Does Medicaid Cover Portable Oxygen Concentrators?

Does Medicaid Cover Portable Oxygen Concentrators?

Oxygen concentrators can be really expensive to buy but they are so useful for those with breathing problems, really transforming their quality of life! If you’re reading this.

I’m sure you feel the same, and you’re hoping to find out if Medicaid covers the cost of portable oxygen concentrators.

The high costs – whether you are hoping to purchase or rent them, are enough to mean that lots of people who will benefit from them can’t afford them. 

What Is A Portable Oxygen Concentrator?

Portable oxygen concentrators are used to deliver oxygen to some patients. They are used for people who have trouble breathing, or who have low oxygen levels in their blood.

Most oxygen tanks are designed to administer air into a patients lungs when they inhale, meaning that they will get as much oxygen as possible from the intake.

Oxygen concentrators are usually used with those who have asthma, lung cancer and other breathing problems similar to these. 

Does Medicaid Cover Portable Oxygen Concentrators?

Cost Of Oxygen Concentrators 

Oxygen tanks are very expensive when you don’t have an insurance that covers them! You should probably expect to pay anywhere between $1500 dollars and $3500 dollars.

Certain factors will mean that the price varies. Air capacity, battery life and certain accessories will impact the prices. 

You don’t have to buy an oxygen concentrator out right, you can opt to rent them out and pay on a daily, weekly or monthly basis.

You can pay up to $35 dollars per day if you choose this option which ends up being very expensive.

If you choose to rent out the oxygen concentrator, you can also get your repairs and any parts that you need included in the price for as much time as your have the device, which will save you money if anything goes wrong. 

Does Medicaid Cover Portable Oxygen Concentrators?

Medicaid differs between states and so this question does not have a simple yes/no answer. The majority of the Medicaid programs do cover the large majority of the portable oxygen concentrator cost.

If the person who is requesting the oxygen concentrator is considered to need it medically, then they will be covered in the cost.

There is information available for the coverage of these types of things in your state available, so if you’re not sure, simply contact your local Medicaid office.

Medicaid does cover the portable oxygen concentrators for most states as they are covered under Durable Medical Equipment (DME) in the Medicaid categorization.

You will qualify for an oxygen tank if you have the following: 

  1. You have a severe lung disease or you are not getting enough oxygen into your body. This has to be diagnosed and confirmed by a doctor. 
  2. Your doctor also has to provide proof that the introduction of oxygen therapy through a concentrator will have a positive impact on your health. 
  3. You will also have to have proof that your blood oxygen levels are in an unsafe range, which will have to be confirmed by your doctor. 
  4. You will also have had to try different methods of treatment, without seeing much improvement. 

You will have to be able to meet all of this criteria in order to qualify for Medicaid to pay for your oxygen tank. If you qualify for this, you will be able to rent out an oxygen concentrator. 

For How Long Will Medicaid Cover This Cost?

Usually, Medicaid begin with a rental time of 36 months. After this time is up, your doctor may think that you still need the equipment.

In this case, and if you still qualify through meeting all of the set specifications, you can extend the rental by another 2 years.

This is only when you are renting it from the same supplier, though. If you still need an oxygen concentrator after this time, you can often get another rental that will last longer than 5 years.

Often this is necessary, because those who suffer from lack of oxygen often get this from chronic breathing problems which they may have for life or a very long time.

After the five year period is over, you are then able to choose a different supplier who you can get your oxygen tank through or you can get it from the same supplier.

You will be able to get all accessories, maintenance and repair during this time so you won’t need to pay for any of these extra fees if you qualify for the Medicaid rental.

Does Medicaid Cover Portable Oxygen Concentrators?

Benefits Of A Portable Oxygen Concentrator 

Portable oxygen concentrators are very convenient pieces of equipment. They offer lots of benefits including:

  • Ease of use. These machines are very easy to use, as they offer very easy to use digital displays which always alert you to any malfunctions. 
  • They create their own air so the tanks will not rupture. 
  • They include multiple settings so you can work out which way is best for you to receive the oxygen. You can choose between pulse flow and continuous flow. 
  • They are small, light and very mobile so you cna live your usual life and still be receiving oxygen.

If You’re Not Covered 

If you’re not covered by Medicaid and you’re looking into purchasing an oxygen concentrator yourself, there are a few things to look out for so that you purchase the best ones for you! 

For instance, you should consider doing some research that looks into the size and weight of the product, the battery life, the different accessories that come with it as well as the warranty of the product.

Because it is such an expensive product that can sometimes go wrong, the warranty is very important to have a look at!

Final Thoughts  

Oxygen concentrators can be very expensive but they can also improve your quality of life in a big way! That’s why finding out if you qualify for receiving them with financial help through Medicaid is very important.

Now you know the basics, all you need to do is to get in touch with the company for your area to check if you qualify for the help with payment for your oxygen concentrator. 

Will Medicare pay for the purchase of a portable oxygen concentrator?

Medicare does not reimburse for any out-of-pocket expenses and Medicare will NEVER pay for the PURCHASE or short-term rental of an oxygen concentrator. Many supplemental insurance companies WILL cover some or all of the PURCHASE or RENTAL of a portable oxygen concentrator.

Is Inogen covered by insurance?

Yes, the Inogen One Oxygen Concentrator is covered by Medicare and many private insurance plans.

Do I need a prescription for a portable oxygen concentrator?

To purchase an oxygen concentrator, you do need a prescription from your doctor, stating your oxygen level. The U.S. Food & Drug Administration (FDA) makes the rules about prescription sales, and at this time, oxygen concentrators are one of the medical devices for which the FDA requires a prescription.