Discover Better Breathing with Medicare Covered COPD Oxygen Concentrator

Understanding Your Medicare Coverage for COPD Oxygen Concentrator

Medicare, the government healthcare insurance program, offers coverage for the diagnosis and treatment of a variety of chronic conditions, including Chronic Obstructive Pulmonary Disease (COPD). COPD often necessitates the use of an Oxygen Concentrator, a device that delivers pure oxygen to those who have difficulty getting enough oxygen into their blood. Medicare Part B considers oxygen equipment and accessories as Durable Medical Equipment (DME), which is eligible for coverage. Following approval from a healthcare professional confirming the medical necessity of an Oxygen Concentrator, Medicare would cover this cost, given certain conditions and criteria are met.

Meeting the Criteria for Reimbursement

To be granted coverage for a COPD Oxygen Concentrator under Medicare, individuals must satisfy certain criteria, which extends beyond just a COPD diagnosis. The main condition is that an arterial blood gas test or an oximetry test shows low levels of oxygen in the blood. This test must be conducted during a formal exercise period or while the individual is at rest. Depending on results, Medicare may cover a stationary Oxygen Concentrator for home use, a portable one for use outside the home, or both. Referral from a healthcare provider is mandatory.

How the Coverage Works

Once the medical necessity for an Oxygen Concentrator is established, Medicare covers 80% of the Medicare-approved amount for rental of the device, after the individual has met the Part B deductible. Any supplemental insurance could potentially cover the remaining 20%. However, individuals might be responsible for all the costs if the supplier of the Oxygen Concentrator isn't enrolled as a Medicare provider. Thus, it’s crucial to choose a DME supplier that is a participating Medicare provider to ensure maximum coverage.

Hidden Costs and Additional Factors

While Medicare provides substantial coverage, it's important to remember that there might be additional costs not covered, such as electricity to run the oxygen equipment or necessary maintenance after the warranty period. It's also worth noting that prices can vary based on factors such as the type of equipment, whether it's new or used, and the region in which an individual resides. Therefore, individuals are advised to make comprehensive inquiries, including about any potential financial aid, subsidies, or grants, to lighten the overall fare.