Will Medicare Pay for My Portable Oxygen Concentrator?

 

 

If you have been prescribed medical oxygen by your doctor, you probably have several questions about how to obtain a portable or home oxygen concentrator through Medicare. Some of those questions might be, “Do I qualify for Medicare? Does Medicare pay for supplementary oxygen equipment? Who do I contact about coverage? What is the application process like to request Medicare assistance for my POC? Why do some claims get denied by Medicare?”

It is often difficult to find straight answers when researching these questions, and that’s because the answer isn’t all black and white. Rest assured, Liberty Medical has the answers for you! The “why” behind the policies of Medicare are all laid out for you here, so that understanding this complicated question becomes much easier.

What’s the Deal with Medicare?

 

 

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.

But 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.

Do I Qualify for Medicare?

 

 

If you are 65 years of age or older, have a medical condition or disability, and have worked and paid for Medicare taxes for a certain period of time, you are eligible for Medicare. The amount you actually pay is determined by different factors. If you are lucky enough to find a Medicare-approved supplier of oxygen equipment in your area, you can begin the application process to determine what costs will be covered.

Your physician will write up a Detailed Written Order that includes:

• Your full name
• A very detailed description of all equipment necessities
• Your specified flow rate (pulse or continuous)
• How long you’ll need to receive supplementary oxygen
• Date of the order
• Date and doctor’s signature

Once your paperwork is submitted, you will either be approved or denied. In cases where patients are denied, it often comes down to an error in the paperwork or missing documents. There is a lot of red tape to go through with this application process, as this is government paperwork with very strict requirements. If you are denied, you must start the application process all over again. You’ll want to be sure you aren’t missing your blood saturation test results, the complete doctor’s order, your certificate of medical necessity, and your oxygen prescription. All documents must be current and up to date. You must have a 24/7 need for oxygen therapy to qualify.

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 though 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!

As an oxygen equipment provider, we have a firsthand understanding of how frustrating the limitations set by Medicare can really be. Our goal at Liberty Medical is to provide you with options that will get you the oxygen device you need sooner, rather than later. We don’t believe in putting your life on hold by making you jump through a hundred hoops just to get the care you need and deserve.

Browse our POC blog to find detailed information on each of the portable and home oxygen concentrators we offer. You have the option to purchase or rent one from our website. Be sure to ask about our financing plans with Care Credit, the Help Card, or PayPal Credit. We’d be more than happy to assist you with your supplementary oxygen needs today! With 30 years of experience, Liberty’s support team will help you determine what the best oxygen solution is for you. Call us at 1-800-375-6060 to learn more. www.traveloxygen.com