Does Medicare Cover Oxygen Therapy?

Yes, Medicare Part B covers oxygen equipment and accessories as durable medical equipment (DME) if your doctor certifies that you have a severe lung disease or you're not getting enough oxygen. If you qualify, Medicare helps pay for systems that provide oxygen, containers that store it, tubing, and related supplies.

To get coverage, your doctor must examine you and confirm that your blood oxygen level is low. They must also state that alternative treatments haven't worked and that oxygen therapy will improve your condition. Once approved, Medicare covers the rental of oxygen equipment for 36 months.

After the 36-month rental period, your supplier must continue to maintain the equipment and provide oxygen for up to two more years, but you only pay for the oxygen contents and maintenance, not the equipment rental. This 5-year cycle ensures you have the oxygen you need without paying for the machine indefinitely.

If you choose the Traditional Medicare path, Part B covers 80% of the Medicare-approved amount for the equipment rental and supplies. You are responsible for the remaining 20% after you meet your Part B deductible.

This is where the rubber meets the road. If you rely on oxygen, those 20% coinsurance bills add up fast. You shouldn't have to ration your breathing because of a bill.

If you have a Medicare Supplement (Medigap) plan, it steps in to pay that 20% coinsurance. By law, Medigap plans fill the gaps in Traditional Medicare, meaning your oxygen therapy could cost you nothing out of pocket once your deductible is met.

If you chose Medicare Advantage instead of Traditional Medicare, your plan must cover at least the same oxygen services as Part B. However, your costs, network rules, and prior authorization requirements will depend entirely on your specific Advantage plan. You'll need to use their approved suppliers, and your copays may differ from the standard 20%.

Remember, the real choice isn't between a supplement and Advantage - it's between Traditional Medicare (where you control your care and a supplement fills the gaps) and Medicare Advantage (where a private company manages your care and costs).