Does Medicare Cover Oxygen Equipment?

Medicare is a federal health insurance program providing healthcare coverage for eligible individuals, including those aged 65 or older, younger people with certain disabilities, and individuals with specific medical conditions. Medical equipment is a necessary component of managing health conditions. Oxygen equipment serves as a medical necessity for individuals with respiratory challenges.

Medicare Part B and Oxygen Equipment

Oxygen equipment falls under Medicare Part B, which serves as medical insurance. Part B covers outpatient services, medical supplies, and doctors’ services when medically necessary. Oxygen equipment is categorized as Durable Medical Equipment (DME), designed for repeated use over a long period. To be classified as DME, equipment must be used for a medical reason, suitable for home use, and expected to last at least three years.

Coverage requires a prescription from a Medicare-enrolled doctor or other healthcare provider. The equipment must be medically necessary to diagnose, treat, or manage an illness, injury, or condition, and align with accepted medical standards. While primarily for home use, Medicare-covered oxygen equipment can also be used outside the home, supporting mobility for beneficiaries.

Qualifying for Coverage

To qualify for Medicare coverage of oxygen equipment, a beneficiary must meet specific medical necessity criteria. A prescription from a Medicare-enrolled doctor or other healthcare professional is required. This prescription must be substantiated by medical documentation, including a recent in-person evaluation by a physician, physician assistant, nurse practitioner, or clinical nurse specialist. This evaluation needs to occur within 30 days prior to the initial certification for oxygen therapy.

Medical records must document a severe lung disease or hypoxia-related symptoms expected to improve with oxygen therapy. Common medical conditions that may necessitate oxygen therapy include severe chronic obstructive pulmonary disease (COPD), pneumonia, asthma, heart failure, and cystic fibrosis. Documentation should also confirm that alternative treatment measures have been attempted or considered and found clinically ineffective.

Qualification involves objective diagnostic testing of blood gas levels, such as an arterial blood gas (ABG) test or a pulse oximetry reading. Medicare guidelines look for specific oxygen saturation levels, such as a partial pressure of oxygen (PO₂) of 55 mm Hg or lower, or an oxygen saturation of 88% or lower, measured at rest on room air. If the resting saturation level is above 88%, further testing during activity may be necessary to demonstrate a need for supplemental oxygen. The results of these tests must be documented in the patient’s medical records.

Covered Oxygen Equipment

Medicare covers various types of oxygen equipment and related supplies when medical necessity is established. This includes stationary oxygen concentrators, which extract oxygen from the air for home use. Medicare also covers portable oxygen equipment, such as portable oxygen tanks (cylinders) refilled or replaced by the supplier, and battery-operated portable oxygen concentrators, which offer increased mobility. Accessories like tubing, masks, and humidifiers, used with the oxygen equipment, are also included.

Medicare’s policy for oxygen equipment involves a rental arrangement rather than an outright purchase. Medicare pays the supplier a monthly rental fee for an initial 36 months. This fee encompasses the oxygen equipment, oxygen contents, supplies, and routine maintenance. After this 36-month period, the supplier must continue providing the equipment, oxygen contents, and supplies for an additional 24 months, totaling five years, if the medical need persists. During this extended 24-month period, Medicare and the beneficiary do not make further rental payments to the supplier, though beneficiaries might be responsible for coinsurance for in-home maintenance visits.

If the medical need continues after five years, the beneficiary can obtain new equipment, starting a new 36-month rental cycle.

Your Costs for Oxygen Equipment

Beneficiaries with Original Medicare have financial responsibilities for oxygen equipment. The annual Medicare Part B deductible applies. In 2025, this deductible is $257. After the deductible is met, Medicare covers 80% of the Medicare-approved amount for oxygen equipment and associated services. The beneficiary is responsible for the remaining 20% coinsurance.

These cost-sharing amounts apply to monthly rental fees throughout the initial 36-month rental period. If a supplier does not accept “Medicare assignment,” they may charge more than the Medicare-approved amount, which could result in higher out-of-pocket costs. When a supplier accepts assignment, they agree to accept Medicare’s approved amount as full payment and cannot bill the beneficiary for more than the deductible and coinsurance. Supplemental insurance options, such as Medigap policies, can help with these out-of-pocket expenses. Medigap plans may cover the Part B coinsurance. Medicaid can also provide assistance with Medicare Part B costs.