, batteries for portable concentrators, or travel insurance. These are your responsibility. Some suppliers offer them at an extra cost; others do not. Ask about these costs upfront so you know your total out-of-pocket expense.

When Medicare stops covering portable oxygen

Medicare coverage ends if your doctor determines you no longer need oxygen. This might happen if your lung condition improves or if your oxygen levels return to normal. Your doctor will order a new blood oxygen test and, if the results show you no longer meet the medical requirement, will stop the prescription. When the prescription ends, notify your DME supplier when ready. If you are renting, you stop paying rent. If you bought the equipment, it is yours to keep, but Medicare will not pay for any future repairs or supplies.

Coverage also ends if you move out of your home for more than 30 days — for example, if you enter a hospital, nursing home, or rehabilitation facility. Medicare assumes you will receive oxygen through that facility. When you return home, your doctor can restart the prescription and you can resume renting or buying from your supplier.

If you disagree with Medicare's decision to stop coverage, you have the right to appeal. Contact your supplier or call 1-800-MEDICARE to request an appeal within 120 days of the notice.

Frequently Asked Questions

Does Medicare cover portable oxygen if I have a Medicare Advantage plan instead of Original Medicare?

Medicare Advantage plans must cover the same oxygen equipment that Original Medicare covers, but your out-of-pocket costs may be different. Some Advantage plans charge a copay instead of 20 percent coinsurance, or they may have different deductibles. Call your plan to ask what you will pay for portable oxygen before you order equipment.

What if my doctor prescribes oxygen but I do not want to use it all the time?

Tell your doctor how often you actually need oxygen — for example, only during exercise or only at night. Your doctor will adjust the prescription to match your real use. Medicare will only cover oxygen for the times your doctor prescribes it. If you use it more often than prescribed, you pay for the extra oxygen yourself.

Can I buy portable oxygen equipment from a store instead of a DME supplier?

You can buy equipment anywhere, but Medicare will only pay if you use a Medicare-approved supplier. If you buy from a non-approved source, you pay the full cost and cannot ask Medicare to reimburse you. Always verify that a supplier is Medicare-approved before you order.

Will my supplemental insurance or Medigap plan help pay for portable oxygen?

Many Medigap plans cover the 20 percent coinsurance that Medicare does not pay, which means you may have little or no out-of-pocket cost. Check your Medigap policy or call your insurance company to confirm what oxygen equipment is covered under your plan.

What should I ask my doctor before getting a portable oxygen prescription?

Ask your doctor how many liters per minute you need, when you should use oxygen (all day, during activity, at night), how long you will need it, and which type of portable system would work best for your lifestyle. Also ask whether your oxygen needs might change and how often you should have your oxygen level rechecked. These details help you and your supplier choose equipment that actually fits your life.