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

Medicare Part B covers 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 will only pay if you use it outside your home and your oxygen levels meet a specific threshold on a blood test.

The coverage includes the portable oxygen device itself, the oxygen supply, and related equipment like tubing and masks. However, you pay 20% of the approved amount after you meet your Part B deductible, and Medicare decides which supplier you can use in most cases. The process requires a prescription from your doctor, a blood oxygen test showing medical need, and approval from Medicare before you receive the equipment.

Key Takeaways

  • Your doctor must prescribe portable oxygen and order a blood oxygen test that shows your oxygen level is low enough to meet Medicare's threshold.
  • Medicare covers the portable oxygen device, the oxygen itself, and supplies like tubing, but you pay 20% of the approved cost after your Part B deductible.
  • You must use a Medicare-approved supplier, and Medicare will not pay for portable oxygen if you only need it at home — it must be for use outside the home.
  • The approval process typically takes one to two weeks after your doctor submits the prescription and test results to Medicare.
  • If your oxygen needs change or you want to switch suppliers, you need a new prescription and Medicare approval before making the change.

What blood oxygen test results Medicare requires

Medicare requires a blood test called an arterial blood gas (ABG) test or a pulse oximetry test to measure your oxygen level. Your oxygen saturation must be at or below 88% while you are at rest, or between 89% and 90% if you have heart problems or swelling in your legs and feet. Some people also may have access to if their oxygen drops below these levels during exercise or sleep, but your doctor has to specifically test for this and document it.

The test must be done within 30 days before your doctor submits the prescription to Medicare, or within 30 days after. If your oxygen levels improve and you no longer need portable oxygen, Medicare will stop covering it. Your doctor should retest you every 30 to 90 days to confirm you still meet the requirement, depending on your condition.

How to start the process with your doctor

Schedule an appointment with your doctor and tell them you need portable oxygen for activities outside your home. Bring a list of activities you want to do — walking, shopping, visiting family — because your doctor needs to understand how you plan to use it. Your doctor will order the blood oxygen test if they have not done one recently.

Once the test results show you meet Medicare's threshold, your doctor will write a prescription that includes your oxygen flow rate (measured in liters per minute) and how often you need to use it. Your doctor will also need to specify whether you need the oxygen only during exercise, only at night, or all the time. This prescription goes directly to a Medicare-approved supplier, not to you.

Choosing a supplier and what Medicare approves

Medicare maintains a list of approved suppliers in your area, and your doctor's office can tell you which ones are available. You do not get to choose any supplier you want — Medicare only pays if you use one on their approved list. If you want to use a supplier not on the list, you can, but Medicare will not cover any of the cost.

The approved supplier will contact you to set up delivery and show you how to use the portable oxygen device. Common portable devices include liquid oxygen systems (which are lighter but need refilling) and portable concentrators (which plug into electricity or run on batteries). Medicare covers whichever type your doctor prescribes, but the supplier may have limited options available.

Your costs and what happens after approval

You pay 20% of Medicare's approved amount for the portable oxygen equipment and supplies after you meet your Part B deductible for the year. The exact cost depends on the device type and your specific prescription. If you have a Medigap or Medicare Advantage plan, your supplemental coverage may pay some or all of the 20% you owe.

Oxygen supplies — the actual oxygen you use — are covered as an ongoing cost. You pay 20% of the approved amount for refills or replacements. If you use a portable concentrator that runs on batteries, Medicare covers replacement batteries. If you use liquid oxygen, Medicare covers the refills you need based on how often your prescription says you should use it.

When Medicare stops covering your portable oxygen

Medicare will stop paying for your portable oxygen if your blood oxygen levels improve and you no longer meet the threshold. Your doctor should test you regularly to confirm you still need it. If you stop using the oxygen for more than 30 days without a medical reason, Medicare may assume you no longer need it and end coverage.

If you move to a different state or area, you may need to switch to a different approved supplier. Your current supplier can help you transfer your prescription, but you should confirm with the new supplier that they accept Medicare before you move. If you want to switch suppliers while staying in the same area, you need a new prescription from your doctor and Medicare approval before the switch happens.

Portable oxygen for travel and temporary use

If you travel, your portable oxygen supplier can help you arrange oxygen delivery at your destination or provide a portable device you can take with you. You should contact your supplier at least two weeks before you travel to arrange this. Medicare covers the cost of portable oxygen you use while traveling, but you still pay your 20% share.

If you need oxygen only temporarily — for example, while recovering from surgery — your doctor can prescribe it for a set time period. Medicare will cover it during that time, and coverage will end on the date your doctor specifies. If you still need it after that date, your doctor can write a new prescription and Medicare will review it again.

Frequently Asked Questions

What if I only need oxygen at home, not when I go out?

Medicare does not cover portable oxygen if you only use it at home. Medicare covers stationary oxygen equipment for home use under different rules. If you need oxygen both at home and away from home, talk to your doctor about coverage for both types of equipment.

Can I buy my own portable oxygen instead of renting from a Medicare supplier?

You can purchase portable oxygen from any supplier, but Medicare will only pay if you use an approved supplier. If you buy from a non-approved supplier, you pay the full cost yourself. Some people choose to do this if they want a specific brand or model not available through Medicare suppliers.

How long does it take to get approved and receive portable oxygen?

The approval process usually takes one to two weeks after your doctor submits your prescription and blood test results to Medicare. Once approved, the supplier typically delivers your equipment within a few days. If you need oxygen urgently, talk to your doctor about expedited approval options.

What happens if my oxygen prescription changes?

If your doctor changes your oxygen flow rate or how often you need to use it, they will write a new prescription. The supplier will update your equipment or provide new supplies based on the new prescription. Medicare will review the change to make sure it is medically necessary.

Does Medicare Advantage cover portable oxygen the same way?

Medicare Advantage plans must cover portable oxygen at least as well as Original Medicare does, but some plans may cover it differently or have different approved suppliers. Check your plan's coverage details or call the plan to confirm what you will pay for portable oxygen equipment and supplies.