If you or your loved one is suffering from respiratory issues, you may need an oxygen concentrator to breathe comfortably. However, these machines can be expensive, and not everyone can afford them. This is where Medicare comes in. In this article, we will discuss whether Medicare pays for portable oxygen concentrators.
What is Medicare?
Medicare is a federal health insurance program that provides coverage for people who are 65 years or older, people with certain disabilities, and people with End-Stage Renal Disease (ESRD). It is divided into several parts, including Part A, Part B, Part C, and Part D.
Does Medicare Cover Oxygen Therapy?
Yes, Medicare does cover oxygen therapy, including oxygen concentrators. However, there are certain criteria that you must meet in order to be eligible for coverage.
Criteria for Medicare Coverage of Portable Oxygen Concentrators
To be eligible for Medicare coverage of a portable oxygen concentrator, you must meet the following criteria:
1. You Must Have a Prescription
You must have a prescription from your doctor stating that you need oxygen therapy. The prescription must also state the amount of oxygen you need.
2. You Must Have a Lung Function Test
You must have a lung function test that shows that your blood oxygen level is low.
3. You Must Be Homebound
You must be homebound, which means that you have a condition that makes it difficult for you to leave your home without the help of another person or equipment.
4. You Must Be Able to Use the Portable Oxygen Concentrator
You must be able to use the portable oxygen concentrator on your own or with the help of a caregiver.
How Much Will Medicare Pay?
Medicare will pay for 80% of the cost of the portable oxygen concentrator. You will be responsible for the remaining 20%. However, if you have a Medigap plan, it may cover the remaining 20%.
In conclusion, Medicare does cover portable oxygen concentrators, but you must meet certain criteria to be eligible for coverage. If you meet the criteria, Medicare will pay for 80% of the cost, and you will be responsible for the remaining 20%. If you have any questions about Medicare coverage of portable oxygen concentrators, it is best to speak to your doctor or a Medicare representative.