How To Get A Free Portable Oxygen Concentrator

Table of content:

Introduction What Do You Need to Qualify for Portable Oxygen Concentrator Coverage?What other Requirements Must You Meet to Qualify for a Portable Oxygen Concentrator?Why is Portable Oxygen Concentrator Coverage Mostly for Rentals?
How Can You Rent a Portable Oxygen Concentrator Through Medicare or Medicaid?What Are the Pros and Cons of Renting a POC?What to do if You can't get POC through Medicare?Conclusion

Oxygen therapy allows patients to breathe life-saving air in a concentrated form. Technology helps store pure oxygen or filter it from the atmosphere for patients.

Oxygen concentrators are vital for seniors and patients managing respiratory issues. A portable oxygen concentrator (POC) is especially helpful. Unlike a standard fixed oxygen concentrator, a POC enables users to move. They are small and lightweight devices. POCs are helpful during travel, social events, outdoor activities, and more.

POCs are not cheap, but there are some ways to acquire one for free. Here is more information on how to get a free portable oxygen concentrator.

What Do You Need to Qualify for Portable Oxygen Concentrator Coverage?

First, you need to choose a suitable insurance program. Medicare, Medicaid, and most private insurance plans classify portable oxygen concentrators as durable medical equipment (DME).

Original Medicare Part B will cover the costs of oxygen equipment plus their accessories. The gadget must be as prescribed by your physician for home use.

Original Medicare also covers the cost for:

● Tubing and mouthpiece
● Oxygen content
● Equipment repairs
● Equipment servicing
● Equipment maintenance

Medicare Part B will also cover the cost of supplemental oxygen and medical supplies. They have coverage for oxygen equipment and accessories lasting 5 years. It's the set reasonable time according to the Centers for Medicare & Medicaid Services (CMS).

You must pay 20% of Medicare-approved oxygen costs for up to 36 months or three years. After the first three years, your supplier will continue the rental services for the next 24 months. If you still need the device beyond five years, you can sign up for a replacement. You will then restart the three-year payment period.

In the Medicare Advantage plan, you will receive similar coverage for portable oxygen concentrators. The coverage may also include other benefits beyond what original Medicare offers.

Medicaid coverage for POCs varies from state to state. The Medicaid programs in many states cover up to 100% of the cost of a portable oxygen concentrator. The cover is for oxygen therapy. It must be medically necessary and fits the state's DME definition. For coverage amount and qualification, contact your state Medicaid agency.

Private insurance plans vary, but some include portable oxygen as a benefit. You need to consult with your agent and understand the policy document.

What other Requirements Must You Meet to Qualify for a Portable Oxygen Concentrator?

The US Food & Drug Administration (FDA) considers POC as Class II Medical Devices. So, you need a valid prescription from a certified doctor to purchase or rent one.

FDA's reason for a prescription is to ensure proper distribution of oxygen and concentrators to patients with certified medical needs.

Medicare, Medicaid, and private health insurance also require a prescription from a qualified registered doctor before processing the coverage.

Why is Portable Oxygen Concentrator Coverage Mostly for Rentals?

POC coverage is mainly for rentals because Medicare considers them DMEs for hire. However, you can also buy a POC, or depending on the agreement with your supplier, you may acquire it after a number of payments.

If you meet the Part B deductible in the original Medicare, you will only pay 20% of the Medicare-approved amount. The eligibility requirements for Medicare coverage for a portable oxygen concentrator are:

Medical Necessity

Your doctor must provide documentation to support a diagnosis of severe lung disease and evidence of low blood oxygen levels that aren't manageable by other treatments.

Doctor's Recommendation

Your doctor must provide information showing proof that oxygen therapy will improve your health. The recommendation indicates that using a portable oxygen concentrator will help ease your symptoms and improve your quality of life.

Continued Medical Need

Medicare and Medicaid will require periodic reviews to show your need to continue with oxygen therapy. As a patient, you must undergo periodic testing and provide updated medical results to maintain coverage.

Medicare-Approved Doctor

Your doctor must be Medicare-enrolled. You need to consult with your physician and Medicare to confirm your doctor's eligibility in the program.

Medicare-Approved Supplier

You must source the portable oxygen concentrator from a supplier that Medicare approves. Such suppliers are the only ones that can bill Medicare for the rental of your device.

How Can You Rent a Portable Oxygen Concentrator Through Medicare or Medicaid?

If you want to rent a Medicare-covered portable Oxygen concentrator, you must have completed Part B of Medicare. Here are the steps to follow when renting a portable oxygen concentrator:

Work with a Provider

The first step in renting POC through Medicare or Medicaid is working with your provider. You must see your provider, usually a pulmonologist, to secure medical documentation and order the equipment. Your provider must also be Medicare-enrolled or Medicaid-enrolled.

Your provider should facilitate the following:

1. Prepare your medical record:

Your provider prepares a medical record showing you meet Medicare or Medicaid coverage criteria for a portable oxygen concentrator. The record details your qualifying diagnosis, showing you have undergone thorough testing requirements and that other treatments have failed to work.

Specifically, your provider's medical record should show:

● Qualifying blood gas studies
● A clinical evaluation within 30 days before the doctor's initial certification
● Your continued need and management through oxygen therapy
● The method of oxygen delivery

It is important to note that the medical record is not a one-day process. The document carries historical records of diagnoses, tests, and treatments.

2. Fill in a Certificate of Medical Necessity (CMN).

The medical record must show matching information on a timely and accurate form CMS-484. Both the provider and the supplier usually complete the form. The supplier who initiates a CMN and your provider will often complete and return the form. The provider dispenses an order to the supplier to inform them of a prescription from the suitable POC.

3. Sign a Detailed Written Order (DWO).

This is a paper trail to document your need for the POC.

Working with the Supplier

The second step of renting a POC through Medicare or Medicaid is to find a supplier. Seek a supplier with knowledge and willingness to communicate to avoid initial access problems in the future. Remember you will deal with your supplier for the next 3 to 5 years.

The supplier does the following:

● Evaluate you for coverage, including acquiring the necessary medical documentation. The supplier also assists with appeals of coverage denials.

● Work with the provider to secure the required medical documentation, DWO, and CMN.

● After the initial order, communicate with your provider to get any required recertifications and documents with continued use of the POC.

● Deliver your supplies, repair or replace the POC, and arrange for the same services if you move or relocate to a different region.

What Are the Pros and Cons of Renting a POC?

Pros of renting a Portable Oxygen Concentrator through Medicare or Medicaid

1. Convenience

Convenience is paramount when treating any medical condition. You will have the freedom and flexibility of receiving oxygen therapy in your own space.

2. Cost-effective

Renting POCs is more affordable than purchasing one. It's the main benefit of renting a POC through Medicare or Medicaid. By renting, you will get the care you need without spending significant money on the product you may not use.

3. Avoid maintenance and repairs

The rental supplier ensures the device is in good working condition. However, the POC still belongs to them. In the case of a personal gadget, you are responsible for maintenance and repairs.

4. Flexibility in rental terms

You may not need to use the POC for a prolonged time. The rental terms may favor you according to the time of usage. If you buy the gadget, the initial cost is way above the rental price over a short period of use.

Cons of Renting a Portable Oxygen Concentrator through Medicare or Medicaid:

1. Dependency on your supplier

Most people choose this option since renting a POC is affordable and convenient. The drawback is sluggish suppliers or those that take too long to resolve issues.

2. Limited Customizations

Renting a POC may be cheap and convenient, but you may not get the level of personalization you need. Medicare- and Medicaid-approved suppliers may lack the gadgets you desire, available from others.

3. Inconveniences upon relocation

Medicare requires you to arrange with another supplier within the new region. Medicare will reimburse only one supplier for the provision of oxygen.

What to do if You can't get POC through Medicare?

Medicare, Medicaid, and other private health insurance are great help when renting a POC. But what if you don't qualify? What can you do in such a situation?

Religious and charitable organizations can help with purchases or meet the rental cost. You can also look for alternative suppliers like ReadyO2.

ReadyO2 has two portable oxygen concentrators for consumers.

● ReadyO2 Pro at $1,999 with a five-settings pulse flow.
● ReadyO2 Lite at $899 with a continuous flow.

Conclusion

Lung complications may require a portable oxygen concentrator (POC). Although expensive, POCs are a good remedy for oxygen therapy.

Health insurance can help lower costs but will mainly offer rental options. You can consult with your doctor and seek an alternative supplier. An example is ReadyO2, which you can still get at an affordable price.

Reference

1. Centers for Medicare & Medicaid Services. Durable Medical Equipment (DME) Coverage. Medicare.gov.

2. Centers for Medicare & Medicaid Services. Getting Oxygen Equipment & Supplies in Certain Situations. Medicare Part B Coverage.

3. Medicare Rights Center. Medicare Interactive.

4. Centers for Medicare & Medicaid Services. Medicare Coverage Database - Article ID 52514.

5. The Medicare Family. Does Medicare Cover Portable Oxygen Concentrators?

6. ReadyO₂. Portable Oxygen Concentrator.

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Article by

Jonathan Reed

I am Dr. Jonathan Reed, a proud member of the readyO₂ team. With a background in respiratory therapy, I’m dedicated to helping those in need by answering questions and providing clarity. I strive to educate and inspire our audience by making complex topics accessible and engaging. My goal is to educate and inspire our audience, ensuring they have the information necessary to make informed decisions about their health. It’s a privilege to support individuals on their journey to better breathing and well-being.