Medicare covers 80% of the cost of a portable oxygen concentrator after you meet your Part B deductible, but the actual amount depends on the specific model and whether your doctor has ordered it as medically necessary.

Medicare Part B covers durable medical equipment (DME), which includes portable oxygen concentrators. The program pays based on a Medicare-approved amount — not the retail price the supplier charges. If a supplier bills $3,000 for a concentrator but Medicare's approved amount is $1,500, the payment calculation uses $1,500. You pay 20% of that approved amount after your deductible is met; Medicare pays the other 80%.

The approved amount varies by concentrator model and by region. Two identical machines from different suppliers may have different approved amounts depending on where you live and which supplier is billing. This is why calling suppliers directly for a price quote does not tell you what Medicare will actually pay.

Key Takeaways

  • Medicare pays 80% of the approved amount for a portable oxygen concentrator after you meet your $240 Part B deductible for 2024.
  • Your doctor must order the concentrator as medically necessary, and you must use it at home; Medicare does not cover concentrators for travel-only use.
  • The approved amount varies by model and region, so the same machine costs you different amounts depending on where you live and which supplier bills Medicare.
  • You can rent a concentrator month-to-month, but if rental payments reach the purchase price, Medicare switches you to a purchase and stops paying rental fees.
  • A Medicare-approved DME supplier must handle the order; you cannot buy a concentrator at retail and submit the receipt to Medicare for reimbursement.

How the 80/20 split works after your deductible

Once you have paid $240 out of pocket toward your Part B deductible in 2024, Medicare begins paying its share. For a portable oxygen concentrator with a Medicare-approved amount of $1,500, you would pay $300 (20%) and Medicare would pay $1,200 (80%). If the approved amount is $2,000, you pay $400 and Medicare pays $1,600.

The deductible applies once per calendar year. If you have already met it by paying for other Part B services (like doctor visits or lab work), you do not pay it again for the concentrator. If you have not met it, the concentrator cost counts toward it.

Your actual out-of-pocket cost also depends on whether you choose to rent or purchase. Rental payments are lower each month but add up over time. Purchase requires a larger upfront payment but no ongoing fees after Medicare and you have paid your shares.

Rental versus purchase: when Medicare stops paying rent

Medicare allows you to rent a portable oxygen concentrator on a month-to-month basis. Monthly rental payments are typically lower than the cost of buying outright. However, Medicare has a rule called the rental cap: once cumulative rental payments reach the purchase price of that model, Medicare stops paying rental fees and you own the machine.

For example, if monthly rent is $150 and the purchase price is $1,500, after 10 months of payments totaling $1,500, the rental period ends. At that point, you own the concentrator and Medicare covers no further costs for that machine. If you need a replacement, you would have to wait a set period before Medicare covers another one.

Some people rent initially to test whether a portable concentrator meets their needs before committing to purchase. Others purchase when ready to avoid the rental cap. A Medicare-approved DME supplier can explain both options and show you the approved amounts for rent and purchase for your specific model.

What your doctor's order must say

Your doctor must write an order stating that you need a portable oxygen concentrator for home use and that it is medically necessary. The order should specify the flow rate (measured in liters per minute) and whether you need it continuously, at night, or during activity. Medicare uses this information to determine whether the concentrator is appropriate for your condition.

The order does not need to name a specific brand or model. Your doctor can write "portable oxygen concentrator, 2 liters per minute" and the DME supplier will help you choose from models that meet that specification and are Medicare-approved.

If your doctor has not yet written an order, contact their office and ask them to send one to a Medicare-approved DME supplier. The supplier can also contact the doctor's office directly to request the order, which speeds up the process.

Finding a Medicare-approved DME supplier

You must obtain the concentrator from a Medicare-approved DME supplier. You cannot buy one at a medical supply store or online retailer and submit the receipt to Medicare for reimbursement. Medicare only pays suppliers it has enrolled and verified.

To find approved suppliers in your area, visit the Medicare DME Supplier Directory at dmepos.cms.gov or call 1-800-MEDICARE and ask for suppliers near you. When you call a supplier, confirm they are Medicare-approved and ask them to verify your coverage before you commit to renting or purchasing.

Some suppliers rent, some sell, and some do both. Ask whether they handle the Medicare paperwork or whether you need to submit forms yourself. Most approved suppliers handle all billing directly with Medicare, so you pay only your 20% share.

Regional variation in approved amounts

Medicare sets approved amounts by region using a system called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule. The same portable oxygen concentrator model may have an approved amount of $1,200 in one state and $1,400 in another. This is why two identical machines can result in different out-of-pocket costs depending on where you live.

You can view the DMEPOS fee schedule on the CMS website, though the data is technical and organized by billing code rather than by product name. A DME supplier can tell you the approved amount for a specific model in your zip code in seconds, so asking them directly is faster than searching the fee schedule yourself.

If you move to a different state or region, the approved amount for your concentrator may change. If you are renting and relocate, contact your supplier to update your address so Medicare payments reflect your new region.

Concentrators for travel: what Medicare does not cover

Medicare covers a portable oxygen concentrator for home use only. If you need a concentrator specifically for travel — such as a lightweight model to carry on an airplane or use in a car — Medicare does not pay for it. Travel concentrators are considered convenience items, not medically necessary equipment.

Some people have two concentrators: a heavier, more powerful one for home use (covered by Medicare) and a lightweight travel model (paid out of pocket). If your doctor orders a portable concentrator for home use, Medicare covers it even if you also use it occasionally while traveling. The distinction is whether the primary purpose is home use or travel.

If you are unsure whether your situation qualifies as home use, ask your doctor to document in the order that the concentrator is for home use and medically necessary for your condition. The DME supplier can then submit this to Medicare for review.

Frequently Asked Questions

Do I need to pay the full cost upfront and then get reimbursed?

No. A Medicare-approved DME supplier bills Medicare directly. You pay only your 20% share (after your deductible) at the time of delivery or rental. Medicare pays its 80% share to the supplier. You do not pay the full amount and wait for a reimbursement check.

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

Medicare does not reimburse you for equipment you have already purchased. The concentrator must be ordered through a Medicare-approved supplier after your doctor writes an order. If you bought one on your own, you would need to work with a supplier to set up a new order for Medicare coverage, which would be a separate transaction.

How long does it take to receive the concentrator after I order it?

Delivery typically takes 5 to 14 days after the DME supplier receives your doctor's order and confirms your Medicare coverage. Urgent orders may be expedited. Contact the supplier to ask about their typical delivery time and whether they offer faster options.

Can I switch concentrator models if the first one does not work well for me?

Yes, but Medicare may not pay for a second concentrator when ready. If you are renting, you can usually switch models within the rental period. If you have purchased, you would own that concentrator and would need to wait a set period (usually 5 years) before Medicare covers a replacement. Discuss options with your DME supplier and doctor before finalizing your choice.

Does Medicare cover replacement parts or repairs?

Medicare covers repairs and replacement parts for a concentrator you are renting. If you own the concentrator, Medicare does not cover repairs after the initial purchase. Some DME suppliers offer maintenance plans or extended warranties you can purchase separately.