Did you know that Medicare has different coverage rules for oxygen equipment rental, repairs, and maintenance?
Unlike other types of DME, oxygen equipment is only rentable on a five-year cycle and without the option to own it.
Medicare pays oxygen suppliers a monthly rental fee for the first 36-months for the equipment, oxygen, supplies, and maintenance. In addition to supplier payments made by Medicare, oxygen patients pay 20% of each month’s rental fee.
After the initial 36-month rental period, oxygen patients pay no more rental fees. However, Medicare allows for an additional 24-months of oxygen for a total of five years with a 20% of rental cost coinsurance payment. Therefore, to extend the oxygen service for 24 additional months, oxygen patients become responsible for coinsurance payments and any needed maintenance during these 24 additional months.
After Five Years
At the end of five years, oxygen patients can either get new oxygen equipment from their supplier or switch suppliers. When using oxygen equipment for less than five years, the supplier will recover their equipment after it’s no longer required.
Medicare also requires competitive bidding oxygen suppliers to provide oxygen and oxygen equipment for an entire 36-month rental period. After the 36-month rental period, the supplier must continue to supply oxygen and oxygen equipment for the rest of the equipment’s reasonable functional lifetime and for as long as a patient continues to need it.
For oxygen patients who travel or permanently move out of a supplier’s service area, the supplier must arrange for the patient to get oxygen and oxygen equipment from a supplier in their area until the 36-month rental period is over.
Repairs and maintenance
It is the responsibility of the oxygen equipment supplier to maintain your equipment in good working order throughout the five-year rental period.
The oxygen supplier must also provide all supplies and maintenance-free of charge during the first 36 months of the rental period. After that, oxygen suppliers can bill you for in-home maintenance visits (20% coinsurance) every six months during the last 24 months of a five-year rental agreement.