Yes, Medicare covers oxygen equipment and its accessories under Part B. Your coverage allows you to rent from a supplier for 36 months with continued supplies for a total of five years, as long as you have a medical need for oxygen. Medicare will help pay for oxygen, contents and supplies if you own your oxygen equipment and meet certain medical requirements.
Your Medicare Part B Coverage
Medicare Part B covers medically necessary and preventive care services. That coverage pays for doctor and emergency room visits, clinical research, ambulance services, mental health care and durable medical equipment, among other things. Oxygen equipment falls under durable medical equipment.
Your costs for durable medical equipment under Medicare Part B include 20% of the Medicare-approved amount as copayment.
When You Rent Your Oxygen Equipment
Medicare helps to pay 80% of the costs for renting oxygen equipment and its accessories when your doctor prescribes it for home use. You rent the oxygen equipment from a supplier for 36 months. That equipment rental covers the oxygen equipment, its tubing or mouthpiece, oxygen contents, maintenance for the machine, servicing for your machine, and repairs.
Your 36-month rental does not mean you only get oxygen for 36 months. As long as you have a medical need for oxygen, your supplier has to provide oxygen equipment and supplies for 24 months after your rental, and must continue to supply you for up to a total of five years. The supplier cannot charge you after the initial 36 month rental, but you will continue to pay your Part B copayment for Medicare’s coverage of your oxygen.
After five years, you can choose a new supplier or stay with the same supplier, but a new 36-month rental period and 5-year supplier obligation period will start.
When You Own Your Oxygen Equipment
You may qualify for Medicare to help pay for your oxygen, contents and supplies even if you own your oxygen equipment. To be eligible for coverage your doctor has to certify that 1) you have a lung disease or are not getting enough oxygen; 2) oxygen therapy may improve your health; 3) your arterial blood gas levels are within a certain range; and 4) alternative measures have failed.
Medicare Part B will cover systems that provide oxygen, containers that store oxygen, and tubing and supplies to deliver the oxygen and oxygen contents, if you meet those requirements. Humidifiers used with your oxygen machine can also be covered under these same conditions.
Medicare has detailed coverage for many common conditions. Make sure your plan makes it simple to access your benefits. Contact our team at Magellan Healthcare to schedule an appointment today.