Medicare vs. Paying Out of Pocket for Oxygen Therapy — What’s Actually Better?
By Yash, RRT — Licensed Respiratory Therapist & Owner, MyRespCo
If you've been prescribed supplemental oxygen therapy, one of your first questions is almost certainly about cost. Medicare covers oxygen equipment — but the coverage structure comes with conditions, compliance requirements, and restrictions that many patients don't fully understand until they're already locked into an arrangement. This guide explains both pathways so you can make an informed decision.
How Medicare Covers Oxygen Therapy
Medicare Part B covers home oxygen therapy as Durable Medical Equipment (DME) when your physician documents that your SpO₂ is at or below 88% at rest, during sleep, or with exertion. Coverage is structured as a rental program, not a purchase.
Here's how the Medicare oxygen rental structure works:
- Medicare pays a monthly rental fee to your DME supplier for months 1–36
- After 36 months of continuous rental, the equipment is considered purchased and Medicare stops paying the rental fee
- Your DME supplier is required to provide equipment, supplies, and maintenance for an additional 24 months (months 37–60) at no rental cost
- Your out-of-pocket cost is typically 20% of the Medicare-approved amount after your Part B deductible
- A Medigap supplement plan may cover the 20% copay
What Medicare Covers (and What It Doesn't)
Medicare covers: stationary home concentrators, portable oxygen equipment, oxygen contents (for tank systems), tubing, cannulas, and related accessories when medically necessary and properly documented.
Medicare does not cover: oxygen for convenience or comfort without documented hypoxemia, equipment upgrades beyond what is medically necessary, or equipment from non-enrolled DME suppliers.
MyRespCo is a Medicare-enrolled DME supplier — meaning we can bill Medicare directly for covered oxygen equipment.
When Paying Out of Pocket Makes More Sense
Despite Medicare coverage, there are situations where purchasing equipment outright — or purchasing from MyRespCo directly — is the better financial and clinical decision:
You Have a High Part B Deductible or No Supplement
If you haven't met your Part B deductible, or you don't have a Medigap supplement to cover the 20% copay, your out-of-pocket costs under Medicare can add up quickly — especially in the first year. Purchasing a home concentrator outright from MyRespCo at $399–$500 may cost less than 12 months of Medicare copays.
You Want a Specific Portable Model
Medicare DME suppliers assign equipment based on medical necessity and supplier inventory — not patient preference. If you want a specific POC model (e.g. Inogen One G5 for its battery life and flow settings), purchasing directly gives you choice that Medicare assignment does not.
You Need Equipment Faster Than Medicare Processing Allows
Medicare DME authorization can take 2–4 weeks. If you need a concentrator now, purchasing from MyRespCo ships within 1–2 business days with full clinical support from our Licensed Respiratory Therapist.
You're Under 65 or Not Yet Medicare Eligible
If you're on private insurance with a high deductible, or uninsured, Medicare isn't an option. Purchasing a refurbished home concentrator or POC from MyRespCo at below-retail pricing with a 1-year warranty is often the most cost-effective path.
The Honest Bottom Line
Medicare coverage is valuable — especially for patients with good supplement coverage who expect long-term oxygen needs. But it is not universally the best financial option, and it comes with equipment assignment constraints, compliance documentation requirements, and a 36-month rental lock-in before ownership.
For patients who want equipment ownership, model choice, and clinical support from day one, purchasing directly from MyRespCo — a Medicare-enrolled, RRT-owned DME supplier — is often faster, simpler, and comparably priced when true out-of-pocket costs are calculated.
Have questions about whether Medicare or direct purchase makes more sense for your situation? Book a $49.99 RT Consultation and we'll walk through the math with you specifically.
→ Complete POC Buyer's Guide
→ Book an RT Consultation — $49.99
→ Portable vs. Home Oxygen Concentrator