Does Medicare cover my portable oxygen concentrator?
Medicare has always assisted in paying for durable medical equipment (DME) such as wheelchairs, in-home hospital beds, etc. As far as oxygen goes, Medicare is able to cover the rental of oxygen devices and pay for some supplies for those who own their own devices. In order to be considered for this, certain conditions must be met. You can check out the oxygen equipment section on the Medicare website for all the details and requirements for this. However, this only applies for the rental of a portable or home oxygen concentrator. Medicare will not purchase or cover the costs of purchasing a portable oxygen concentrator.
Why? In 2013, Medicare cut their reimbursement rates by 50%. That means that many suppliers of oxygen equipment cannot afford their contract with Medicare because they are paid so little. Thus, there is little to no return on investment for providers. The cost of providing loyal customers and patients with portable oxygen concentrators is greater than the amount Medicare will reimburse them. Providers must cover the costs of their POC’s up front and bill Medicare later, which proves to be too expensive for most suppliers.
To make matters worse, Medicare has implemented a Competitive Bidding Program, where companies with the lowest bids were offered a contract with Medicare. This makes it very difficult for patients to find an oxygen supplier that is fully approved by Medicare in many areas.
Because of this issue, a lot of patients may opt to receive a cheaper form of oxygen therapy that can be found through oxygen tanks. The problem with oxygen tanks is that, although they are cheaper, they will end up costing you much more in the long run due to the constant need for oxygen refills. With portable and home oxygen concentrators, no refills are required, and you are therefore saving money when you purchase one. Plus, POC’s significantly increase your quality of life, as you aren’t tied to a heavy, cumbersome oxygen tank all day. You are free to come and go as you please with your POC at your side, breathing easier and enjoying the freedoms of life without being confined to your home.
Medicare’s Equipment Rental Agreement
After meeting all the requirements listed on the Medicare website, you may be eligible to rent your oxygen equipment for a payment period of 36 months (3 years). Your supplier must continue to meet your supplemental oxygen needs by continuing this agreement for 24 months after those three years are up, for a total of five years. During this time, your provider will own the equipment that you are renting. When the 3-5 years are up, you have the option to renew your rental agreement.
Basically, you can rent your portable oxygen concentrator through Medicare, but the odds of you finding a contracted provider in your area are very low. The rental agreement is only available through a contracted Medicare provider. Many patients discover that after all the paperwork, medical documents, and waiting for an answer, that Medicare-approved providers just don’t value their patients as much as they should. The process to receive Medicare assistance for renting a portable oxygen concentrator is often tedious and filled with hassles, such as going through a full-blown bureaucratic process for even the simplest queries.
The Good News
More and more patients are taking control of their future by purchasing their own portable oxygen concentrators. The benefits of owning your POC far outweigh the cost you are paying. Not only does it help treat your specific condition or illness, it gives you the independence to travel, work, visit loved ones, socialize, enjoy hobbies, and so much more!
Please let us know if you have any questions.