Medicare covers portable oxygen concentrators, but only if a doctor prescribes one and you meet specific conditions

Medicare Part B pays for portable oxygen concentrators when a physician determines you have a medical need — usually chronic lung disease, heart disease, or severe anemia that leaves your blood oxygen too low. The device must be prescribed, not purchased over the counter. Medicare covers the rental or purchase of the concentrator itself, plus the supplies that go with it, such as tubing and masks. However, the amount Medicare pays depends on whether you rent or buy, and whether the supplier is enrolled in Medicare.

The process starts with your doctor ordering the concentrator as Durable Medical Equipment (DME). You then work with a Medicare-approved DME supplier to get the device. Medicare will not pay if you buy from a non-approved supplier, even if the concentrator is identical. The supplier handles the paperwork with Medicare; you do not submit a claim yourself.

Key Takeaways

  • Your doctor must write a prescription stating you have a medical need for a portable oxygen concentrator; Medicare does not cover devices ordered without a physician's order.
  • You must use a Medicare-approved DME supplier, and the supplier submits the claim to Medicare on your behalf.
  • Medicare pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent coinsurance.
  • Renting costs less upfront but adds up over time, while purchasing has a higher initial cost but becomes cheaper after about 13 months of rental payments.
  • Portable concentrators are heavier and use more power than stationary models, so Medicare may deny coverage if your doctor does not document that you need portability specifically.

How Medicare determines what it will pay

Medicare assigns an approved amount to each type of portable oxygen concentrator based on current pricing data. This approved amount is not the same as the retail price; it is usually lower. Medicare pays 80 percent of the approved amount, and you pay 20 percent as coinsurance. You must also meet your Part B deductible first — in 2024, that is $240 — before Medicare begins to pay.

The approved amount varies by device model and by whether you are renting or buying. A rental concentrator has a monthly approved amount; a purchase has a one-time approved amount. If you rent for 13 consecutive months, you own the equipment at that point, and Medicare stops paying rental fees. Some suppliers offer the option to purchase early and credit previous rental payments toward the purchase price, but Medicare does not require this.

If your supplier charges more than the Medicare approved amount, you may owe the difference — called balance billing — unless the supplier has agreed to accept Medicare's approved amount as payment in full. Always confirm with your supplier before you receive the concentrator whether they will balance bill you.

What your doctor needs to document for coverage

Your physician must order the concentrator and document in your medical record that you have a condition requiring supplemental oxygen. Common diagnoses include COPD, pulmonary fibrosis, cystic fibrosis, severe asthma, heart failure, and severe anemia. The doctor's order must specify the oxygen flow rate you need, measured in liters per minute.

For a portable concentrator specifically, your doctor should document why you need portability — for example, that you leave home regularly for work, medical appointments, or daily activities. If your doctor orders a portable concentrator without noting that you need to move around, Medicare may deny the claim and cover only a stationary model instead, which is cheaper. Ask your doctor to mention in the prescription that you require a device you can carry or transport.

Medicare may also request a Certificate of Medical Necessity (CMN) from your doctor. The DME supplier usually handles this paperwork, but your doctor must complete and sign it. The CMN confirms that the concentrator is medically necessary and that you meet Medicare's criteria. Without a signed CMN, the claim will be delayed or denied.

Renting versus buying: the cost difference

Renting a portable concentrator costs less per month but more over time. A typical monthly rental approved amount ranges from $50 to $90, though this varies by device and region. After you pay your Part B deductible, Medicare covers 80 percent of the monthly approved amount, and you pay 20 percent coinsurance each month.

Buying a portable concentrator has a higher upfront cost — the approved amount for purchase typically ranges from $800 to $1,500 depending on the model — but you own it after one payment. After 13 months of rental, you own the rented concentrator anyway, so the total cost of renting for 13 months often exceeds the cost of purchasing outright. If you expect to use oxygen for more than a year, buying is usually cheaper. If your need is temporary or uncertain, renting may make sense.

Some suppliers offer a rent-to-own option where monthly rental payments are credited toward a purchase price. This can be useful if you want to try the device before committing to ownership, but confirm with your supplier and Medicare that this arrangement is allowed and how it affects your coinsurance.

Finding a Medicare-approved DME supplier

Not every medical supply store is a Medicare-approved DME supplier. You can search for approved suppliers in your area on the Medicare DME Supplier Directory at the Centers for Medicare & Medicaid Services (CMS) website, or call 1-800-MEDICARE to ask for a list. Your doctor may also have a preferred supplier they work with regularly.

When you contact a supplier, confirm three things: that they are Medicare-approved, that they carry the specific concentrator model your doctor prescribed, and that they will submit the claim to Medicare on your behalf. Ask whether they will balance bill you if their charge exceeds Medicare's approved amount. Get the answers in writing or take notes with the date and name of the person you spoke with.

If your first choice of supplier is not Medicare-approved, do not buy from them and expect Medicare to reimburse you. Medicare will not pay, and you will owe the full cost. Stick with an approved supplier to may support Medicare covers its share.

What happens if Medicare denies your claim

Medicare may deny coverage if your doctor did not document a medical need, if the concentrator was not prescribed, if you used a non-approved supplier, or if the claim lacks a signed Certificate of Medical Necessity. You have the right to appeal a denial.

To appeal, you must act within 120 days of the denial notice. Contact your DME supplier first — they often handle appeals on your behalf. If the supplier does not help, you can file an appeal yourself by writing to the Medicare contractor listed on your denial notice. Include a copy of your doctor's prescription, your medical records showing your diagnosis, and an explanation of why you believe the claim should be covered.

If your appeal is denied again, you can request a hearing before a Medicare Administrative Law Judge. This process takes longer but is free. Your doctor or supplier can provide supporting documentation to strengthen your case.

Portable concentrators versus stationary models under Medicare

Stationary oxygen concentrators are cheaper and use less electricity, so Medicare's approved amount for a stationary model is lower than for a portable one. If your doctor does not specifically document that you need portability, Medicare may cover only a stationary concentrator. Stationary models are heavier, require a power outlet, and are designed to stay in one room.

Portable concentrators weigh between 5 and 10 pounds, run on batteries or AC power, and are meant to travel with you. They cost more because of the battery technology and smaller size. If you spend most of your time at home and rarely leave, a stationary model may be sufficient and cheaper. If you work, travel, or attend appointments outside your home, a portable model is more practical, and your doctor should document this in the prescription.

Frequently Asked Questions

Does Medicare Part D cover oxygen concentrators?

No. Part D covers prescription drugs only. Oxygen concentrators are covered under Part B as Durable Medical Equipment. Do not confuse the two programs.

What if I already own a portable concentrator and want Medicare to pay for it?

Medicare will not reimburse you for equipment you bought before getting a prescription and working with a Medicare-approved supplier. Medicare pays only when you follow the correct process: doctor's prescription, Medicare-approved supplier, and claim submitted before or at the time of delivery. If you bought a concentrator on your own, you cannot go back and ask Medicare to pay.

Can I use my Medigap or Medicare Advantage plan to cover the 20 percent coinsurance?

Many Medigap plans cover the 20 percent coinsurance for DME. Medicare Advantage plans vary — some cover DME the same way Original Medicare does, while others have different rules. Check your plan documents or call your plan's customer service to confirm what your coinsurance will be.

What if I need a new concentrator because mine broke?

If you are renting, contact your supplier — they usually replace a broken concentrator at no cost as part of the rental agreement. If you own the concentrator, you are responsible for repair or replacement costs unless the device is still under warranty. Medicare does not pay for repairs or replacements after you own the equipment.

Do I need prior authorization from Medicare before I order a concentrator?

Your DME supplier will handle any prior authorization needed. Some suppliers submit the prescription and CMN to Medicare before ordering the concentrator to confirm coverage; others order it and submit the claim afterward. Ask your supplier what their process is so you know when to expect the concentrator to arrive.