If you’re managing a chronic respiratory condition, understanding Medicare’s oxygen coverage is crucial for planning your care and expenses.
In this article, we’ll explore how oxygen therapy is covered under Original Medicare, Medicare Advantage, Medigap, and Medi-Share 65+.
We’ll also discuss the equipment and services you may need, including oxygen tanks, portable oxygen concentrators, equipment rental, and respiratory therapy.
Does Medicare Cover Oxygen Under Original Medicare?
Yes, Medicare covers oxygen under both Part A (hospital care) and Part B (outpatient care), but coverage depends on how and where the oxygen is used.
Oxygen in Hospitals
If you are admitted to a hospital, Medicare Part A covers the cost of oxygen therapy as part of your inpatient care.
This includes the oxygen itself, equipment, and any necessary monitoring. There are no additional costs beyond the usual Part A deductible and coinsurance for hospital stays.
Oxygen at Home
Medicare Part B covers oxygen therapy for home use if it is deemed medically necessary. To qualify, your doctor must document that:
- You have a severe lung disease or hypoxemia that requires supplemental oxygen.
- Other treatments have not been effective.
- Your blood gas levels meet Medicare’s specific criteria for oxygen therapy.
Once approved, Medicare covers:
- Oxygen tanks or concentrators (stationary and portable options).
- Equipment delivery, maintenance, and tank refills.
- Oxygen-related supplies, such as tubing and masks.
Cost Considerations
Under Part B, beneficiaries are responsible for 20% of the Medicare-approved amount after meeting their annual Part B deductible. This applies to both oxygen equipment and related services. Medicare rents oxygen equipment rather than purchasing it outright, typically covering rental costs for up to five years.
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Does Medicare Cover Oxygen Under Medicare Advantage?
Yes, but coverage varies by plan.
Medicare Advantage (Part C) plans, offered by private insurers, must cover the same oxygen benefits as Original Medicare but often include additional perks. Some plans may offer:
- Lower out-of-pocket costs for equipment rental or maintenance.
- Expanded access to portable oxygen concentrators.
- Additional services like home visits from respiratory therapists.
- Flexible coverage options for more advanced equipment.
However, coverage specifics vary widely by plan. It’s crucial to review the details of each plan’s oxygen therapy benefits to ensure it meets your needs.
Do Medicare Supplement (Medigap) Plans Cover Oxygen Costs?
Yes, but only for out-of-pocket costs.
If you use oxygen therapy at home, a Medigap plan can help cover the 20% coinsurance you would otherwise pay under Part B. If you have Plan G, N, F, or C, your Medigap plan can cover the entire coinsurance. With plans G or N, you would just have to pay the Part B deductible, which is $257 as of 2024.
Additionally, some Medigap plans, including Plan G, may cover excess charges from providers who do not accept Medicare’s approved amount as full payment.
(Note: Medigap Plans F and C, which also cover the Part B deductible, are no longer available to new Medicare beneficiaries).
While Medigap does not expand Medicare’s oxygen benefits, it can significantly reduce your financial burden by helping you pay the out-of-pocket costs under Part B.
Does Medicare Medi-Share 65+ Pay for Oxygen?
Medi-Share 65+ is a faith-based health-sharing plan tailored for individuals with Medicare.
It’s an affordable Christian alternative to Medigap plans, and provides similar benefits: Medi-Share 65+ generally pays 100% of all costs over the first $500 per household per year approved but not paid under Original Medicare (Parts A and B).
Medi-Share 65+ members often benefit from:
- Discounts on durable medical equipment, including oxygen tanks and portable concentrators.
- A flexible approach to sharing costs related to respiratory care, provided they align with the program’s guidelines.
Medi-Share 65+ is not an insurance plan. Instead, it’s a non-profit association of like-minded Christians who agree to help share unexpected medical costs of other members.
Unlike traditional insurance products like Medigap and Medicare Advantage plans, Medi-Share 65+ doesn’t share costs for pre-existing conditions right away. Instead, it imposes a waiting period of up to six months.
However, the waiting period is waived for those who enroll during the Fall Enrollment period (October 15th through December 7th), or who enroll within the first 6 months of joining Medicare Part B, normally at age 65.
Medi-Share 65+ is very popular because it usually costs much less each month compared to traditional Medigap policies. Monthly costs are just $99 for those age 65-74, and $150 for those age 75 and up. This compares very favorably with Medigap Plan G, especially in higher cost-of-living areas.
Does Medicare Cover Oxygen for Respiratory Therapy?
Yes, Medicare covers respiratory therapy under Part B.
Here’s how it’s covered across different plans:
- Original Medicare: Respiratory therapy is covered under Part B when provided by a Medicare-certified provider. Beneficiaries pay 20% coinsurance after meeting the Part B deductible ($257 as of 2025).
- Medicare Advantage: Many plans offer expanded respiratory therapy benefits, including home visits and telehealth options.
- Medigap: Medigap plans cover coinsurance costs for respiratory therapy under Original Medicare, reducing out-of-pocket expenses.
- Medi-Share 65+: Pays 100% of respiratory therapy costs approved but not paid under Medicare Part B, other than the first $500 per household per year.
Does Medicare Cover Portable Oxygen Concentrators?
Portable oxygen concentrators are becoming increasingly popular for their convenience and mobility.
While Medicare covers stationary concentrators, it rarely covers portable models. Beneficiaries who require a portable oxygen concentrator may need to pay out of pocket or seek help through a Medicare Advantage plan, or through one of Medi-Share 65+’s discount programs.
Tank exchanges for traditional oxygen systems are covered under Medicare Part B as part of ongoing oxygen therapy. The costs of delivery and refills are included in the rental agreement for oxygen equipment.
Choosing the Right Plan for Oxygen Therapy
Navigating oxygen therapy coverage can be complicated, but understanding your options is key.
Original Medicare provides a strong foundation, while Medicare Advantage and Medigap plans offer additional financial protections and benefits. Medi-Share 65+ can be a viable alternative for those seeking a faith-based, community-oriented approach to healthcare.
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Take Control of Your Oxygen Coverage
If you or a loved one require oxygen therapy, a Medigap Advisors Personal Benefits Manager can help you find the best plan for your needs.
Schedule a free consultation today to explore your options, get personalized recommendations, and ensure you’re fully covered for all your oxygen and respiratory therapy needs.
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Misty Berryman is one of your Personal Benefits Managers at Medigap Advisors. She loves working for Medigap Advisors for many reasons, including being part of the solution to one of life’s most important healthcare challenges: choosing the right Medicare plan. Read more about Misty on her Bio page.