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Does Medicare Cover Oxygen Units on Airplanes?

Q. I need oxygen 24/7 but the airlines won’t allow me to take my own unit onboard. Will Medicare reimburse me for the cost of oxygen supplied by an airline?

A. No. Medicare only reimburses for equipment and services supplied by Medicare-approved providers.

But Medicare Part B does cover rentals of oxygen equipment and supplies for patients to use in their homes, and a separate add-on payment may be made for those who need portable equipment. Some of these portable units may be allowed on aircraft.

Under Department of Transportation rules that took effect in May 2009, all U.S. airlines must permit passengers to use certain types of portable oxygen “concentrators” while traveling on any plane that has 20 seats or more and is flying on any domestic or international route. This also applies to foreign airlines for flights that start or end in the United States.

Portable oxygen concentrators extract oxygen from the air and are not regarded as hazardous because they do not contain compressed or liquid oxygen. Those that are allowed aboard airplanes must display manufacturers’ labels showing that the Federal Aviation Administration has approved them as meeting safety standards. To date, the FAA has approved 11 brands of these units.

If you regularly use one of the approved units and Medicare covers it, there’s nothing to stop you from using it during a flight. However, if you’re flying abroad, you should first check with the company that supplied it. “Medicare coverage does not extend to equipment used outside the United States,” Medicare officials say. “So the supplier may not allow the beneficiary to take rented equipment that is the property of the supplier outside of the country.”

If your regular Medicare-covered equipment does not bear the FAA’s stamp of approval, and is not accepted by the airline, you would have to pay out-of-pocket to rent an approved portable unit temporarily or to use one provided by the airline. Medicare does not cover this expense.

Beyond federal regulations, each airline may have its own rules for passengers—for example, requiring a letter from a physician explaining your need for the device. The airline may also require earlier check-in at the airport. So when booking a flight, be sure to give the airline advance warning that you will need to use a portable oxygen concentrator and check its requirements.

Bear in mind, too, that portable concentrators may not be suitable for all patients who need round-the-clock oxygen. This is something you’d need to discuss with your doctor.

Patricia Barry is a senior editor at the AARP Bulletin.

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