For a FREE Consultation Call 1-800-958-0192 To Speak To One Of Our Respiratory Specialists
Customers often come to us here at Portable Oxygen Solutions and ask us a simple question: Will medicare pay for a portable oxygen concentrator? Ah yes, a very good question indeed and an important one too for anyone looking to purchase a quality portable concentrator. And because we get this question so much, today we decided to write an article explaining to you why it may be difficult, at best, to get a portable concentrator through medicare.
Will Medicare help pay for a portable oxygen concentrator? The short answer is both yes and no. So, why do we hear so many oxygen users say their respiratory equipment supplier told them Medicare does not cover portable oxygen concentrators (POC)? The truth is these respiratory suppliers don’t want to provide you an oxygen machine costing thousands of dollars when they can get by setting you up with oxygen tanks costing a few hundred dollars. Medicare and other insurances do have rental fees for Portable Oxygen Concentrators, which means they do pay a certain amount for this technology. However, the respiratory equipment suppliers are not convinced Medicare pays enough and they are not required by Medicare to give you a portable oxygen concentrator. They are only required to supply equipment that maintains your oxygen needs.
Currently, Medicare uses a fee schedule to set prices for rental of oxygen equipment. Oxygen equipment is limited to a 36-month rental period. Due to the reimbursement guidelines, respiratory suppliers who bill Medicare tend to be cautious and very selective with what types of oxygen equipment they provide to you. Once you qualify for supplemental oxygen, Medicare will begin paying the respiratory supplier the monthly rental fee for 36 months (3 years), and then just a small "service fee" for the following 24 months. Medicare respiratory suppliers that provide oxygen to you are required to maintain the equipment for a total of 60 months (5 years).
Given these circumstances, the medical equipment companies will first consider how many months are left within your 36 month rental period. They are not likely to supply a portable oxygen concentrator to you if you are not at the beginning of your 36 month rental period, especially if you are wanting to move from another equipment provider. As an example, if you have been on oxygen for 12 months and you want to move to another respiratory supplier in hopes of getting a portable concentrator, the new supplier would only receive 24 months of rental payments before moving into the "maintenance fee only" months. So there is very little financial incentive to accept you as a new oxygen patient and provide you with a Portable Oxygen Concentrator. Why?...Because the cost of the Portable Concentrator exceeds the amount Medicare will reimburse the equipment company. With this said, they are only looking for newly diagnosed oxygen patients at the beginning of their 3 year rental period or those patients who have been on oxygen for 5 years and Medicare has ruled the patient can start over with a new 36-month payment period and a new 5-year obligation period. Note: Medicare considers the useful life of oxygen equipment to be 5 years, therefore, at the end of the 5 year useful life period, the equipment company can start the rental process over again. This also requires the equipment company to replace the old respiratory equipment with new equipment. At this point is where you will have your best chance in obtaining a portable oxygen concentrator from your Medicare respiratory supplier.
Do you really want to wait up to 5 years before you can see if a Portable Oxygen Concentrator is right for you? Do you really want the burden of having to carry or pull heavy, bulky oxygen tanks around everywhere you go for several years?
If you thought getting a Portable Oxygen Concentrator from local equipment companies has been difficult to this point, Medicare just made things a lot tougher by implementing their National Competitive Bidding (NCB) process for medical equipment supply companies in most areas of the country. Companies with the lowest bid were those awarded Medicare contracts. This means the Medicare rental fee that is reimbursed to equipment suppliers has been reduced even more! You also have less oxygen suppliers to choose from because bidders who were not among the lowest priced are excluded from the market and not allowed to serve new oxygen patients. So there continues to be less and less financial motivation for oxygen equipment supply companies to set you up with a portable oxygen concentrator.
Portable Oxygen Solutions has chosen not to bill Medicare or Private Insurance so we do not have these restrictions. You want a Portable Oxygen Concentrator, our answer is YES!
Now, more and more patients are taking charge of their own lives and taking control of their own healthcare! How?...By purchasing their own equipment. The benefits of portable oxygen concentrators are far greater than the cost of the machines. There is a world of possibilities with portable oxygen concentrators that are as active as you are.
Don’t let your oxygen prescription change your life! A portable oxygen concentrator will allow you to continue to work, travel, play sports, participate in hobbies, socialize and maintain your independent lifestyle while finding it easier to comply with your oxygen therapy.
The Right Oxygen Equipment Can Be As Important As The Oxygen, Itself!! Stay Active. Live Well.
Save $1000’s Off Retail!!
Questions? Need Advice?
Please Call Us Toll Free 1-800-958-0192