Medicare and Oxygen
Medicare, oxygen and the 36 month capped rental period
Services and Supplies from RxStat Pharmacy
- Portable Oxygen Concentrators
- Self filling oxygen cylinders
- Quiet oxygen concentrators
- Rental, travel oxygen
- Nebulizer Medications
- Nebulizer Compressors
- Nebulizer Circuits
- Home Oxygen
- CPAP and BiPAP Supplies
- Respiratory Therapists
- Overnight Oximetry Services
- Medicare Compliance Staff
- Portable Oxygen Specialists
Medicare will pay for oxygen equipment for 36months. After the 36th month of rental,the beneficiary will own the oxygen equipment.
Section 5101(b) of the Deficit Reduction Act (DRA) of 2005 establishes a 36 month (3 year) limit or "cap" on monthly oxygen payments for stationary and portable oxygen equipment. This cap applies to monthly payments made for oxygen equipment on or after January 1, 2006.
For beneficiaries that already had oxygen prior to this date, the 36 month rental period began January 1,2006.
After January 1, 2009 or 36 months of rental, Medicare stops making rental payments to the provider. This is referred to as "capped out" meaning your rental period is capped out. The provider that takes your 36th month rental payment from Medicare is responsible to take care of your oxygen needs, including all your supplies, for a total of five years. You might be eligible for new oxygen equipment after a total of 5 years. Medicare has placed a five year "useful" life on your oxygen equipment.
Medicare will continue to pay for oxygen contents for beneficiary owned portable oxygen systems after the "cap". This applies to portable and stationary oxygen systems that need refills.
Will your current oxygen system meet your needs in the future? Is it small enough? Light enough? Quiet enough?
It is important that you evaluate your current oxygen system to make sure it will meet your needs for a total of 5 years. Medicare's policy is that the expected life of an oxygen system is 5 years.
Medicare will pay for "oxygen contents" if you use oxygen cylinders for portability, however, they have not clarified the ownership of the cylinders because they are often exchanged when empty. If you use many portable cylinders, you might have a problem getting refills.
Suggested equipment checks before you "cap out".
Rx Stat Inc. believes the 36 month oxygen cap is a bad rule. There is no incentive for your provider to continue to take "good" care of you after you "cap out" or Medicare stops paying the rental payments.
Concentrator
- When was it last serviced?
- Oxygen purity
- Filters, internal and external
- Hours on concentrator.
- Noise level
- General appearance
- Weight for travel
Portable oxygen
- Does it meet your needs now?
- Is it light enough?
- Does it need refills?
- How many cylinders do you use on a monthly basis?
- Can you travel?
Because of uncertainty about payment to an oxygen provider for portable oxygen refills, will you be dependant on someone to fill your empty cylinders or do you have the ability to fill your own portable oxygen cylinders?
If you wait to long before checking your oxygen equipment, you will not be able to change equipment or providers if you need to. The closer you get to the end of your 36 month rental period, the less options you will have for change.
Providers will not be willing to take on a new oxygen patient if they cannot at least cover the cost of the equipment with the remaining rental months from Medicare.
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Click here for your FREE Respiratory Equipment Consultation. Do not buy a portable oxygen concentrator until to you find out if it will meet your individual needs.
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