Getting an oxygen concentrator in the United States typically requires a prescription from a doctor, a qualifying oxygen test, and a supplier who can set you up with the right equipment. The process involves a few steps, but once you understand what’s needed, it moves fairly quickly. Here’s how it works from start to finish.
Why You Need a Prescription
Oxygen concentrators that deliver therapeutic levels of oxygen are classified as prescription medical devices by the FDA. Devices that cannot maintain a flow rate of at least 6 liters per minute for 15 minutes are specifically designated as prescription-only. The only exception is emergency-use oxygen equipment that meets that minimum threshold and is labeled accordingly, which can be sold over the counter but isn’t designed for ongoing home use.
This means you can’t walk into a store or go online and buy a medical-grade oxygen concentrator without a valid prescription. Some websites may appear to sell them without one, but reputable suppliers will require documentation before shipping.
Getting the Prescription
Your doctor will order an oxygen level test to determine whether you qualify. This is usually a pulse oximetry reading (the clip placed on your finger) or an arterial blood gas test, which is a blood draw from an artery. Medicare and most insurers require one of these tests as proof of medical need.
The general thresholds that qualify you for home oxygen therapy are an arterial oxygen level at or below 55 mmHg, or a blood oxygen saturation of 88% or less while at rest in a stable condition. If you have signs of complications like right-sided heart failure, fluid retention, or elevated red blood cell counts, the threshold is slightly more generous: an arterial oxygen level at or below 59 mmHg or saturation of 89% or less. Patients with resting oxygen saturation at or below 92% are typically referred for further blood gas evaluation.
Once your test results confirm you need supplemental oxygen, your doctor fills out a Certificate of Medical Necessity. This document specifies your oxygen flow rate, how many hours per day you need it, and whether you need it during sleep, activity, or both. The certificate goes to your equipment supplier and, if applicable, your insurance company.
Choosing Between Stationary and Portable Units
Oxygen concentrators come in two main types, and many people end up with both.
Stationary concentrators are designed for home use. They plug into a wall outlet, weigh around 35 pounds, and deliver a continuous flow of oxygen typically up to 5 liters per minute. They’re reliable workhorses for overnight use and long periods at home, but they aren’t meant to leave the house.
Portable concentrators run on rechargeable batteries and weigh between about 3 and 5 pounds. Models like the Inogen One G4 weigh as little as 2.9 pounds. Most portable units deliver oxygen in pulse doses, meaning they release a small burst of oxygen each time you inhale rather than flowing continuously. This conserves battery power but may not work for everyone, especially during sleep when breathing patterns change. Your doctor’s prescription will specify whether continuous flow is necessary, which narrows your options.
If you need oxygen only during activity or travel, a portable unit alone may be sufficient. If you need it around the clock, expect to use a stationary unit at home and a portable one when you’re out.
Where to Get Your Equipment
The standard route is through a durable medical equipment (DME) supplier. These companies are accredited by organizations approved by the Centers for Medicare and Medicaid Services, including the Accreditation Commission for Health Care (ACHC), the Healthcare Quality Association on Accreditation (HQAA), and the Joint Commission. Your doctor’s office often has relationships with local DME providers and can send your prescription directly.
You can also purchase concentrators from online medical equipment retailers. If you go this route, verify the seller requires a prescription and carries FDA-cleared devices. Be cautious with heavily discounted units from unfamiliar websites. Used concentrators are available from reputable resellers, but check the remaining warranty and how many hours the unit has logged, since the internal components wear over time.
What It Costs
New portable oxygen concentrators typically run between $2,000 and $4,000, with batteries and accessories adding to the total. Used units range from $1,000 to $2,500 depending on condition and remaining warranty. Rentals start at roughly $150 per week, which makes sense for short-term needs like post-surgical recovery or travel but adds up quickly for long-term use.
Stationary home concentrators generally cost less than portable models, often in the $600 to $2,000 range depending on features and flow capacity.
How Insurance Covers It
Medicare Part B covers home oxygen equipment as a rental. You don’t buy the concentrator outright through Medicare. Instead, the DME supplier owns the equipment, bills Medicare monthly, and you pay your share of each rental payment. The rental period is capped at 36 months. After those 36 months, the supplier must continue providing the equipment and maintenance at no additional cost for as long as you have a medical need. When the equipment reaches the end of its useful life, you can get a replacement for both stationary and portable units.
Private insurance plans vary, but most follow a similar structure: you need a qualifying test, a Certificate of Medical Necessity, and an in-network DME supplier. Call your insurer before ordering to confirm coverage details, as some plans require prior authorization.
If you don’t have insurance or prefer to buy outright, you’ll pay the full purchase price. Some DME suppliers offer payment plans.
Flying With a Portable Concentrator
The FAA allows portable oxygen concentrators on commercial flights if the device meets specific acceptance criteria. The concentrator must be legally marketed in the U.S. under FDA requirements, must not emit radio frequency interference, and must not generate compressed gas or contain hazardous materials beyond standard batteries. Newer models must carry a red-labeled statement confirming FAA compliance.
Several models have been specifically tested and approved, including devices from Inogen, AirSep, SeQual, Respironics, and DeVilbiss. Airlines may have their own additional requirements, so notify the airline at least 48 hours before your flight. Bring extra batteries: most airlines require enough battery life to cover 150% of your flight time.
Maintaining Your Concentrator
Keeping your concentrator running well takes a few minutes each week. Wipe down the exterior with a damp cloth weekly. Remove and wash the intake filters weekly, let them air dry completely, and replace them once a month. If your unit has a humidifier bottle, wash it with soap and warm water each time you refill it, using only distilled water. Disinfect the bottle weekly by soaking it for 20 minutes in a mixture of three parts white vinegar to one part water, then rinsing thoroughly.
Replace your nasal cannula and tubing every one to two weeks. Don’t try to wash and reuse them, as they’re designed to be disposable.
Fire Safety at Home
Oxygen doesn’t burn on its own, but it makes everything around it burn faster and hotter. Keep your concentrator and all oxygen tubing at least 10 feet from any heat source or open flame, including gas stoves, candles, cigarettes, e-cigarettes, and even appliances that generate heat like blow dryers and electric razors. Plug the concentrator directly into a wall outlet, never into an extension cord or power strip. Avoid aerosol sprays, oil-based lip balms, petroleum jelly, and alcohol-based hand sanitizer near the equipment. Keep a working fire extinguisher nearby and make sure your smoke detectors are functional.