How to Pay for a Portable Oxygen Concentrator

July 9, 2021

Portable oxygen concentrators are great devices for those with a medical need for oxygen who live an active, on-the-go lifestyle. After choosing to buy a portable oxygen concentrator, you’ll likely have some questions, especially related to how you’ll pay for the device. There are several options when it comes to getting a portable oxygen concentrator.

The most pressing question might be how to get Medicare to cover the concentrator since they’re not exactly cheap. The answer isn’t entirely straightforward or black and white. There are conditions that must be met and some hoops you’ll need to jump through.

EverGo POC

EverG0 Portable Oxygen Concentrator, Source: GoCPAP.com

Medicare has always paid for durable medical equipment like wheelchairs. But when it comes to medical oxygen equipment, the rules change a bit. Medicare does cover part of medical oxygen equipment, but not all of it. They’ve always paid a certain amount towards oxygen equipment, but in 2013, their reimbursement rate was slashed by 50 percent. In the past, durable medical equipment providers would cover the cost of the equipment and then bill Medicare later, but this was too costly for suppliers to cover.

Because of this, insurance providers are now likely to cover less expensive oxygen supplies instead.

Portable Oxygen Concentrators and Medicare

If you meet certain criteria set by Medicare, it will help pay for a portable oxygen concentrator. According to their website, they’ll help cover the cost if the following conditions are met:

  • Your doctor says you have a severe lung disease or you’re not getting enough oxygen.
  • Your health might improve with oxygen therapy.
  • Your arterial blood gas level falls within a certain range.
  • Other alternative measures have failed.

To figure out if Medicare will help cover the cost of the portable oxygen concentrator, you’ll have to meet the above criteria and fill out an application that includes a detailed written order from your doctor. In the order, you’ll have to include:

  • Your full name
  • A detailed description of all equipment necessities
  • Your needed flow rate
  • How long you’ll need to receive medical oxygen
  • Date of the order
  • Doctor’s signature

Once you have that order, you can submit all your paperwork and soon find out if you’ve been approved or denied. If you are denied, it’s likely due to a paperwork error, so be very careful when you submit your application. The government paperwork has very strict requirements. If you’re denied, you’ll have to start the application process over again.

Owning vs. Renting Portable Oxygen Concentrator Equipment

If you qualify, Medicare helps pay for the systems that provide the oxygen, containers that store the oxygen, the tubing and other related supplies. You’ll pay just 20 percent of the Medicare-approved amount, and this rule applies with many insurance policies, too.

You’ll get the device from a durable medical equipment provider directly and that provider bills Medicare monthly. Talk to your doctor about options because it can be difficult to find Medicare-approved providers due to a competitive bidding program Medicare implemented when they cut their reimbursement rate.

rent vs buy

Source: Caniretireyet.com

If you own your own concentrator, Medicare will help pay for the supplies needed if you meet Medicare’s criteria and conditions. It’s important to note that Medicare will not purchase or pay for the cost of purchasing a portable oxygen concentrator.

Prices vary depending on equipment cost and reimbursement rates, so it’s difficult to pinpoint exactly what you’ll be paying. Some suppliers will let you pay a flat monthly rate, and that’s based on the price of the concentrator and how much Medicare will reimburse you.

Renting portable oxygen equipment can be complicated due to some rules you need to follow. You must rent the equipment for 36 months. After that time, your supplier must continue supplying the equipment for an additional 24 months, maxing out at five years, as long as you have a medical need for oxygen. After five years, you can stay with your existing supplier or select a new one and the 36-month rental period starts over. It’s important to understand that if you decide to rent, it’s at least a five-year commitment.

Because of this, it can make providers picky about what sort of equipment they’ll provide. How long you’ve been diagnosed with a medical need for oxygen can play a factor in cost and what sort of equipment you’ll receive.

The downside to renting is you aren’t putting your money towards something you’ll eventually own, and it’s not uncommon to be renting a portable oxygen concentrator with a shorter lifespan. Some durable medical equipment companies will actually allow you to finance a new portable oxygen concentrator through them with monthly payments so you’ll eventually own it. If you decide you only need a concentrator for a short amount of time, like for a trip, you can do a short-term rental.

Financing a Portable Oxygen Concentrator with CareCredit

CareCredit entered the durable medical equipment market in 2017 through a multi-year agreement with OxyGo. OxyGo is a leading provider for oxygen therapy and equipment. CareCredit is a top company for health care financing and serves millions of people annually.

If you use your CareCredit credit card, you can look into a variety of monthly payment options for purchases that are $200 or more. This is ideal when planning a monthly budget. You can use your CareCredit credit card for dental, vision, cosmetic and veterinary care at more than 200,000 healthcare provider and retail locations within the CareCredit network.

Consider Dipping into your IRA

For certain things, you can withdraw money from your IRA without facing a harsh financial penalty. Typically, if you withdraw money before age 59.5, you can face an additional 10 percent early-distribution penalty on taxable income. But there are some medical exceptions.

If you are uninsured or your medical expenses total more than your insurance will cover that year you may be able to take penalty-free distributions from your IRA. It’s important to remember this only applies if you’re paying medical expenses greater than 7.5 percent of your adjusted gross income.

If you’re unemployed, you can take penalty-free distributions to pay for medical insurance. But you must meet certain conditions:

  • You lost your job.
  • You received unemployment compensation for 12 weeks.
  • You received the distributions during the year you received the unemployment payment or the following year.
  • You received the distributions no later than 60 days after you got another job.

You also won’t be penalized if you’re disabled and can be for any purpose. However, a physician must determine that you aren’t able to work due to a physical or mental disability. The disability must be expected to result in your death or be determined to last for an indefinite period.