Getting oxygen at home requires a prescription from your doctor, a qualifying blood oxygen test, and a supplier who delivers and sets up your equipment. You cannot buy medical-grade oxygen over the counter. The process typically involves a few medical appointments, some paperwork, and a decision about which type of oxygen system fits your daily life. Here’s how it works from start to finish.
Who Qualifies for Home Oxygen
Your doctor will order a blood oxygen test to determine whether you need supplemental oxygen. The gold standard is an arterial blood gas draw, where blood is taken from an artery (usually at the wrist) to measure exactly how much oxygen it carries. A simpler option is pulse oximetry, the small clip placed on your finger. If both tests are done and the results conflict, the arterial blood gas takes priority.
Medicare, and most private insurers that follow similar guidelines, covers home oxygen when your oxygen saturation is 88% or below, or your arterial oxygen pressure is at or below 55 mmHg. These readings can be taken at rest, during sleep, or during exercise. So even if your resting levels look fine, you may still qualify if your oxygen drops significantly when you walk or sleep. A drop of more than 5 percentage points in saturation during sleep, combined with symptoms like restlessness or poor concentration, can meet the threshold.
There’s also a second qualifying group: if your saturation sits right at 89% or your arterial pressure falls between 56 and 59 mmHg, you can qualify when you also have signs of heart strain from low oxygen. This includes fluid buildup in the legs (a sign of heart failure), elevated pressure in the lung arteries, or an abnormally high red blood cell count above 56%.
The Prescription Process
Home oxygen starts with your attending physician, who must have examined you recently, typically within a month of starting therapy. Your doctor needs to document that other treatments for your underlying condition (inhalers, antibiotics, physical therapy for clearing secretions) have already been tried and weren’t enough on their own.
The prescription itself must be specific. It has to include your diagnosis, the oxygen flow rate in liters per minute, how many hours per day you’ll use it, and an estimate of how long you’ll need it (for example, six months or lifetime). A vague prescription like “oxygen as needed” does not meet coverage requirements. Your doctor then completes a Certificate of Medical Necessity, a standard form that insurance uses to verify everything checks out. A nurse or respiratory therapist can help fill it in, but the physician must review and sign it.
Once the paperwork is complete, your doctor’s office or a hospital discharge coordinator will help connect you with a durable medical equipment (DME) supplier. This is the company that delivers your oxygen system, sets it up in your home, and trains you on how to use it.
Types of Home Oxygen Equipment
There are three main ways to get oxygen at home, and each has trade-offs around portability, cost, and convenience.
Oxygen concentrators are the most common choice for home use. These electrically powered machines pull in room air, strip out the nitrogen, and deliver purified oxygen through tubing to your nose. You plug them into a wall outlet, and they run continuously without needing refills. That makes them low-maintenance and cost-effective over time. Portable battery-powered versions exist for leaving the house, though they’re smaller and deliver oxygen differently (more on that below).
Compressed gas cylinders are the classic green metal tanks. They contain at least 99.5% oxygen under high pressure, with a gauge on top showing how much remains and a regulator that releases oxygen when you inhale. They don’t need electricity, which makes them a reliable backup during power outages. The downside is that they run out and need regular refills or tank swaps from your supplier.
Liquid oxygen systems store pure oxygen cooled to minus 297°F, compressed into a smaller volume than gas tanks. When released, the liquid converts to breathable gas. These systems hold more oxygen in a smaller space, so the portable units tend to be lighter than compressed gas for the same supply. They also require periodic refills.
Continuous Flow vs. Pulse Dose
Your prescription will specify a flow rate in liters per minute, which is a continuous flow measurement. Continuous flow means oxygen streams to you steadily, whether you’re inhaling or not. This is the most common prescription type and what stationary home concentrators deliver.
Portable concentrators often use pulse dose delivery instead. Rather than a constant stream, they detect each breath and release a small burst (called a bolus) of oxygen measured in milliliters per breath. This conserves battery life and makes the device smaller. However, there is no direct conversion between pulse dose settings and continuous flow liters per minute, because everyone’s breathing rate and depth differ. If your doctor prescribes 2 liters per minute continuous, a pulse dose setting of “2” on a portable device is not automatically equivalent. Your supplier or respiratory therapist should test your oxygen levels on the portable unit to confirm the setting keeps your saturation where it needs to be.
What It Costs
The typical monthly cost for oxygen equipment and supplies runs around $300. Medicare and most private insurance plans cover about 80% of that, leaving you with roughly $60 per month out of pocket. If you carry a secondary insurance policy, it may pick up the remaining balance. Under Medicare, oxygen equipment is classified as a rental for the first 36 months. After that period, ownership of the equipment transfers to you, and the supplier remains responsible for maintenance and repairs for an additional two years.
If you’re uninsured or want to purchase a concentrator outright, stationary home units generally range from $800 to $2,000 depending on flow capacity. Portable concentrators cost more, often $2,000 to $3,500. Buying outright avoids monthly rental fees but means you handle your own repairs and replacement supplies.
Keeping Your Equipment Clean
Oxygen equipment needs regular cleaning to prevent bacteria buildup and keep the device running efficiently.
- Humidifier bottle: If your system includes a water bottle that moistens the oxygen before it reaches your nose, empty it, rinse it, and refill it with distilled water or cooled boiled water every day. Don’t use tap water or bottled water that’s been stored in warm conditions, as both can harbor bacteria.
- Air intake filter: Pull it out and wash it in cool, soapy water once or twice a week. Let it dry completely in a shaded area before reinserting it. Keeping a spare filter on hand lets you swap them during cleaning.
- Bacterial filter: Check it weekly but don’t wash it with water. Follow the manufacturer’s instructions for replacement timing.
- Nasal cannulas and tubing: These are technically single-use items in clinical settings. At home, many suppliers recommend replacing nasal cannulas every two to four weeks and tubing every one to three months. Your DME provider will include replacement supplies.
If you stop using your concentrator for a stretch, clean it at least twice a month while it sits in storage to prevent dust buildup inside the device.
Fire Safety Rules
Oxygen doesn’t explode on its own, but it makes everything around it burn faster and hotter. This makes fire safety non-negotiable.
Keep your oxygen equipment at least 6 feet away from any heat source or open flame: candles, fireplaces, gas stoves, space heaters, wood stoves, and electric baseboard heaters. The same 6-foot buffer applies to devices with electric motors or heating elements, including hair dryers, electric razors, and electric blankets. Post “No Smoking” signs in every room where oxygen is used. No one in the household should smoke in those rooms, and you should never smoke while wearing your cannula.
Avoid petroleum-based products on your face and upper body. Vaseline, oily lotions, and oil-based lip balm are all flammable near concentrated oxygen. Water-based moisturizers are a safe alternative. Keep cleaning products that contain alcohol, grease, or other flammable liquids stored away from your equipment as well.
Traveling With Oxygen
Portable oxygen concentrators are permitted on commercial flights because they concentrate oxygen from cabin air rather than storing pressurized gas. Compressed gas cylinders and liquid oxygen tanks are not allowed on planes. If you fly with a portable concentrator, bring enough spare batteries in your carry-on luggage to last the entire flight plus any expected delays. Spare batteries need to be individually protected from short circuits, which usually means keeping the terminals covered or storing each battery in its own plastic bag.
Airlines require advance notice, typically 48 hours, when you plan to use a portable concentrator on board. Each airline maintains its own list of accepted devices, so check before booking. For road trips, you can travel with any type of oxygen system, but keep tanks secured upright in a well-ventilated area of the vehicle and never leave them in a hot, closed car.