How to Pay for a Portable Oxygen Concentrator
If you are facing lung disease or a breathing disorder that requires you to receive supplemental oxygen, some options can make breathier easier. And we breathe so that we can leverage the oxygen in our bodies to burn the sugars and fatty acids that produce energy.
Portable oxygen concentrators (POC) create an excellent solution for those who need help to breathe better. These devices help those with low levels of blood oxygen and can either operate by battery power or when plugged into electrical outlets.
Benefits of portable oxygen concentrators
These portable units receive air, purify it, and then distribute it into the changed air. The air comes out of the concentrator as almost purely oxygen with few traces of nitrogen. Without these devices, many people would be unable to maintain an active and on-the-go lifestyle.
Benefits of portable oxygen concentrators include:
- Better night’s sleep – Those who need help breathing will be able to get a good night’s sleep when using a POC.
- Mobility – When leveraging a POC, users can go for rides in the car, run errands, go on walks, enjoy picnics, and so much more.
- Improved stamina – With the right amount of oxygen to burn into fuel, those with a POC can get dressed without taking a break, can take their dog for a walk, can prepare meals, go to work, clean the house, and so much more.
- Improved mental alertness – When you do not receive the right amount of oxygen to your brain, it can cause mental fogginess. The supplemental oxygen made available through a POC can help improve the health of your brain and other organs in your body.
- Independent lifestyle – When you have access to the oxygen you need to get through the day, you can lead your own, independent lifestyle and be less reliant on others for assistance.
Paying for your portable oxygen concentrator (POC)
If you are struggling with lung disease or another breathing disorder, you likely know that a POC can provide you with the solution to make life easier. However, you may be concerned about how to pay for a POC as they don’t come at a low cost. In most cases, Medicare can pay for the device, but some conditions need to be met to get approved.
Historically, Medicare has paid for typical durable medical equipment. Wheelchairs are the perfect example of a piece of medical equipment that Medicare will cover. Unfortunately, the rules are a bit different when it comes to medical oxygen-related devices. Back in 2013, Medicare changed its reimbursement rate for oxygen equipment. Though durable medical equipment providers would previously cover the cost of the oxygen-related equipment and would proceed to bill Medicare later, this practice became too expensive to sustain. And thus, now only 50% of costs are covered.
If you can meet certain criteria that has been set by Medicare, you may be able to get your portable oxygen concentrator paid for in full. You will need to meet the following requirements as identified on the Medicare website.
- 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.
If you are Medicare-eligible and need to find out if Medicare will cover the cost of your POC, you will need to complete an application and prove that the above criteria have been met. You will also need to provide a detailed written order from your doctor that reiterates your need for the medical oxygen equipment.
The doctor’s order will need to include your full name, a description that lists the equipment necessities, your particular needed flow rate, and how long you will need to receive the medical oxygen. Be sure too that the order is dated and that the doctor signs. Once that order is in hand, your paperwork can be submitted, and you will be able to find out if you have been approved or denied. Don’t give up hope right away, though if you are denied, as it may mean that you made an error in your paperwork. So, be sure to check the paperwork carefully and do not hesitate to get assistance from a medical representative that can review your documents for accuracy. Healthcare advocates are often available through your clinic or hospital and can help you through the process.
Renting your portable oxygen concentrator
If you do qualify, Medicare will help you pay for the items needed for your POC. Patients then just pay just 20% of the Medicare-approved amount. This 20% guideline applies to the coverage of many insurance policies too. You will then rent your equipment from a durable medical equipment provider for three years. At the end of the three years, your supplier will be required to continue to provide your oxygen equipment and the related supplies for an additional two years. This means that your particular supplier will need to provide the equipment and supplies for a total of five years, provided you continue to need the equipment.
According to the Medicare website, the monthly rental payments to the supplier cover not only your oxygen equipment, but also any oxygen accessories and services like:
- Tubing or a mouthpiece
- Oxygen contents
- Oxygen machine maintenance
- Oxygen machine servicing
- Oxygen machine repairs
When you rent the unit, the unfortunate consequence is that you will not be putting your money towards a unit that you’ll eventually own. It’s not uncommon, however, to be renting a POC with a shorter lifespan. Some medical oxygen equipment suppliers will allow you to finance a new portable oxygen concentrator through them with monthly payments, and this can be a benefit if you prefer to own the unit.
If you determine that buying our own concentrator is a better option for you than renting, Medicare will help pay for the supplies needed if you meet Medicare’s criteria and conditions. Medicare will not, however, purchase or pay for the cost of the POC. And, note that prices for the equipment will vary, as will potential reimbursement rates. In some cases, your durable medical equipment provider will give you the option to pay a flat monthly rate, which will be based on the price of the POC and how much Medicare will reimburse you.
Using CareCredit to finance a Portable Oxygen Concentrator
CareCredit is a credit card that is designed specifically for use on health and wellness related expenses. Accepted at over 20,000 providers across the country, CareCredit can now be used for durable medical equipment related expenses through OxyGo, a top provider for oxygen therapy and equipment.
When you use your CareCredit card, you will have access to various payment options for purchases of $200 or more.
Using your IRA for your Portable Oxygen Concentrator
If you have an individual retirement account (IRA), you can sometimes withdraw funds for medical-related needs without being charged a penalty. According to the Charles Schwab website, you can avoid an early withdrawal penalty when funds are used to pay medical expenses that are otherwise unreimbursed and are more than 7.5% of your adjusted gross income (AGI).
If you’re unemployed, however, you can take penalty-free distributions to pay for medical insurance. Yet, certain conditions must be met. You must be able to prove that you lost your job and that you received unemployment compensation for 12 weeks. You must also have received the distributions during the year you received the unemployment payment or the following year. And, you must have received the distributions no later than 60 days after you got another job.