Does Medicare cover oxygen therapy?

Medicare's home-oxygen benefit can include stationary oxygen concentrators, portable equipment, oxygen contents, tubing, cannulas, masks, and other necessary accessories. The equipment must be ordered for home use and supplied by a Medicare-enrolled durable medical equipment supplier. Medicare's medical equipment coverage guide explains the broader Part B DME rules that also apply to many other covered items.

Original Medicare coverage is based on medical necessity and the supplier rules. A Medicare Advantage plan must provide at least the same Medicare-covered services, but its network, prior authorization, supplier options, and cost-sharing can differ. Review your plan materials or use our Original Medicare versus Medicare Advantage comparison before arranging equipment.

A treating practitioner must order the oxygen and document that it is medically necessary. Medicare's National Coverage Determination contains detailed clinical criteria, including qualifying blood-gas or oxygen-saturation testing in many situations. Your supplier and clinical team handle much of the documentation, but you should ask whether the order, test results, and medical record support have been sent before delivery.

Coverage is not based only on a diagnosis or on a preference for oxygen at home. Ask the ordering clinician how your test results meet the coverage standard and keep copies of the order and supplier paperwork. If your needs are tied to home health services, our Medicare home health care guide explains what is and is not included in that separate benefit.

After the Part B deductible, Original Medicare generally pays 80% of the Medicare-approved rental amount and you pay the remaining 20%. Medicare generally rents oxygen equipment for a 36-month period. During that rental period, the supplier provides the oxygen equipment, supplies, and routine service covered by the monthly payment. Medicare.gov explains that the supplier must continue to provide equipment and service for an additional period after the rental ends if you still have a medical need.

Use a supplier that accepts Medicare assignment whenever possible. That can help limit charges to the Medicare-approved amount. If you have a Medigap policy, it may help with Part B cost-sharing. See our Medicare Supplement guide and Medicare Advantage versus Medigap comparison for the cost-sharing differences.

Confirm that your clinician has sent the order and supporting records, ask whether your supplier is enrolled in Medicare and accepts assignment, and request a written explanation of your expected share of the cost. If you are enrolled in Medicare Advantage, call the plan before delivery to ask about supplier-network and prior-authorization requirements.

If a claim is denied or the supplier gives you conflicting information, do not assume you must pay the full amount immediately. Ask for the reason in writing and review your Medicare Summary Notice or plan Explanation of Benefits. A licensed agent can help you understand plan rules, while your clinician and supplier handle the medical documentation.