Does Your Insurance Cover Portable Oxygen Concentrators? Find Out

Most insurance plans do cover portable oxygen concentrators, but it depends on the specific policy and provider.

Typically, Medicare Part B covers 80% of the cost of a portable oxygen concentrator, with the patient responsible for the remaining 20%.

The cost of a portable oxygen concentrator can vary greatly, ranging from $1,000 to $3,000, depending on the model and features.

Some insurance plans may require a doctor's prescription or prior authorization before covering the cost of a portable oxygen concentrator.

For another approach, see: Oxygen Concentrator

Insurance coverage for portable oxygen concentrators can be a bit complex, but I'll break it down for you. Blue Cross Blue Shield, for instance, covers portable oxygen concentrators if you meet their specific requirements, which vary by state.

You'll need to check with your local branch to see what's covered under your plan. Medicare, on the other hand, covers portable oxygen concentrators if your doctor says you need one to make your life easier at home. You can rent the equipment with Medicare coverage, and if you own your own portable oxygen concentrator, Medicare will help cover necessary supplies and services.

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United Healthcare only grants benefits limited to a single purchase of a DME, such as a portable oxygen concentrator. You'll need to purchase, rent, or obtain the DME from an authorized seller or directly from the prescribed network physician to receive network benefits.

Humana requires initial approval before your doctor can lead you to a specific service. They'll consider whether or not the service is medically necessary, covered, and meets the general and accepted medical practice. Durable medical equipment, such as a portable oxygen concentrator, will also need prior authorization if the costs exceed $750.

Here's a list of insurance companies that cover portable oxygen concentrators:

Keep in mind that each insurance company has its own set of requirements and guidelines, so be sure to check with your provider to see what's covered under your plan.

If your doctor decides you no longer need your current oxygen equipment, they can contact your supplier to order new equipment that meets your needs, including mobility needs both inside and outside your home.

Your supplier can't change the type of equipment you receive each month unless your doctor orders a change.

To avoid running low on oxygen, contact your supplier immediately if you need more oxygen tank refills.

If you travel by plane, your oxygen supplier isn't required to provide an airline-approved portable oxygen concentrator, and Medicare won't cover oxygen-related expenses for air travel. You may be able to rent a portable oxygen concentrator from your supplier or through online companies that work with most airlines.

Here are some key things to know about your oxygen supplier:

Insurance companies will pay for rental charges on precise durations, but some may only pay part of the expenses.

If you're eligible for benefits, you'll need to provide prescriptions, Certificates of Medical Necessity, physician orders, and other medical files.

Most insurance companies will only grant medical assistance to those who deserve it, and they'll check if you need the machine to avoid health risks and oxygen toxicity.

Equipment that costs $150 or greater, and rental items of any price, will need a Certificate of Medical Necessity that includes specific information.

You'll need to submit these documents to get insurance coverage benefits, and if you don't meet the guidelines, your request will be denied.

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Paying for a Concentrator can be a complex process, but understanding the requirements can help you navigate it more smoothly. Most insurance companies require prescriptions, Certificates of Medical Necessity, physician orders, and other medical files to determine eligibility.

Insurance coverage for portable oxygen concentrators varies by company, but generally, they pay for rental charges on precise durations, with some companies paying the entire cost or part of the expenses. If you're unsure about your insurance coverage, it's best to check with your provider directly.

To be eligible for insurance coverage, you'll typically need to meet specific guidelines and standards, which may include having a medical condition that requires oxygen therapy. Your doctor will need to order the equipment, and you may need to provide additional documentation, such as a Certificate of Medical Necessity, which must include certain information.

Some insurance companies, like United Healthcare, only grant benefits for a single purchase of a DME, such as a portable oxygen concentrator, and may require prior authorization for costs exceeding $1,000. Others, like Humana, require initial approval before your doctor can lead you to a specific service, and may need prior authorization for costs exceeding $750.

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Here's a brief overview of the costs associated with renting a portable oxygen concentrator with Medicare coverage:

You can pay for a portable oxygen concentrator through purchase or rental. The rental payments can't exceed the purchase price.

If you choose to rent, you can do so continuously as long as your oxygen needs persist.

You can rent a portable oxygen concentrator, but the rental payments can't exceed the purchase price.

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If you're renting a portable oxygen concentrator, you'll pay 20% of the cost once you've met your Part B deductible. This applies to Medicare coverage.

You can rent the equipment for the first 36 months, and your monthly payment will cover the oxygen concentrator, accessories, and services.

After 36 months, your equipment supplier must provide you with the portable oxygen concentrator for an additional 24 months. Your medical need for the equipment will determine the duration of this period.

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If you still need the device past the 5-year timeframe, you can choose to stay with your supplier or pick a new one. Then, the 36-month payment period and 5-year obligation period will start over again.

You may have to pay additional coinsurance for maintenance up to once every 6 months if your supplier comes to inspect and service the device in your home.