Portable oxygen therapy is a medical treatment providing supplemental oxygen to individuals whose respiratory or cardiac conditions prevent them from getting enough oxygen from the air alone. This therapy significantly improves the quality of life, allowing users to maintain mobility and independence outside the home. Because oxygen is classified as a drug, its use is strictly regulated, meaning the first step to obtaining a portable supply is not a purchase but a prescription. This guide details the necessary medical steps, the entities that supply the equipment, the types of devices available, and the financial considerations involved in securing a portable oxygen supply.
Medical Requirements for Obtaining Oxygen
Acquiring a portable oxygen supply begins with establishing medical necessity through a licensed physician. The physician must perform a face-to-face evaluation to document a qualifying diagnosis, such as severe Chronic Obstructive Pulmonary Disease (COPD) or heart failure, that results in low blood oxygen levels. Medical testing is required to quantify the oxygen deficiency, often using a pulse oximeter (a non-invasive method using a clip on the finger to estimate oxygen saturation (SpO2) in the blood) or an Arterial Blood Gas (ABG) test.
A common qualification standard requires the patient’s oxygen saturation to be at or below 88% while resting on room air, or an arterial oxygen pressure (PaO2) of 55 mm Hg or lower. Since portable oxygen is intended for use during activity, a walk test is often performed to see if the patient’s oxygen levels drop below this threshold during exertion. The final prescription must be highly detailed, specifying the diagnosis, the exact oxygen flow rate (measured in liters per minute), the frequency of use, and the estimated duration of the need.
Primary Sources for Portable Oxygen Supply
The primary source for obtaining portable oxygen equipment is a Durable Medical Equipment (DME) company. These companies are responsible for providing the device, setting it up, and managing ongoing maintenance and refills. The DME supplier must be one approved by their specific insurance provider, such as Medicare.
Hospital discharge programs represent another common source, often coordinating with DME providers to ensure a patient leaves the facility with the correct equipment. For short-term needs, like vacations or travel, specialty rental companies offer portable oxygen concentrators (POCs) that are often FAA-approved for air travel. These specialty providers typically work outside of the insurance reimbursement system, requiring the user to pay a daily or weekly rental fee directly.
Understanding Portable Oxygen Devices
The equipment used for portable oxygen delivery falls into three main categories. Portable Oxygen Concentrators (POCs) are battery-operated devices that draw in ambient air, filter out nitrogen, and deliver concentrated oxygen (typically 90-95% purity). Most POCs use a pulse dose system, delivering oxygen only when the user inhales, which conserves the battery life.
Compressed gas cylinders, or tanks, contain oxygen (typically \(\geq 95\%\) purity) stored under high pressure. While simple and highly reliable, these tanks hold a finite supply, are heavy, and require regular refills from the DME supplier.
Liquid Oxygen (LOX) stores 100% pure oxygen at an extremely cold temperature (-297°F), making it highly concentrated; one liter of liquid yields approximately 860 liters of gaseous oxygen. LOX systems are often prescribed for patients requiring high flow rates but require specialized handling due to the risk of cold-temperature burns and the need for dedicated refill stations.
Coverage and Financial Considerations
Medicare Part B categorizes oxygen equipment as Durable Medical Equipment, covering 80% of the Medicare-approved rental cost after the annual Part B deductible is met. The patient is then responsible for the remaining 20% coinsurance.
Medicare’s policy mandates a 36-month rental period, during which time the DME supplier is paid a monthly fee that covers the equipment and necessary supplies. After 36 months, the supplier must continue to provide the equipment and necessary supplies for the remainder of its five-year estimated useful life, but Medicare stops making rental payments. Private insurance plans often follow similar rental models but may have different co-payment amounts and contract lengths. It is important to confirm the specific terms of coverage before committing to a supplier.