The air we breathe is a mixture of gases, only about 21% of which is oxygen. This element is fundamental to life. When a health condition compromises the lungs’ ability to transfer sufficient oxygen into the bloodstream, supplemental oxygen therapy becomes necessary to prevent organ damage and support basic bodily functions. Medical-grade oxygen is highly purified and regulated. It is considered a prescription drug, and obtaining it for home use involves following a specific medical and logistical pathway.
The Initial Step: Obtaining a Prescription
The process of securing home oxygen therapy begins with a formal consultation and evaluation by a licensed healthcare professional. Medical oxygen is regulated by the Food and Drug Administration (FDA) as a prescription drug. It cannot be purchased over the counter due to the risks associated with improper use, such as oxygen toxicity or fire hazards. A prescription ensures the oxygen is pure, the flow rate is correct, and the therapy is medically appropriate for the patient’s specific needs.
The physician must document an underlying medical condition that causes low blood oxygen levels, known as hypoxemia. Common conditions that typically warrant oxygen therapy include Chronic Obstructive Pulmonary Disease (COPD), severe pulmonary fibrosis, and certain types of heart failure. The documentation must establish a medical need for the therapy to secure insurance coverage and to justify the prescription.
To qualify for a prescription, specific testing is required to objectively measure the severity of hypoxemia, usually performed while the patient is in a chronic stable state. A simple, non-invasive pulse oximetry test measures the oxygen saturation of the blood (SpO2) by clipping a sensor onto a finger or earlobe. A more definitive Arterial Blood Gas (ABG) test, which measures the partial pressure of oxygen (PaO2) directly from an arterial blood sample, may also be required.
Generally, a patient qualifies for long-term home oxygen if the blood oxygen saturation is consistently at or below 88% or the partial pressure of oxygen is at or below 55 mm Hg while at rest. Qualification may also be met if the saturation drops to these levels during sleep or during exercise. The prescription provided by the physician is highly specific, detailing the exact flow rate in liters per minute (LPM), the frequency of use, and the duration of need.
Sources for Home Medical Oxygen
Once a prescription is secured, the next step involves acquiring the necessary equipment, which is typically facilitated by a Durable Medical Equipment (DME) company or a specialized respiratory care provider. These providers are the logistical link between the physician and the patient, handling the delivery, setup, and ongoing support of the oxygen system. Finding a provider that is accredited and in-network with the patient’s insurance plan is a necessary first consideration.
The DME company works closely with the prescribing physician to gather all required medical documentation, often including a Certificate of Medical Necessity (CMN), to verify coverage eligibility. This coordination ensures that the prescribed equipment type and flow settings meet the specific requirements set by the insurer for reimbursement. Without this careful administrative process, the patient may be responsible for the full cost.
Upon approval, the DME provider schedules the delivery and installation of the equipment in the patient’s home. During this setup visit, a qualified respiratory therapist or technician provides comprehensive training to the patient and caregivers. This training covers the proper operation, safety protocols, and routine maintenance of the oxygen delivery system. This is essential due to the flammability risks associated with concentrated oxygen.
The provider is also responsible for the ongoing logistical support of the oxygen supply. For systems that require physical replenishment, such as compressed gas tanks or liquid oxygen, the DME company manages the regular delivery and exchange of full containers. For oxygen concentrators, the provider handles the technical maintenance, including filter changes and equipment checks, ensuring the device continues to meet the prescribed oxygen purity levels.
Types of Oxygen Delivery Systems
Patients have three primary formats for receiving home oxygen, and the choice depends largely on the prescribed flow rate, the patient’s mobility, and lifestyle. The most common system is the oxygen concentrator, an electrically powered device that separates nitrogen from the surrounding air, delivering an oxygen concentration of up to 95%.
Oxygen Concentrators
Stationary concentrators are large, designed for continuous, high-flow use in the home, but they require a reliable power source and a backup oxygen supply for power outages. Portable oxygen concentrators (POCs) operate on battery power and are designed for mobility outside the home. Most POCs use a pulse-dose technology, which delivers a burst of oxygen only when the user inhales, conserving the supply.
Compressed Gas Tanks
The second primary option is compressed gas tanks, which store oxygen in a gaseous state under high pressure in metal cylinders. These tanks do not require electricity, making them a reliable backup power source or a simple option for patients needing oxygen intermittently. Compressed tanks come in various sizes, with smaller cylinders being highly portable but requiring frequent refilling or exchange by the DME company.
Liquid Oxygen
Liquid oxygen is the third format, storing oxygen cooled to approximately -297° Fahrenheit. This allows a much greater volume of oxygen to be stored in a smaller, lighter container compared to compressed gas. A liquid oxygen system consists of a large stationary reservoir at home and smaller, portable units that the patient can refill for use away from the base unit. This option is often favored by patients requiring high-flow rates or those with an active lifestyle, as the portable units are lightweight and last longer than portable compressed tanks.