Medicare and Oxygen

[Brittany Foster]

Hi Joan,
When I got my oxygen, it was a diagnosis of hypoxemia and chronic hypoxia which is low blood oxygen levels and low oxygen in the tissues of the body. The doctor gave information based off of 6 minute walk test oxygen saturation results as well as bloodwork that showed reduced levels of oxygen in the blood. Have you looked into qualifying based off of a diagnosis of “hypoxemia” which would be required in order to get oxygen. I believe levels of oxygen need to be below 89 for a certain amount of time in order to even qualify for regular oxygen. The POC got approved for me just based off of this diagnosis, this was before they diagnosed me with PH too.

[Beverly Duffield]

Medicare will pay for a home oxygen concentrator if your sats drop to 88% and below (for any reason). They do not cover portable concentrators but do cover wheeled portable tanks. Remember sleep apenea often needs a CPAP and oxygen to prevent brain damage as well as further heart damage and portables just don’t have enough strength.

[Brittany Foster]

Good points Beverly. As someone who has both the tanks and the POC, it is worth noting that many of the POC only go up to 3l continuous flow. For exercising I need up to 4l so most of the time the POC isn’t as useful as the actual concentrator that is in my house (the larger one where I fill the tanks). Before someone considers a POC make sure that you are able to use pulse flow because that is the setting that will last the longest too. Just throwing that out there if someone was interested in a POC but on continuous flow. I learned that the hard way and ran out of continuous oxygen after only using it for less than an hour. It runs out a LOT FASTER.

[Joan Strosin]

Thank you for the info about pulse vs constant flow. That is quite important info to consider. I have yet to find out if I can do the pulse setting. At this time, I only use 1 to 2 liters.

[rosemary martin]

Medicare pays for my portable and my concentrator – I have Inogen -i had to be grandfathered in because NJ was no longer covering Inogen. Go figure – my portable goes up to 4 – they do have a 5 liter one…4 liters is not enough for me will get doctor to send another RX to get the 5.. I am trying to ascertain if one of the local carriers here have similar products. I am resisting tanks as i am still working..hard enough with a hose running down the hallway here…hah

[Constance]

I have been on oxygen for 2 years I have had no problems with medicare approving my oxygen supplements, I will say however, that medicare will not approve of both a POC and bottles at the same time one must choose, I still have my big concentrator at home. I am still working and found that using a backpack for my O-2 bottle allows me the freedom I so fondly remember. My back pack holds either a B or C tank. Mine has to be set on 5liters and it is working beautifully. The med supply places have the backpacks but are terribly expensive (medicare will not cover this) I found a very affordable one on Amazon so this is the one I have and I feel like a liberated woman. Just wanted to pass on this information.

[Brittany Foster]

Hi Constance,
Thank you for sharing this advice with us. I also use an oxygen backpack for my o2 tanks. I use a camelback backpack which is one that hikers use. I got mine for 50 bucks but I’m sure Amazon sells some cheaper. It fits the tank perfectly without having it wobble around in a backpack. I would suggest bringing a tank or getting the dimension of the tank and comparing it to the backpack! So glad it gives you more freedom! I’d be lost without my backpack! Its like another limb now hahahaha!

[saf6m]

I have PAH, CHF, and COPD, plus had a small stroke a year ago. I have been on O2 for over a year now. I have a home concentrator, which had to be exchanged for a large one a month ago. I failed another 6-minute walk and had to have my oxygen increased to 6L for activity and 4L at rest. I am finding that the 4L is increasingly not sufficient to keep my pulse ox above 88%. I can not afford the portable concentrator, so I found a back-pack for less than $40.00 on eBay. I am free to roam using the backpack. I just have to have the extra tank(s) in our vehicle if I am going to be longer than 3 hours. I hate the push along tank carrier – it is too confining.

[Brittany Foster]

Hey!
I can relate, I don’t like using the push along tank. Sometimes I have to on the days where I am experiencing more lower back pain, but other than that I also use the tanks in a backpack. I put mine in a camelback brand that the hikers usually use. It actually fits perfectly without moving around in the backpack and is comfortable for me. I’m glad you found something like that to make it easier for you to get around. I’m sorry you had a miserable 6 minute walk result. I hope the 6l starts to help you!

[ronald cole]

Hello Friends
I have been on a CPAP for 24 years. Medicare is fighting everything surrounding
Sleep Apnea. You have to push Suppliers for what you’re entitled. The two worse large Companies for service is LINCARE and One Other, I forgot. I just switched to a small local company and hoping for the best. I have been trying to get My Oxygen as prescribed by my Pulmonary Physician and even the Sleep Disorders Physician and it’s a nightmare. Now they want me to take an expensive overnight sleep study just to qualify for Oxygen. Medicare wants to Pay for that, I just had one 10 months ago and now they want another just to approve my concentrator. I do know I am sinking, I am fighting this alone and so weak, it is hard to even cook or shower. I just accept it and take it a day at a time. I was able to Consolidate all my Doctors at one place, UT Southwestern which is a Premier Place for PH. I know it is a battle for strength and life, I am so happy to have all of you, we are a band of Brothers and Sisters and I appreciate all of you.
Ron Cole.

[Brittany Foster]

Hi Ron,
I’m really glad that you are here in this group and share so much. I truly appreciate everything you have to add to the conversations. I’m sorry that with Medicare they are fighting you on the conditions that you have had for years. I know firsthand how frustrating it is when you continue to get tests that just prove your condition over and over again. Sometimes I just want to yell “it DIDNT change just let me get what I KNOW I NEED!” We know our bodies better than anyone and know what will help us get through the tough days and live the best we can with the cards we have been dealt.

I am glad that you are in such a great place with having good doctors and a reliable medical team even though fighting with insurance is such a hassle ! I would suggest talking with the doctors usually they have people in the offices who do the fighting with the insurance companies for you. Sometimes it just takes a doctor to write something about your condition and some medical records to be sent right from them. I can’t even imagine how stressful that must be for you. Just know that you can always vent it out and talk about it here. Sending you lots of positivity and I hope all of the insurance stuff is behind you soon. Keep us posted.

[saf6m]

Thank you, Brittany…. and best of health to you also. We have to live our lives as best we can under the given circumstances.

[Gayle Meagher]

I switch back and forth between the tanks and the push cart. I have the M9 which it the fatter small tank. Not the tall one. I have to have it on 5 pulse which makes it last about 2 hrs. Sometimes when I’m sitting still like in church, I cut it back to 4. But, since you have to consciously breathe to activate it you can get tired. I know I would feel so much better if I pushed thru the exercise.I am on 6L cont. at home. I take it easy and don’t go very many places with the tanks. Maybe lunch and then I like to walk at a store and hold on to the buggy to get a walk in and help my food go down. I’m due to get Medicare in Dec. So I will need lots of advice! Tks for allowing me in the group. Sorry this is long….

[Brittany Foster]

Hi Gayle,
there is no such thing as a “long post” here! I’m glad that you found this forum. I know it is hard when it feels like you have to conserve your air when you’re out and use a different setting to get more time. Seems crazy that we have to think about being timed for air ! But it makes it easier when you have back up tanks to use too. Do you find that the continuous flow helps you more? Personally, i have a hard time with the pulse flow because of something similar to what you said with the having to think about breathing with the pulse flow. It just doesn’t work as well for me but there are times when I have to use it because the continuous just runs out too quickly ! I hope the best outcome for you when you get on Medicare.

[Marjorie Okie]

I’m on Medicare and on 3L oxygen 24hrs. When I turned 65, I had to have a sleep study test to get oxygen for my bipap. I read Medicare would not provide both a POC and tanks. I was given the small tanks. They are hard for me as the strap falls off when I walk with my cane. My Lincare O2 office said they don’t carry the backpacks. I am trying to get them to order one. I use the home concentrator with a 25ft hose covered with 1/4 inch split loom tubing to keep cats from biting it plus no kinks. A portable concentrator would be heaven. I stay home a lot. I use pulse setting on 3 liters when out to make my tank last longer.

[Brittany Foster]

Hi Marjorie,
I am also on oxygen and try to be as active as possible with the tanks. For an oxygen backpack I use this camelbak pack that hikers use. It fits the tank in perfectly. I got it from an REI sports store or a Dick’s Sporting goods would be able to help!

[Kathleen Sheffer]

Bonus for looking super sporty, Brittany!

[Brittany Foster]

@kathleen-sheffer just your every day hiker 😉 hahaha!! The one thing I did have to do when I got it though is take out the magnet in the strap that usually is used to hold the water tube on hiking backpacks. There was a big warning label on it not to use because of the magnet with a pacemaker and I didn’t see it until after having it on ! Luckily nothing happened to my device, but I made sure to cut the magnet right out of it!

[saf6m]

I ordered a backpack for the small oxygen tanks from Ebay. It works great …

[Marjorie Okie]

Yes, I know that and have checked on it. I’m trying to get Lincare to make them available when you do O2 through them. If I can’t get them to change their policy then yes, found one for $15.

[saf6m]

I guess I am lucky …. The Med Supply Depot that we obtain my oxygen from gives more than I expected. For trips, they loan me a small concentrator so I do not have to take tanks with me. They bend over backward to see that my needs are met.

[Brittany Foster]

@saf6m I also know great private companies that are amazing with this ! I love the private companies more than the bigger companies based on my experiences. I’m glad yours is so accommodating and gets you what you need.

[saf6m]

The company, Med Supply Depot is owned and operated by the hospital/clinic – Guthrie Robert Packer Hospital and Guthrie Clinic… they are wonderful.