What Conditions Qualify for Home Oxygen?

Chest pressureIn order to qualify for home oxygen, you need medical evidence that proves your health depends on supplemental oxygen therapy. You will need to fulfill a number of health qualifications before you can obtain your home oxygen equipment. Let’s take a look at what diagnoses or conditions allow you to qualify for home oxygen and what you will need to do from there. 

Conditions and Diagnoses That Qualify You for Home Oxygen

Because medical oxygen is considered a prescription drug, anyone qualifying for home oxygen will need to meet a number of requirements. First, your doctor will need to provide a diagnosis indicating that you need oxygen therapy, whether short or long term. These diagnoses or conditions can include:[1]

Additionally, hypoxia-related symptoms that could improve with oxygen therapy, like erythrocytosis, cognitive impairment, morning headache or nocturnal restlessness, may qualify you for home oxygen.[2] While there are a number of diagnoses or conditions that may qualify, you will have to demonstrate that your oxygen saturation or arterial blood gas measurement indicates that you are hypoxemic. If there is sufficient evidence that your oxygen levels are too low and may be helped by oxygen therapy, you will most likely qualify. 

What Blood Oxygen and Oxygen Saturation Measurements Qualify for Home Oxygen?

Before you qualify for home oxygen, you will likely undergo several tests. Two of the most important tests to qualify for home oxygen will be your pulse oximetry measurement and your arterial blood gas study measurement. A pulse oximeter is able to measure your oxygen saturation, while an arterial blood gas study (ABG) is able to measure your blood oxygen levels

Typically, in order to qualify for home oxygen therapy, your doctor must be able to document that you have any of the following:

  • An arterial blood gas measurement (PaO2) at or below 55 mm Hg or an oxygen saturation at or below 88%, taken at rest while awake.
  • An arterial blood gas measurement at or below 55 mm Hg, or an oxygen saturation at or below 88%, taken while you are sleeping for a specified duration. This measurement would be required for a patient who demonstrates a PaO2 at or above 56 mm Hg or an oxygen saturation at or above 89% while awake.
  • A greater than normal decrease in oxygen level during sleep (a drop in PaO2 of more than 10 mm Hg, or a decrease in oxygen saturation of more than 5%) associated with symptoms or signs reasonably attributable to low blood oxygen levels. 
  • An arterial blood gas measurement at or below 55 mm Hg or an oxygen saturation at or below 88%, taken during exercise for a patient who demonstrates a PaO2 at or above 56 mm Hg, or an oxygen saturation at or above 89%, during the day while at rest, with improved results when oxygen is administered.

If you demonstrate any of the following, your doctor may indicate that oxygen therapy is required, though it may only be required during certain activities. For example, you may only need oxygen therapy while you sleep or while you exercise to keep your oxygen levels up and within the safe range. 

If Your Condition and Testing Indicates Home Oxygen, What’s Next?

If you have a condition that qualifies you for home oxygen, and your ABG and pulse oximetry results indicate that you would benefit from oxygen therapy, the next step is getting your oxygen prescription. Your doctor will write your oxygen prescription, which will include important information. Your oxygen prescription will tell you:

  • When you will need to use oxygen therapy (for example: during sleep, during exercise or throughout the day)
  • How frequently you will need oxygen treatments (for example: during exercise, or 12 per day)
  • How long your oxygen treatments should last (for example: 15 minutes, or 1 hour)
  • The amount of time you will need to use oxygen therapy (for example: for 3 months, or long-term)
  • What your flow rate should be in liters per minute (for example: 2 LPM)
  • The dosing you require (for example: continuous flow, high flow or pulse dosing)

In addition to your prescription, you will need a Certificate of Medical Necessity to get your oxygen equipment. You should also have evidence that your qualifying doctor’s appointment was no more than 30 days before the date on your Certificate of Medical Necessity. 

From there, you can discuss what kind of oxygen equipment is right for you and your needs. Depending on your oxygen requirements, you may have the option of compressed oxygen tanks, liquid oxygen tanks or an oxygen concentrator

Qualifying for Home Oxygen With an Oxygen Concentrator

If you qualify for home oxygen, you may also qualify to use an oxygen concentrator for your oxygen therapy. Many people prefer oxygen concentrators over oxygen tanks because of the benefits they offer. 

While an oxygen tank only contains a finite amount of oxygen and eventually needs to be refilled or replaced, an oxygen concentrator can provide an endless supply of oxygen as long as it has power. Additionally, an oxygen concentrator is easy to use, with clear buttons indicating functions, as well as alarms and notifications that let you know if something is not working as it should. This can give many patients additional peace of mind. Finally, an oxygen concentrator can be much easier to move around with you. Oxygen tanks are heavy and awkward, making getting around much more complicated. 

For many patients, an oxygen concentrator offers a significant number of benefits that ultimately make oxygen therapy work better for them. At Inogen, we believe that oxygen therapy should always improve your life, allowing you to enjoy the best quality of life possible for you.

Contact Inogen to Find Out More About Qualifying for Home Oxygen

If you are interested in using an oxygen concentrator, rather than oxygen tanks, contact Inogen’s oxygen specialists at 855-MY-INOGEN, and we can assist you. Our specialists are available to answer questions about choosing which of our oxygen concentrators might be the best fit for your oxygen needs and your life. We can also walk you through several qualifying processes. 

For more information about getting a prescription to qualify for home oxygen, qualifying for insurance coverage or even qualifying for Medicare with our Free Medicare Eligibility Check, contact Inogen today. With one of our oxygen concentrators, you can enjoy more of life on oxygen. We look forward to helping you breathe better.

Oxygen. Anytime. Anywhere.

Sources:

[1] “Home Oxygen Therapy CG-DME-18.” Amerigroup, Anthem, 7 Oct. 2020, medpol.providers.amerigroup.com/dam/medpolicies/amerigroup/active/guidelines/gl_pw_a053649.html. 

[2] “Home Use of Oxygen (NCD 240.2).” UnitedHealthcare, United Healthcare Services, Inc., 9 Dec. 2020, www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-guidelines/h/home-use-oxygen.pdf. 

Additional Sources:

Bottrell, John. “Who Qualifies For Home Oxygen?” COPD.net, Health Union, LLC., 31 Oct. 2019, copd.net/living/qualifying-home-oxygen. 

“Home Oxygen Qualifying Guidelines.” ResMed, ResMed, Sept. 2016, document.resmed.com/en-us/documents/articles/1019404_Oxygen_Qualifying_Guidelines_amer_eng.pdf. 

Leader, Deborah. “How to Get Medicare to Cover Your Oxygen Supplies.” Verywell Health, About, Inc., 18 Sept. 2020, www.verywellhealth.com/medical-oxygen-and-medicare-914953. 

“Qualifying For Home Oxygen Therapy.” PrecisionMedical, Precision Medical, Inc., Accessed 29 Mar. 2021, www.precisionmedical.com/blog/qualifying-for-home-oxygen-therapy/.

 
 

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