Monday, May 16, 2022

Does Medicare Cover Oxygen At Home

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How Does Oxygen Equipment Rental Work

Understanding Medicare: FAQs on Supplemental Oxygen Medicare Coverage

Unless you own your own oxygen therapy equipment, youll need to rent it from a Medicare-approved supplier. The supplier may rent you the equipment for 36 months. If your doctor feels that you need to continue this treatment, you can continue to rent the equipment for up to five years. Once those five years are over, the supplier is no longer obligated to rent the equipment to you, and you will need to find another supplier and begin a new rental period.

Oxygen therapy equipment includes:

More About Oxygen Therapy

You may need oxygen therapy to treat one of many different conditions.

In some cases, trauma or severe illness could lessen your ability to breathe effectively. Other times, a disease like COPD might change the chemistry of the gases in your blood, lowering the amount of oxygen your body can use.

Heres a list of some conditions that may require you to use occasional or continuous oxygen therapy at home:

  • COPD
  • sweating
  • fast breathing or heart rate

If you have these symptoms, your doctor will perform certain tests. These may include breathing activities or exercises, blood gas testing, and oxygen saturation measurements. Special tools may be used in the activity tests, and blood gas testing requires a blood draw.

Testing oxygen saturation with a pulse oximeter on your finger is the least invasive way to check your oxygen level.

Typically, people whose oxygen drops to between 88 percent and 93 percent on the pulse oximeter will require oxygen therapy, at least occasionally. Guidelines for how much oxygen to use and when will depend on your specific condition.

In some cases, your doctor may prescribe pulmonary rehabilitation in addition to oxygen therapy.

Pulmonary rehab helps people with a condition like COPD learn to manage it and enjoy a better quality of life. Pulmonary rehab often includes education on breathing techniques and peer support groups. This outpatient therapy is typically covered by Medicare Part B.

Does Medicare Advantage Cover Oxygen

Medicare Advantage does cover oxygen. As you may know, Medicare Advantage plans must cover everything that Original Medicare covers, BUT MA plans can cover items and services differently. Youll want to check with each provider to see how it is covered..

To learn more call a Senior65 agent at 800-930-7956.

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Does Medicare Cover Inogen

Inogen is a portable oxygen concentrator, which is a device that is used for oxygen therapy. Oxygen therapy involves using a medical device to provide individuals with more oxygen, helping the patient breathe better. Medicare may cover Inogen and other oxygen therapy tools if you meet specific criteria.

How Does Inogen Work?Inogen provides a much needed boost of oxygen for individuals with a variety of health conditions, including chronic obstructive pulmonary disease , asthma, heart failure, pneumonia, sleep apnea, and much more. These conditions can cause the lungs to absorb oxygen less effectively, making the 21 percent oxygen in the air insufficient. Oxygen therapy provides these patients with additional oxygen that can be used for as many hours each day as needed.

When most people think of oxygen therapy, they picture the giant metal oxygen tank getting pulled around on a small dolly, but, Inogens portable oxygen concentrators provide a much more mobile option, allowing you to take your oxygen anywhere with ease.

Inogens systems are designed to allow their users to continue to live an active lifestyle. These tanks are lightweight, making them great for traveling or running errands around town. Their small size also allows you to leave the house without having to lug around a giant tank.

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When Is Oxygen Therapy Used

Does Medicare Cover A Home Oxygen Concentrators?

According to the National Heart, Lung, and Blood Institute , your lungs normally gather enough oxygen for your bodys needs from the air you breathe. The oxygen enters your bloodstream through tiny blood vessels that cover your lungs air sacs , and its carried to the heart to be pumped to organs throughout your body. If structures in your lungs are damaged or compromised from illness or disease, your lungs may not be able to absorb enough oxygen from the air. Oxygen therapy delivers oxygen to the lungs to help your body get the right amount it needs.

According to the NHLBI, doctors use oxygen therapy to treat the following conditions:

  • Chronic obstructive pulmonary disease
  • Heart failure
  • Cystic fibrosis
  • Sleep apnea

Your doctor may order tests such as an arterial blood gas test or a pulse oximetry test to measure the amount of oxygen in your blood to determine whether oxygen therapy is right for you. In most cases, people on oxygen therapy may feel less fatigue and shortness of breath it can also increase the lifespan of some people with COPD, according to the NHLBI.

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Details For Using Oxygen Dme

When it comes to oxygen equipment, Medicare will pay for you to rent this durable medical equipment. Your rental covers both the oxygen equipment and the other necessary accessories such as tubing, mouthpieces, and masks.

After 3 years, Medicare will stop paying the rental fee, but the Medicare supplier must still continue to supply you with both maintenance and accessories to go with your equipment for the next 2 years. The supplier cannot invoice you for these services. Finally, at the end of 5 years, the DME supplier doesnt have to continue providing your oxygen equipment or the maintenance required for it. At this point, you will start over on a new 3- year period either with the same DME supplier or a new one, if you prefer.

B Durable Medical Equipment

Durable medical equipment like oxygen pumps are covered under Medicare Part B. Part B covers not only equipment but also many other outpatient services like doctor visits, lab testing, diagnostic imaging, medical supplies, and even outpatient surgeries.

In order for Medicare to cover your oxygen therapy, Medicare must prescribe the therapy for you and document why he believes it is medically necessary.

Usually, your doctor will conduct some testing to measure the level of gas in your blood. He can also document other therapies that you may have tried which have failed to improve your health.

For your part, you will need to use a Medicare-approved DME supplier when ordering your equipment. This not only meets Medicares rules but is also in your favor because Medicare has negotiated the lowest pricing possible with these vendors.

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What Does Medicare Cover

Oxygen therapy equipment is covered by Medicare as durable medical equipment . After youve met your deductible , Part B will cover equipment and supplies for oxygen therapy. Medicare will cover 80 percent of expenses, and youll be responsible for the remaining 20 percent.

In order for Medicare to cover your costs, you must meet the following requirements:

  • Your doctor says you have a severe lung disease and/or youre not getting enough oxygen
  • Your health could potentially improve with oxygen therapy
  • Your arterial blood gas levels need to be higher
  • Other treatments to improve your condition have failed
  • Your doctor accepts Medicare assignment
  • You use a Medicare-approved supplier

Any oxygen therapy administered as part of inpatient treatment in a hospital will be covered by Part A.

If youre a smoker with breathing disorders, the Part B smoking cessation benefit may provide up to eight smoking cessation sessions each year as well as nicotine patches.

Medicare Coverage For Home Oxygen Equipment And Supplies

Medicare Oxygen Coverage Renewal Period

Medicare considers home oxygen equipment and accessories to be durable medical equipment , which it covers. Medicare Part B medical insurance will cover oxygen equipment and accessories used in your home if your doctor determines that the supplies are medically necessary and you meet certain other criteria.

4 requirements you must meet for Medicare to cover oxygen equipment and supplies:

  • Oxygen therapy may improve your health
  • Your arterial blood gas level the levels of oxygen and carbon dioxide in your blood and your blood acidity falls into a specific range
  • Your doctor determines you have a severe lung condition or you are not getting enough oxygen
  • Other alternatives have failed

To qualify for Medicare coverage, you must have Medicare Part B or a Medicare Advantage plan. Medicare Advantage plans are required by law to cover everything Medicare Part A and Part B covers.

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Why Are Portable Oxygen Concentrators Popular

Portable oxygen concentrators are popular because theyre small, light, and convenient to use. Many portable oxygen concentrators weigh as little as 5lbs and are less than 10 inches high. That means you can easily put them in a carrying case and take them with you as you go shopping, visit friends, go out to dinner, or even catch a flight.

Portable oxygen concentrators require batteries that must be changed regularly, but they dont need refilling the way gas or liquid oxygen delivery systems do. That makes them much more convenient than other delivery systems. Most units are very user-friendly too, so its not an extra stressor to have one close at hand.

However, portable oxygen doesnt come cheap, with most units costing somewhere between $2000 $3500.

If youve been prescribed portable oxygen and are worried about the cost, you might be wondering if Medicare will pay for a portable oxygen concentrator. Unfortunately in most cases, the answer is no.

Qualifying For Portable Oxygen

If you enjoy the freedom and independence that comes from using oxygen on the go, you may want to consider a portable oxygen concentrator like one of the Inogen One models.Inogen products can be covered by insurance companies, including Medicare and Medicaid, to help with payments or rental of our oxygen products. With an Inogen One, Medicare will pay for portable oxygen rental if all of the following apply to you:

  • You meet the aforementioned daytime arterial blood gas testing criteria
  • Your doctor provides a prescription saying that you require supplemental oxygen and/or have a severe lung disease
  • Your medical documentation indicates that you are mobile in your home and would benefit from the use of a portable system
  • Alternative treatments have failed

If the above conditions apply, you meet the medicare oxygen requirements and may be able to rent an Inogen One with Medicare.

With an Inogen One Medicare rental, you will qualify for getting oxygen at home with a monthly rental of oxygen supplies. You will pay 20% of the Medicare approved amount, with the Part B deductible still applying. You will be able to rent your oxygen equipment for 36 months, after which time your supplier must continue to provide oxygen equipment and related supplies for an additional 24 months, and up to 5 years, as long as you have a medical need for oxygen. Even with state of the art equipment like the Inogen One, Medicare offers rental coverage for getting oxygen at home.

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Caire Freestyle Comfort Portable Concentrator

This is a small, compact, and lightweight POC that you can take it wherever you go. It is designed to be quiet to maximize the user-friendliness of the machine. You may contact the supplier since they offer installment plans for the unit.

Hence, here are some amazing features of this portable concentrator unit:

  • Price: $2,495
  • Battery life: 4-hour battery life
  • FAA approved: YES
  • Accessories: includes Freestyle Comfort, small 8 cell battery, power supply with AC input cable, carry bag and strap, vehicle power cord, cannula and manual

How Do You Make Portable Oxygen

Does Medicare Cover A Home Oxygen Concentrators?

Directly purchasing your portable oxygen concentrator from Inogen is the quickest and easiest way to get an Inogen One unit. You can buy a portable oxygen concentrator for sale now directly from our website by clicking the link below, or you can call us at 1-800-695-7915 to talk to one of our oxygen specialists.

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Oxygen Equipment And Accessories

According to Medicare.gov, Medicare Part B the medical insurance-part of Medicare covers rental of certain durable medical equipment , including oxygen equipment and accessories, which your doctor prescribes for use in your home.

If you already own oxygen equipment, Medicare will cover oxygen and supplies when the following conditions are met:

  • You have a severe lung disease thats verified by your doctor, or another condition thats preventing you from getting enough oxygen.
  • Your health would benefit and improve by using medical oxygen.
  • Your arterial blood gases fall below a certain level.
  • Alternative treatment options have been unsuccessful.

If you meet the conditions above, Medicare will help pay for systems that provide oxygen, containers that store oxygen and oxygen equipment and accessories such as nasal cannulas and tubing necessary to deliver oxygen. Medicare may also cover a humidifier if its used with your oxygen equipment.

How To Save On The Cost Of A Portable Oxygen Concentrator

Many stores have a financing option so you can spread the cost of buying a portable oxygen concentrator. As we always say, do double-check the small print before signing up for a financing option.

Some manufacturers sell reconditioned or second-hand portable concentrators, which cost a bit less than new ones. This can be a good way to save money, however, do check with them to find out how they ready the machines for sale and what tests they do to make sure theyre in good working order.

Another money-saving option is to rent an oxygen concentrator. This is a good choice if you only need it for a short time, such as after surgery or for traveling on an airplane Renting can work out more expensive than buying in the long term though, so its not a good option for longer-term use.

Its also smart to compare prices. Online stores do vary a bit in how much they charge, so comparing suppliers can save a bit of money. Its also a good idea to see which accessories are included in the price. If youre getting batteries and spare cannula included, it can work out cheaper than buying them separately.

Unfortunately, Medicare doesnt generally cover portable oxygen concentrators. However, they do cover some oxygen therapy if you cannot afford to buy privately. If you can afford to buy privately, there are ways you can save a bit on a portable concentrator as outlined above.

Amie Clark

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Overview: Qualifying For Home Oxygen

First, if you want to receive home oxygen treatment youll need to meet the following criteria:

  • Be evaluated by a doctor, in-person
  • Have a medical record that documents your need for oxygen therapy
  • Show diminished oxygen saturation on an arterial blood gas study
  • Receive a prescription from a qualified healthcare professional
  • Read on for an in-depth description of this process.

    Does Medicare Pay For Oxygen Rentals

    Understanding Medicare: Changing Your Medicare Oxygen Provider

    If you are enrolled in Medicare Part B and your oxygen tank and other equipment is prescribed by a doctor, Medicare should cover costs related to your equipment rental:

    • If you rent oxygen equipment and receive coverage under Medicare, youll need to rent the equipment from a supplier for 36 months.

    • After that period concludes, your supplier will continue providing oxygen equipment and supplies for another 24 months , as long as you have a medical need for oxygen.

    Medicare Part B covers oxygen tanks and other equipment, such as:

    • Tubing

    • Repairs of equipment

    After youve rented your equipment for 36 months:

    • Your supplier must ensure equipment is in good condition and working order. This requirement continues until the end of your five-year rental period, and the supplier cannot charge you for these services.

    • Medicare will continue paying for the delivery of oxygen contents after your 36-month rental period.

    • If your medical needs extend past five years, your supplier does not have to continue supplying oxygen contents and equipment.

    • A new five-year supplier obligation period begins after the first five-year period ends. You will have the option to switch to another supplier at this time.

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    Since An Oxygen Concentrator Is Considered A Dme Does That Mean Medicare Will Cover It Not Exactly

    Coverage on the concentrator will still depend on if the patients doctor provides the proper documentation in their medical record. Correct documentation includes the physician cataloging that the oxygen concentrator is a medical necessity and writing the patient a prescription stating that he/she requires medical grade oxygen.

    If and when Medicare decides to cover the cost of a concentrator, they will enter a contract with a Medicare-approved provider. This agreement states that this provider will supply the patient a concentrator on an extended rental basis. Meanwhile, Medicare will cover the entirety or a portion of the cost of the rental. The contracts between the patient, the Medicare-approved provider, and Medicare will last for 36 months. After the initial three years, renewal may be necessary. To renew the contract, updated documentation and information from the patients doctor will be required.

    Even when a patient has all of their documents in order and meets all the requirements, the provision of an oxygen solution can take months. Furthermore, many people find that the Medicare-approved provider does not accommodate patients very well. Often ignoring, and avoiding patients who have asked for assistance, or sending them through an extensive bureaucratic system for even the most simple of requests.

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