Medicare's coverage of Inogen and similar portable oxygen concentrators

Medicare Part B covers portable oxygen concentrators, including Inogen brand models, but only if your doctor prescribes them and you meet specific medical requirements. Medicare does not cover the full cost — you typically pay 20 percent of the approved amount after you meet your Part B deductible. The device itself must be prescribed by a doctor who has documented that you have a chronic lung condition requiring supplemental oxygen.

Coverage depends on whether you rent or buy. If you rent through a Medicare-approved supplier, Medicare pays the rental company directly and you pay your share. If you buy, Medicare covers 80 percent of the approved purchase price, and you pay 20 percent. The approved amount varies by region and supplier, so the actual dollar amount you owe will differ depending on where you live and which supplier you use.

Key Takeaways

  • Your doctor must prescribe a portable oxygen concentrator and document that you have a chronic lung condition requiring supplemental oxygen for Medicare to consider coverage.
  • Medicare Part B covers 80 percent of the approved cost for purchase or rental through a Medicare-approved supplier, and you pay 20 percent after meeting your deductible.
  • You must use a Medicare-approved durable medical equipment (DME) supplier; buying directly from a retailer or non-approved seller means Medicare will not cover any cost.
  • The approved amount Medicare pays varies by region, so the out-of-pocket cost depends on your location and which supplier you choose.
  • If you have a Medigap or Medicare Advantage plan, your supplemental coverage may reduce or eliminate your 20 percent cost-share.

How to get a prescription and start the coverage process

Your primary care doctor or pulmonologist must evaluate you and write a prescription for supplemental oxygen. The prescription should specify the type of device (portable concentrator), the flow rate you need, and how many hours per day you need to use it. Without this prescription, Medicare will not cover any oxygen equipment.

Once you have the prescription, contact a Medicare-approved DME supplier in your area. You can search for approved suppliers on Medicare.gov or call 1-800-MEDICARE to get a list. The supplier will verify your Medicare coverage, confirm your prescription with your doctor's office, and explain your out-of-pocket costs before you receive the device. Do not order from a non-approved supplier — Medicare will not pay, and you will owe the full cost yourself.

Rental versus purchase: which costs less

Rental and purchase have different cost structures. With rental, you pay a monthly fee (your 20 percent share) for as long as you use the device. With purchase, you pay 20 percent of the approved purchase price upfront, then own the device. The break-even point depends on how long you expect to use oxygen and the approved amounts in your region.

If your doctor expects you to need oxygen for a short time — weeks or a few months — rental is usually cheaper. If you need it long-term, purchase often costs less over time because you stop making monthly payments once you own it. Ask your DME supplier to show you the total cost for both options so you can compare. Some suppliers also offer trade-in programs if you later want to upgrade to a newer model.

What Medicare considers "medically necessary" oxygen

Medicare covers oxygen only if your blood oxygen level (measured by pulse oximetry or arterial blood gas test) falls below a certain threshold at rest, during exercise, or during sleep. Your doctor must document these test results in your medical record. Common conditions that may have access to include COPD, pulmonary fibrosis, cystic fibrosis, and severe heart disease — but the diagnosis alone does not may provide coverage. The oxygen level measurement is what Medicare requires.

Your doctor may need to order a sleep study or exercise test if your resting oxygen level is borderline. Medicare will not cover oxygen based on symptoms alone, such as shortness of breath. The test results must show that supplemental oxygen will improve your oxygen saturation and reduce strain on your heart and lungs.

Costs you will owe after Medicare pays

Your out-of-pocket cost includes your Part B deductible (which resets each year) and 20 percent of the Medicare-approved amount. In 2024, the Part B deductible is $240, but this amount changes yearly. Once you meet the deductible, you pay 20 percent of whatever the approved amount is for your device and region.

If you have a Medigap plan (supplemental insurance), it may cover your 20 percent cost-share, reducing what you owe to zero or a small copay. If you have a Medicare Advantage plan, your out-of-pocket costs depend on your plan's rules — some cover DME with a copay, others cover it like Original Medicare. Check your plan documents or call your plan's customer service to learn your exact costs before ordering.

Maintenance, repairs, and replacement supplies

Medicare covers replacement parts and supplies needed to keep your oxygen concentrator working, such as tubing, masks, and filters. These are covered under the same Part B rules — you pay 20 percent after your deductible. If your device breaks and cannot be repaired, Medicare will cover a replacement if your doctor confirms you still need oxygen and the device is no longer functional.

Your DME supplier is responsible for maintaining and repairing rental equipment at no cost to you. If you own the device, repairs may be covered if the device is still under warranty or if the repair is deemed medically necessary. Ask your supplier what is covered under your rental agreement or warranty before you sign.

When Medicare denies coverage and what to do

Medicare may deny coverage if your blood oxygen test results do not meet the threshold, if your doctor did not order the right tests, or if you ordered from a non-approved supplier. If you receive a denial letter, you have the right to appeal. The letter will explain the reason for the denial and tell you how to request a review.

To appeal, gather your test results, your doctor's prescription, and any other medical records that show you need oxygen. Send these to the address listed on the denial letter within the timeframe given (usually 120 days). If the appeal is denied, you can request a hearing before an administrative law judge. Your doctor can also write a letter supporting your case and send it with your appeal. Many people succeed on appeal when they provide complete medical documentation.

Frequently Asked Questions

Does Medicare cover Inogen specifically, or only generic oxygen concentrators?

Medicare covers any portable oxygen concentrator, including Inogen, as long as it is prescribed by your doctor and you order it from a Medicare-approved supplier. Medicare does not prefer one brand over another — coverage is based on medical need and the device type, not the manufacturer.

What if my doctor prescribes oxygen but I do not want to use it right away?

You can wait to order the device. The prescription is valid for a set period (usually one year), so you can start coverage whenever you are ready. If the prescription expires, your doctor can write a new one. There is no penalty for delaying, and Medicare will not charge you until you actually receive the device.

Can I buy an Inogen from a retail store and have Medicare pay for it?

No. Medicare only pays when you order from a Medicare-approved DME supplier. If you buy from a retail store, online retailer, or non-approved seller, Medicare will not cover any part of the cost, even if you have a valid prescription. Always confirm the supplier is Medicare-approved before placing an order.

Will my supplemental insurance cover the 20 percent I owe?

Most Medigap plans cover your Part B cost-share, which means they pay the 20 percent you would otherwise owe. Medicare Advantage plans vary — some cover DME like Original Medicare, others have different rules. Call your plan to confirm what your out-of-pocket cost will be before you order.

What happens if I move to a different state?

Medicare coverage follows you, but the approved amount may change because it varies by region. You will need to find a new Medicare-approved supplier in your new state. Contact your current supplier to arrange transfer of your rental or to discuss your options if you own the device. Your new supplier can help you understand the costs in your new location.