Yes, Lincare accepts Medicare for most respiratory and oxygen equipment

Lincare is one of the largest suppliers of home respiratory equipment in the United States and accepts Medicare as payment for oxygen concentrators, portable oxygen tanks, continuous positive airway pressure (CPAP) machines, and related supplies. However, Medicare coverage depends on whether your doctor has written a prescription, whether the equipment meets Medicare's medical necessity rules, and whether Lincare is in-network with your specific Medicare plan.

Not every piece of equipment Lincare sells is covered by Medicare. Medicare covers items it classifies as durable medical equipment (DME) — machines and supplies meant to last at least three years and treat a medical condition. Oxygen equipment generally qualifies. Comfort items, convenience products, or equipment your doctor says you want but do not medically need typically do not.

Key Takeaways

  • Lincare accepts Medicare for oxygen concentrators, portable oxygen, CPAP machines, and related respiratory supplies when prescribed by your doctor.
  • Your doctor must document that the equipment is medically necessary, and Medicare will only pay if the item meets its durable medical equipment rules.
  • You will owe a copay or coinsurance amount set by Medicare, usually 20 percent of the approved cost after you have met your Part B deductible.
  • Before ordering from Lincare, ask whether they are in-network with your specific Medicare plan, because out-of-network costs can be much higher.
  • If Lincare denies a claim or says Medicare will not cover something, you can request an explanation and file an appeal with Medicare directly.

How Medicare pays Lincare for equipment

When you order respiratory equipment from Lincare with a valid prescription, Lincare submits a claim to Medicare on your behalf. Medicare reviews the claim to confirm the equipment is on its approved list and that your doctor's notes show medical necessity. If approved, Medicare pays Lincare a set amount — called the allowed amount — which is usually less than Lincare's full price.

You are responsible for paying your share of that allowed amount. After you have paid your Part B deductible for the year (currently $240, though this changes annually), you typically owe 20 percent of the allowed amount. Lincare should tell you what your out-of-pocket cost will be before you take the equipment home. Some Medicare Advantage plans (Part C) have different cost-sharing rules, so check your plan documents or call the plan directly to confirm.

Lincare cannot bill you for the difference between what Medicare allows and what they charge — that is called balance billing, and it is illegal. If Lincare charges you more than your 20 percent share, contact Medicare to report it.

What respiratory equipment Medicare typically covers through Lincare

Medicare covers oxygen equipment when your doctor documents that your blood oxygen level is below a certain threshold. This includes stationary oxygen concentrators (machines that pull oxygen from room air), portable oxygen tanks, liquid oxygen systems, and oxygen-conserving devices. Medicare also covers CPAP and BiPAP machines for sleep apnea when a sleep study shows you need them, along with masks, tubing, and filters.

Nebulizers for delivering inhaled medications, ventilators for people who cannot breathe on their own, and suction machines are also covered when medically necessary. Lincare supplies all of these, but coverage is never automatic. Your doctor must write a prescription that includes the specific equipment, the reason you need it, and how often you will use it. Medicare reviewers use this information to decide whether to approve payment.

Equipment that is purely for comfort — such as a humidifier added to an oxygen system just to make the air feel less dry — may not be covered separately. Ask Lincare and your doctor which parts of your order are covered and which you may need to pay for out of pocket.

Checking whether Lincare is in-network with your plan

Lincare has contracts with Original Medicare (Part A and Part B) and with many Medicare Advantage plans, but not all. If you have a Medicare Advantage plan, your plan may require you to use a specific DME supplier, or it may allow you to choose from a network of suppliers that includes Lincare. Using an out-of-network supplier can mean much higher costs for you.

Before you order, call the customer service number on the back of your Medicare card and ask whether Lincare is in-network. If you have a Medicare Advantage plan, also ask whether you need a referral or prior authorization before Lincare can submit a claim. Some plans require Lincare to get written approval from the plan before ordering equipment, which can add a week or two to the process.

What to do if Medicare denies coverage

If Lincare submits a claim and Medicare denies it, Lincare will send you a notice called an Explanation of Benefits (EOB). This document explains why Medicare said no — for example, your doctor's notes did not show medical necessity, or the equipment is not on Medicare's covered list. Read the EOB carefully, because it tells you what information was missing or what rule was not met.

You have the right to ask Medicare to reconsider. This is called filing an appeal. You can ask Lincare to help you gather additional medical records or a letter from your doctor explaining why you need the equipment, then submit those documents to Medicare with a written request for reconsideration. The appeal process usually takes 30 days. If Medicare denies the appeal, you can request a hearing before a Medicare official.

Do not assume that a denial is final. Many denials are overturned on appeal when a doctor provides clearer documentation of medical necessity. If you are unsure how to file an appeal, call 1-800-MEDICARE and ask for help, or contact your State Health Insurance information Program (SHIP), which offers free counseling about Medicare disputes.

Your costs and what to expect at delivery

Your out-of-pocket cost for Lincare equipment depends on your deductible status and your plan type. If you have not yet met your $240 Part B deductible, you will owe the full allowed amount until the deductible is satisfied. After that, you owe 20 percent. For example, if Medicare's allowed amount for an oxygen concentrator is $1,000, and you have already met your deductible, you owe $200.

Lincare should give you a cost estimate before delivery. Ask them to put it in writing so you know exactly what you will owe. If the estimate seems high or you do not understand it, ask Lincare to explain which parts are covered by Medicare and which are not. Some supplies — like replacement tubing or filters — may have different cost-sharing rules than the main equipment.

Lincare also provides ongoing support: they deliver refills, maintain equipment, and troubleshoot problems. These services are usually included in the equipment cost, not billed separately. If you move or change your address, tell Lincare right away so deliveries are not delayed.

When to contact Lincare or Medicare directly

Contact Lincare if you have questions about your prescription, delivery timing, equipment setup, or what your out-of-pocket cost will be. Lincare's customer service can also tell you whether they are in-network with your plan and whether prior authorization is needed. You can reach Lincare through their website or by phone — the number is usually on paperwork your doctor gave you.

Contact Medicare (1-800-MEDICARE) if you have questions about coverage rules, want to file an appeal, or believe Lincare has billed you incorrectly. Medicare can also tell you whether a specific piece of equipment is on its covered list. If you are confused about your Explanation of Benefits, Medicare can walk you through it.

Frequently Asked Questions

Do I need prior authorization from Medicare before Lincare can send me equipment?

Original Medicare does not require prior authorization for most respiratory equipment, but your doctor's prescription must include medical necessity documentation. If you have a Medicare Advantage plan, check your plan documents or call the plan — some require written approval before Lincare can proceed.

What if I cannot afford the 20 percent copay?

If cost is a barrier, ask Lincare whether they offer payment plans. You can also contact your State Health Insurance information Program (SHIP) to learn about programs that help with Medicare cost-sharing. Some nonprofits that focus on respiratory disease also offer financial information.

Can I use Lincare if I have both Medicare and Medicaid?

Yes. Lincare accepts both. Medicare is the primary payer, meaning it pays first. Medicaid may cover your copay or coinsurance if you meet your state's income limits. Tell Lincare you have both so they bill in the correct order.

What happens if my oxygen needs change and I need different equipment?

Your doctor can write a new prescription for different equipment. Lincare will submit a new claim to Medicare. If your needs have changed significantly — for example, you now need portable oxygen when you did not before — make sure your doctor documents the reason for the change in your medical record, because Medicare will want to see it.

Can I switch to a different supplier if I am unhappy with Lincare?

Yes. You can ask your doctor to send your prescription to another Medicare-approved DME supplier. Make sure the new supplier is in-network with your plan. Lincare will stop billing Medicare once you have switched, though you may need to return any equipment they own.