Medicare covers oxygen therapy at home, but only if a doctor prescribes it for a medical reason and you meet specific requirements.
Medicare Part B pays for supplemental oxygen — the kind you use at home to treat a chronic lung condition — if your doctor documents that your blood oxygen level is too low. The coverage includes the oxygen itself, the equipment to deliver it (like a concentrator or tank), and the supplies you need to use it (tubing, masks, regulators). You typically pay 20 percent of the approved amount after you meet your Part B deductible; Medicare pays the other 80 percent.
The catch is that Medicare requires specific proof before it will pay. Your doctor must order a blood oxygen test, and the results must show your oxygen level is below a certain threshold. Medicare also requires that the oxygen be prescribed by a doctor who has seen you in person within the past six months. If you already have oxygen from another source, you may need to switch to a Medicare-approved supplier to get coverage.
Key Takeaways
- Medicare Part B covers home oxygen only when a doctor prescribes it based on a blood oxygen test showing levels below Medicare's threshold.
- You pay 20 percent of the approved cost after your Part B deductible; Medicare covers the remaining 80 percent.
- Your doctor must have seen you in person within the past six months and must order the oxygen through a Medicare-approved durable medical equipment supplier.
- Coverage includes the oxygen, the equipment to deliver it, and ongoing supplies like tubing and masks.
- If you use oxygen only during exercise or sleep, Medicare may still cover it, but your doctor must document when and why you need it.
What Test Your Doctor Needs to Order
Your doctor must order an arterial blood gas test or a pulse oximetry test to measure your blood oxygen level. The arterial blood gas test is more precise — it involves drawing blood from an artery — but pulse oximetry (a clip on your finger) is faster and is often used first. Medicare looks at the results to decide whether your oxygen level is low enough to warrant coverage.
The threshold Medicare uses depends on whether you are resting, exercising, or sleeping. At rest, your oxygen level must be 55 millimeters of mercury or lower, or your oxygen saturation must be 88 percent or lower. If your resting level is higher but drops during exercise or sleep, your doctor can still request coverage for oxygen use during those specific times. Your doctor will submit the test results along with the prescription to a Medicare-approved supplier.
How to Find a Medicare-Approved Oxygen Supplier
You cannot straightforward buy oxygen from any company and expect Medicare to pay. You must use a durable medical equipment (DME) supplier that is enrolled with Medicare. These suppliers are vetted by Medicare and agree to accept Medicare's approved amount as full payment (after your deductible and coinsurance).
To find a supplier near you, visit the Medicare Supplier Directory at dmepos.cms.gov or call Medicare at 1-800-MEDICARE. You can search by your zip code and the type of equipment you need. Your doctor can also recommend a supplier they work with regularly. Once you choose a supplier, give them your doctor's prescription and your Medicare information, and they will handle the paperwork with Medicare.
What Happens If Your Oxygen Needs Change
If your condition improves and you no longer need oxygen, your doctor can discontinue the prescription and notify your supplier. Medicare will stop paying, and the supplier will stop delivering oxygen to you. If your condition worsens and you need more oxygen or a different type of equipment, your doctor can order a new test and update the prescription.
Medicare requires that your oxygen prescription be reviewed and renewed periodically — usually every 90 days for the first year, then annually after that. Your doctor and supplier will handle most of this paperwork, but it is worth asking your supplier when your next review is due so you are not caught without oxygen if there is a delay.
Oxygen Equipment Medicare Covers
Medicare covers several types of oxygen delivery equipment. A stationary concentrator (a machine that pulls oxygen from the air in your home) is the most common and is usually the least expensive option. A portable concentrator is smaller and runs on batteries, so you can take it with you. Liquid oxygen systems are also covered but are less common because they require regular refilling. Oxygen tanks (compressed gas) are covered as well.
Your doctor and supplier will recommend the type that fits your lifestyle and medical needs. If you are mostly at home, a stationary concentrator may be all you need. If you travel or spend time away from home, a portable concentrator or backup tanks may be necessary. Medicare covers the equipment itself, and the supplier typically owns or leases it to you — you do not buy it outright in most cases.
What You Pay Out of Pocket
Your costs depend on whether you have met your Part B deductible for the year. Once you meet the deductible (which varies year to year), you pay 20 percent of Medicare's approved amount for the oxygen and equipment. The supplier bills Medicare for the rest.
If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower. Medigap plans can cover some or all of your coinsurance, and Medicare Advantage plans have their own cost-sharing rules. Check your plan documents or call your plan to understand what you will owe. Some suppliers also offer payment plans if you want to spread out your 20 percent share over time.
If Your Claim Is Denied
If Medicare denies your oxygen coverage, it is usually because your blood oxygen test did not show a level low enough to meet Medicare's threshold, or because your doctor did not submit the test results with the prescription. Ask your doctor to review the test results and explain why they believe you need oxygen despite the numbers. Sometimes a second test or a test done under different conditions (like during exercise) can show a clearer need.
You also have the right to appeal a denial. Your supplier or doctor can file an appeal on your behalf, or you can contact Medicare directly at 1-800-MEDICARE to ask about the denial and next steps. The appeal process can take several weeks, so it is worth starting it as soon as you receive the denial notice.
Frequently Asked Questions
Does Medicare cover portable oxygen for travel?
Yes, if your doctor prescribes it. A portable concentrator or backup oxygen tanks are covered under the same rules as stationary equipment. Your supplier can help you arrange portable oxygen before a trip, and some suppliers can coordinate with suppliers in other states if you are traveling long distances.
What if I need oxygen only at night?
Medicare covers oxygen prescribed for nighttime use only, as long as your doctor documents that your oxygen level drops below the threshold during sleep. Your doctor may order a sleep study to measure your oxygen levels while you sleep, and the results will support the prescription.
Can I use my own oxygen equipment instead of renting from a Medicare supplier?
Medicare will not pay for oxygen equipment you own or rent from a non-approved supplier. You must use a Medicare-approved DME supplier for Medicare to cover the cost. If you already own equipment, ask your supplier whether you can use it and have Medicare pay for supplies like tubing and masks instead.
Does Medicare cover oxygen if I have COPD?
Medicare covers oxygen for COPD if your blood oxygen test shows a level low enough to meet Medicare's threshold. COPD is a common reason people need oxygen, but the coverage decision is based on your test results, not your diagnosis alone.
Will my Medicare Advantage plan cover oxygen differently than Original Medicare?
Medicare Advantage plans must cover oxygen at least as well as Original Medicare does, but they may have different suppliers, different out-of-pocket costs, or different approval processes. Check your plan's coverage details or call your plan to understand how oxygen is covered under your specific plan.