Does Medicare Cover Your Oxygen Costs? Here's What You Need to Know

Breathing, an activity most of us take for granted, can become a persistent concern for some due to health conditions requiring supplemental oxygen. As medical equipment costs add up, understanding what your insurance, like Medicare, will cover becomes vital.

How Medicare Handles Oxygen Therapy

Medicare Part B can cover oxygen equipment and accessories prescribed by a doctor for home use. However, there are specific conditions for this coverage:

Medical Necessity: Your doctor must document that you have a severe lung disease or you're lacking enough oxygen in your blood. Tests like an arterial blood gas test will substantiate this need.
Approved Suppliers: Coverage is available if you receive oxygen equipment and supplies from a Medicare-approved supplier.
Equipment Rental: Instead of a purchase, Medicare covers the rental of the equipment. Typically, Medicare beneficiaries will pay 20% of the Medicare-approved amount for the duration of the rental, with the Part B deductible also applying.

Oxygen Equipment Covered by Medicare

Medicare provides coverage for various oxygen-related equipment and supplies, including:

Oxygen Concentrators
Portable Oxygen Tanks
Oxygen Accessories (e.g., tubing, masks)

Once you've qualified for coverage, Medicare rents the equipment to you for 36 months. After this rental term, the supplier must continue providing equipment for an additional 24 months with no additional rental charge.

Beyond Medicare: Exploring Other Financial Assistance Programs

While Medicare provides robust coverage for those in need of oxygen therapy, the expenses related to oxygen therapy can still become burdensome. Here’s where additional financial resources and assistance programs can be crucial.

Government Aid and Financial Assistance

Medicaid: Depending on the state, Medicaid may cover additional services not provided by Medicare. It's essential to check with Medicaid in your area for specific benefits related to oxygen therapy.
State Health Insurance Assistance Programs (SHIPs): Offer free insurance counseling to help navigate both Medicare and any potential additional financial aid.
Low-Income Subsidy Programs: If you're eligible for Medicaid or other low-income relief programs, these might lower costs not covered by Medicare.

Credit Solutions

Understanding your financial options can alleviate the strain of covering costs. Some individuals explore medical credit cards or personal loans specifically for healthcare expenses.

Medical Credit Cards: Can be used for out-of-pocket expenses with features like deferred interest periods.
Personal Loans: Used for covering medical expenses and typically offer fixed interest rates and fixed monthly payments.

Educational Opportunities

Navigating the complexities of medical insurance and financial aid requires a fair amount of know-how.

Workshops: Local community centers might offer workshops on managing healthcare costs effectively.
Online Courses: Platforms offer courses on financial literacy tailored to medical expenses, providing insights to better manage healthcare costs.

With these resources, you can better understand your financial landscape, not only mitigating the financial stress of healthcare but empowering yourself to take informed steps.

Helpful Resources & Opportunities

💸 Medicaid: Check your local state’s services for additional oxygen cost coverage.
📞 SHIPs: Free counseling programs in your state for navigating Medicare and financial assistance.
💳 Medical Credit Cards: Consider for out-of-pocket medical costs with potential interest-free periods.
🎓 Educational Workshops: Offered at local centers, focusing on financial literacy and insurance management.
🏦 Personal Loans: Explore if medical expenses become burdensome and need consolidated payment options.

For those requiring supplemental oxygen, understanding these options is not only crucial but empowering, allowing informed decisions on managing both health needs and financial well-being.