Home oxygen therapy is a medical treatment required by individuals with chronic respiratory conditions, such as severe Chronic Obstructive Pulmonary Disease (COPD) or advanced heart failure, to maintain adequate blood oxygen levels. Because oxygen is classified as a medication, obtaining a home oxygen system is a regulated process requiring medical oversight. This process involves documenting physical need, selecting appropriate equipment, and coordinating with specialized suppliers and insurance providers.
Obtaining the Necessary Medical Prescription
The first step in securing home oxygen is establishing a clear medical necessity, which must be documented by a healthcare provider. This necessity is determined through specific physiological tests that measure the level of oxygen in your blood. The two most common tests are pulse oximetry and an arterial blood gas (ABG) test.
To qualify for long-term therapy, a person typically needs to demonstrate an oxygen saturation level (SpO2) at or below 88% while breathing room air. This measurement is often taken when the person is in a chronic stable state, meaning they are not experiencing an acute illness. The qualification may also be met if the blood’s partial pressure of oxygen (PaO2) is at or below 55 mmHg.
Testing is required not only at rest, but also potentially during exertion or sleep, as oxygen needs can fluctuate significantly based on activity level. If the SpO2 drops below 88% for a cumulative period of five minutes or more during an overnight oximetry study, a person may qualify for nocturnal oxygen therapy. The resulting prescription must be highly detailed, specifying the diagnosis, the required flow rate in liters per minute (LPM), and the frequency of use, such as continuous, nocturnal, or as needed.
Understanding Home Oxygen Equipment Options
Once a medical prescription is secured, the next decision involves selecting the appropriate hardware: oxygen concentrators, compressed gas tanks, and liquid oxygen systems. Oxygen concentrators are the most common choice, operating by drawing in ambient air, filtering out nitrogen, and delivering a purified stream of oxygen. These stationary or portable units require an electrical power source or rechargeable batteries to function, offering a continuous supply without the need for physical refills. Stationary concentrators can often deliver high flow rates up to 10 LPM, and a long cannula tubing allows for mobility within the home.
Compressed gas systems consist of heavy metal cylinders filled with oxygen under high pressure. They are advantageous because they do not require electricity to operate, making them a reliable backup during power outages or for short-term use. However, the oxygen supply is finite, meaning the tanks must be regularly exchanged or refilled, and the larger tanks can be heavy. Smaller, portable compressed tanks are available, but they offer a limited duration of use before needing replacement or connection to a home-fill system.
Liquid oxygen systems provide the highest concentration of oxygen and are typically reserved for individuals requiring very high flow rates, often greater than 6 LPM. Oxygen is stored in a cryogenically cold, liquid state in a large stationary reservoir, which is refilled by a supplier every few weeks. The liquid form is highly dense, allowing small portable units refilled from the reservoir to be significantly lighter and provide longer duration than comparable compressed gas tanks. There is a risk of cryogenic burns from accidental contact with the extremely cold liquid during the self-filling process.
Navigating Insurance and Supplier Acquisition
After the equipment type has been determined, the logistical and financial process begins with a Durable Medical Equipment (DME) supplier. DME suppliers provide, deliver, and maintain the medical devices prescribed for home use, acting as the primary link between the patient, the physician, and the insurance company. The supplier coordinates the necessary paperwork and delivery of the chosen oxygen system to your home.
A significant hurdle is securing insurance coverage, which requires a process known as prior authorization for the equipment. The DME supplier uses the physician’s prescription and medical test results to generate a Certificate of Medical Necessity. Coverage, whether through private insurance, Medicare, or Medicaid, is contingent on this documentation and the specific policy requirements.
Medicare Part B covers the rental of home oxygen equipment and supplies, provided the patient meets strict qualifying criteria for continuous, nocturnal, or exertion use. The DME supplier manages the delivery, sets up the equipment, and provides initial training on proper use and basic maintenance. They also handle ongoing support, including routine maintenance, filter replacement for concentrators, and scheduling tank exchanges or liquid oxygen refills.
Essential Safety and Usage Guidelines
Once the oxygen system is installed in the home, following specific safety protocols is paramount because oxygen actively supports combustion. No smoking should occur in any room where oxygen is being used or stored. Oxygen tubing and the equipment itself must be kept a minimum distance of five to ten feet away from all heat sources, including stoves, candles, gas heaters, and electrical devices such as hair dryers.
It is also important to avoid using flammable products like petroleum-based lotions, oil, grease, or aerosol sprays near the equipment. If a concentrator is being used, it needs to be placed in a well-ventilated area, at least 12 to 18 inches away from walls or drapes, to prevent overheating and ensure efficient operation. Compressed gas tanks must always be stored securely in an upright position to prevent them from tipping over and potentially damaging the regulator.