The Process—Coverage of Oxygen by Medicare

The Will Erwin Headache Research Foundation was founded with the mission to find a cure for cluster headaches and migraines, increase awareness about the different types of debilitating headaches, and inform those in need of the available treatment options. The Foundation strives to remain a knowledge leader in the field and keep others informed of any changes and updates to the research associated with these debilitating headaches. Our goal is to promote treatments, education, and insight so you can make the best decision for yourself.

Oxygen treatment is one of the oldest, most natural tricks in the book. It is often used for the treatment of cluster headaches. However, the process to receive coverage for oxygen treatment by Medicare can be difficult.

Oxygen Treatment

Oxygen treatment is one of the natural, simple remedies to cluster headaches. Being inexpensive and safe, it is a great resource for lessening the severity of cluster-related pain. Researchers have found that patients often need a whopping dose of oxygen to be effective, namely 7 Liters per minute of flow or more through a large facemask called a non-rebreather mask (so you can’t rebreathe the carbon dioxide and keep getting fresh oxygen). Mayo clinic states that taking brief, deep breaths through an oxygen mask has provided dramatic relief within 15 minutes to those who use it.

Clearly, it is a viable option for people dealing with cluster headaches, however, it is close to impossible to receive coverage for oxygen treatment with Medicare.

How to Become Covered?                                                            

Firstly, the qualifications for outpatient oxygen are only covered through Medicare Part B. Once that is secured, Medicare requires you to meet a number of conditions to qualify:

  • A doctor has diagnosed a severe lung condition that prevents the person from getting enough oxygen.
  • The person’s health might improve with oxygen therapy.
  • Their arterial blood gas level falls within a specific range.
  • They have tried other measures, but their health has not improved.

A couple of the indicators don’t line up with the typical cluster headache symptoms, so it will be difficult to sway Medicare to provide coverage.

What is Covered by Medicare?

Medicare will cover the rental oxygen equipment and accessories prescribed by your doctor. Some of these may include:

  • Tubing or a mouthpiece
  • Oxygen contents
  • Oxygen machine maintenance
  • Oxygen machine servicing
  • Oxygen machine repairs

The expectation is you will pay 20% of the Medicare-Approved Amount. The rent length is 36 months, after this time the supplier must continue providing for up to a total of 5 years if you have a medical need for oxygen.

Conclusion

Oxygen is a great resource for people dealing with cluster headaches. Unfortunately, it can be hard to access. Medicare insurance has set expectations and qualifications for oxygen coverage that don’t accurately fit the criteria of cluster symptoms. Another option is to buy your own oxygen equipment. A new oxygen concentrator can range in price from $595-$2,000. It is important to consult with your physician as to whether oxygen is right for you and how to get it.

The Will Erwin Headache Research Foundation

The Will Erwin Headache Research Foundation works diligently to provide knowledge and awareness of the available treatment options for the millions of people who suffer from migraines and debilitating headaches. The Foundation is dedicated to furthering migraine and headache research to find a cure to the pain for sufferers worldwide. To help The Foundation in its mission, please consider contributing today.

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