Oxygen Therapy

Last Updated 11/19/2021

Author:Erin Popovich Endowment Program Committee

What is oxygen therapy?

If you have been diagnosed with a disease that makes it hard to breathe, such as chronic obstructive pulmonary disease (COPD) or any of the conditions that belong in the interstitial lung disease (ILD) family, you may have symptoms such as:

  • Shortness of breath, especially when you walk or exercise;
  • Cough;
  • Tiredness;
  • Headaches;
  • Swollen ankles when you get up in the morning; or
  • Blue fingertips or lips.

Low oxygen levels in your blood—a condition called hypoxemia—affects your body in several ways. Lung disease may significantly change the tubes in your lungs (called alveoli) or the space that surrounds the alveoli (called the interstitial space) in your lungs, which may cause your heart to pump harder to circulate blood—and therefore oxygen—through your body.

Low oxygen levels make it difficult to perform basic activities or even walk. All organs in your body depend on a good oxygen supply to function properly. Most importantly, low oxygen may affect your brain. You may notice, for example, that you have trouble paying attention or remembering things. You or your friends and family may even notice that you’re slurring your words.

Your health care provider will need to perform specific tests to qualify you for oxygen therapy. For example, your provider may order a blood test to see the oxygen content of your blood. You qualify for oxygen therapy under the following conditions:

  • If your saturated oxygen (SaO2) level on room air (that is, without oxygen) at rest while you’re awake is 88% or less as measured by a pulse oximeter (a small, noninvasive device that clips onto your finger and measures the amount of oxygen in your blood) or is 55 mm Hg or less as measured by a blood test, you qualify for continuous oxygen therapy.

    If your SaO2 level on room air at rest while you’re awake is above 88%, your health care provider may check your SaO2:
      •  At rest on room air;
      •  With exertion on room air;
      •  With exertion on oxygen; and
      •  At rest after exertion on oxygen.

    If your SaO2 is 88% or less after these tests, you qualify for oxygen therapy.
  • If after these tests in the provider’s office or hospital your SaO2 doesn’t drop below 88%, your provider may want to monitor your SaO2 levels while you’re sleeping, called nocturnal oximetry.

    Your provider will send an order to a durable medical equipment (DME) supplier. The DME supplier, working with a testing company, will send you a pulse oximeter. You sleep with the device clipped to your finger. While you’re sleeping, the oximeter records your oxygen levels. The next day, you return the oximeter to the DME supplier, and the testing company will send the results to your health care provider.

    If your SaO2 is 88% or less for 5 minutes, you qualify for nocturnal oxygen only. In this case, the DME supplier will send you a stationary oxygen concentrator (see “Stationary oxygen therapy systems” for more information) and backup oxygen cylinders in case of a power outage.
  • If your SaO2 at rest is above 88% as measured by a pulse oximeter both while you’re awake and while you sleep but you still have trouble breathing, you will need to meet additional criteria, such as:
      •  Have evidence of edema, which may suggest heart failure
      •  Have evidence of pulmonary hypertension or right heart failure
      •  Have elevated blood counts, with a hematocrit level greater than 56%

Depending on the results of these tests, your health care provider may prescribe oxygen therapy. This supplemental oxygen is delivered by an oxygen therapy system.

Note:

Note:

Please see Paying for Oxygen Therapy for information about Medicare and private insurance reimbursement for oxygen therapy.

Benefits of oxygen therapy

Oxygen therapy will help you breathe better so that you can maintain your lifestyle as much as possible. Once you start oxygen therapy, you may notice benefits such as:

  • Better quality of life
  • Less breathlessness and fatigue
  • Less stress on your internal organs, such as your heart
  • More energy
  • Better memory and sharper thinking

Remember, oxygen therapy can make you feel better than you did before it!

How will oxygen therapy affect my lifestyle?

Complete Guide to Oxygen Therapy

Complete Oxygen Therapy Guide

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Getting Started with Oxygen Therapy

Getting Started

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There’s no question that you need to make some changes in your day-to-day routine when you have an oxygen therapy system. But, remember that oxygen therapy is there to help you breathe better, be more active, and live your life to the fullest.

Here are a few tips for making the most of life with your oxygen therapy system:

  • Be patient with yourself. Give yourself time to lean what you can do with your oxygen therapy system.
  • Make sure that your stationary oxygen therapy system comes with enough tubing so that you can move around your home easily.
  • If you’re planning to travel, be sure to read our Trip Planning Guide for information about traveling with an oxygen therapy system, including airline restrictions.
  • Get the support you need! Ask your health care provider about support groups in your area. Talking with other people who are on oxygen therapy can help tremendously. Also, the American Lung Association maintains a Support and Community page, or you can phone the Lung HelpLine at 1-800-LUNGUSA to learn more about programs, events, and resources.

Your oxygen therapy prescription

When your health care provider prescribes oxygen, the prescription should include the following information:

  • How often you should use your oxygen therapy system
  • How many liters a day of oxygen you should use
  • The type of flow rate (continuous or pulsed flow)
  • When you should use oxygen (for example, all day, only when you’re walking around, only when you’re sleeping)
  • The type of oxygen therapy system you need and how often you’ll need replacement supplies
  • A certificate of medical necessity (required by Medicare and many other insurance providers)

Stationary oxygen therapy systems

Stationary oxygen therapy systems come in two types: oxygen concentrators and liquid oxygen systems.

Oxygen concentrators

This is the most commonly used home stationary device. This system works by drawing in room air, separating out nitrogen and other room air components to leave medical grade oxygen, and passing the oxygen through the concentrator’s tubing. The oxygen streams through the tubing to your nasal cannula so you can breathe it in.

Stationary oxygen concentrators are about the size of a bedside table and weigh between 20 and 70 pounds. These systems typically come with about 50 feet of tubing, so that is how far you can move about your home while using the system. (If you need longer tubing, talk to your DME supplier.) Low-flow concentrators (up to 5 liters per minute) and high-flow concentrators (up to 10 liters per minute) are available. These systems must be kept in a well-ventilated area of your home. They require routine filter cleaning to work well and periodic maintenance by your DME supplier. Newer stationary oxygen concentrators produce enough oxygen that you can store it in a refillable tank to take with you in a backpack when you leave your home. Filling tanks yourself means that you do not have to rely on your DME supplier to provide portable oxygen tanks.

  • Advantages. Newer oxygen concentrator models enable you to fill portable tanks from your stationary concentrator for easier mobility.
  • Disadvantages. Oxygen concentrators are large and require electricity, regular maintenance, and filter cleaning to work. If your power goes out, you will have to rely on your backup system for oxygen.
Note:

Neither Medicare nor insurance companies will reimburse you for the cost of the electricity needed to run your oxygen concentrator. You may be able to deduct the cost of electricity from your income tax, however. Check with your tax preparer for more information. Also, financial assistance may be available to help you with the cost of electricity. Check with your health care provider for more information.

Oxygen concentrator
Oxygen concentrator
Oxygen concentrator

Liquid oxygen systems

When oxygen is cooled to very low temperatures, it becomes a liquid. This liquid oxygen is then stored in metal tanks. When the liquid oxygen warms up, it passes through the tubing to your nasal cannula as gas, which you then breathe in.

Stationary liquid oxygen systems are large—up to 120 pounds. In fact, the main tank is too heavy to move, so if you have a summer home or will be away from home for a while, you’ll have to arrange for another home liquid oxygen system. How often your DME supplier must fill the main tanks depends on how much oxygen you use. Talk to your DME supplier about the length of tubing you’ll need to move around your home easily and comfortably.

  • Advantages. Liquid oxygen systems are quiet (they have no moving parts) and don’t require electricity to work. Also, you can fill smaller, portable tanks from your main home tank.
  • Disadvantages. Liquid oxygen is not used often. The home tank is large and must be secured so it doesn’t tip over. Misuse or mishandling can cause personal injury by frostbit/burn. Also, the main home tank has to be refilled regularly, which makes these systems more expensive to maintain and less convenient because you must be home to accept the delivery. Some of the liquid oxygen in the system (approximately 1 pound daily) will evaporate naturally. As a result, home liquid oxygen is not available everywhere, so you’ll need to check with your DME supplier to make sure it’s available where you live or where you’ll be traveling.
Note:

Both oxygen concentrators and liquid oxygen systems are available as pulse-flow (also called demand-flow) systems and continuous-flow systems. Pulse-flow systems have a sensor that can tell when you inhale and deliver oxygen only when you breathe in. Continuous-flow systems provide oxygen constantly, even when you’re not breathing in. Your health care provider will prescribe the system that best meets your needs.

Portable oxygen therapy systems

Portable oxygen therapy systems come in three types: portable oxygen concentrators (POCs), portable compressed gas cylinders, and portable liquid oxygen.

Portable oxygen concentrators

Portable Oxygen

POCs work the same way stationary concentrators do except that they run on batteries as well as electricity. POCs come in a variety of sizes, but note that the smaller the POC, the less oxygen it might produce and the shorter the battery life it might have. Some POCs can be as small as a purse, and some are big enough to be on rollers. Many POCs have a rechargeable battery that will last up to a few hours. If yours does not, be sure to keep extra batteries on hand for your system.

Most POCs work by a pulsed-flow rate, which means that they deliver oxygen only when you inhale. If you need a POC with continuous- or high-flow-rate settings, be aware that not all POCs can provide this. If you need continuous-flow oxygen therapy, your health care provider must specify that on the prescription.

There are many POCs on the market today. The way a POC provides oxygen (pulsed flow, continuous flow, or both) and the oxygen flow rate it offers depend on the device and manufacturer. Work with your DME supplier to find the POC that best meets your needs.

Note:

POCs can be very expensive. As a result, not all DME suppliers offer them.

Most airlines allow POCs, but be sure to check with your airline before you travel with your POC. (See Trip Planning Guide: Traveling With Oxygen Therapy for more information about traveling with your oxygen therapy system.)

Portable compressed gas cylinders

Portable compressed gas cylinder

Portable compressed gas cylinders are available in many sizes, from some that weigh a few ounces and that you can carry in a backpack to those that weigh 8 pounds or more that you pull on a small cart. Some of these portable cylinders can provide oxygen continuously, but they will last just a few hours depending on your liter flow.

Note:

The higher the flow rate of oxygen, the faster you’ll use the oxygen stored in the cylinder.

If you have an oxygen conserver with your cylinder, the tank provides oxygen only when you breathe in. In this case, the oxygen in the cylinder may last up to several hours, depending on the size of the cylinder. Some of these cylinders can be filled from your stationary oxygen concentrator—talk to your DME supplier to find out more information.

Note:

Use caution when handling these cylinders. They are under high pressure and can be extremely dangerous if they were to fall and crack a valve.

For information about Medicare reimbursement for portable oxygen therapy systems, please see Paying for Oxygen Therapy.

Portable liquid oxygen tanks

Portable liquid oxygen tank

Portable liquid oxygen is a less commonly prescribed oxygen therapy system, and many DME suppliers may not provide this option. However, the benefits of portable liquid oxygen are that it can provides higher flow rates of continuous-flow or oxygen, it is lightweight, and in some cases may last longer than POCs or compressed gas cylinders. Patients with very high oxygen needs may require this device. In addition, you can fill your portable liquid oxygen tanks from your larger stationary liquid therapy system. These systems require no electricity to operate.

Other components for your oxygen therapy system

Besides the tanks or concentrators that store and supply your oxygen, you need some or all of the following accessories to use your oxygen therapy system:

Oxygen tubing

Tubing

This thin hose connects from your stationary oxygen therapy system to your nasal cannula or mask. Most stationary systems come with up to 50 feet of tubing. Discard and replace your tubing once every 6 months.

If your health care provider has prescribed high-flow oxygen therapy (ie, you require more than 6 liters per minute of oxygen), your system will come with special high-flow tubing, which is slightly larger in diameter.

To clean your tubing, complete the following steps:

  1. Wash the tubing in warm, soapy water.
  2. Rinse the tubing in a solution of 10 parts water to 1 part vinegar to kill any bacteria.
  3. Rinse the tubing with hot water.
  4. Hang the tubing to dry.

Reservoir or Oxymizer

This device helps conserve oxygen and allows patients to have more oxygen available when inhaling. It sits below the nose (left) or is attached to a nasal cannula like a pendant (right) to provide additional oxygen.

oxygen therapy nasal canula

Nasal canula

This 2-prong piece attaches to the tubing and delivers oxygen into your nose. You should remove the cannula and wipe it clean with a damp cloth once or twice a day. You should discard and replace your nasal cannula once a month.

 To clean your nasal canula, complete the following steps: 

  1. Wash the canula in warm, soapy water.
  2. Rinse the canula in a solution of 10 parts water to 1 part vinegar to kill any bacteria.
  3. Rinse the canula with hot water.
  4. Hang the canula to dry.
oxygen therapy face mask

Face mask

If your health care provider has prescribed high-flow oxygen therapy, you may need to use a face mask instead of a nasal cannula. This mask covers both your nose and your mouth and attaches to the tubing. Your should remove the mask and wipe it clean with a damp cloth once or twice a day. You should discard and replace your oxygen mask once a month.

To clean your face mask, complete the following steps:

  1. Wash the face mask in warm, soapy water.
  2. Rinse the face mask in a solution of 10 parts water to 1 part vinegar to kill any bacteria.
  3. Rinse the face mask with hot water.
  4. Hang the face mask to dry.
oxygen therapy humidifier

Humidifier

A humidifier is a container filled with distilled water that attaches to the oxygen therapy system. The water mixes with your oxygen to help prevent it from drying out your nasal membranes.

To clean your humidifier, complete the following steps:

  1. Wash the humidifier in warm, soapy water.
  2. Rinse the humidifier in a solution of 10 parts water to 1 part vinegar to kill any bacteria.
  3. Rinse the humidifier with hot water.
  4. Set the humidifier aside to dry.

Note: POCs may not work with a humidifier.

Filters

Filters are small components that help keep the oxygen you breathe in clean and free from dust, bacteria, and other things that can make it hard for you to breathe. Which filters you need depends on your oxygen therapy system.

Safety tips for using your oxygen therapy system

To help you breathe and avoid lung and sinus infections, be sure to keep up with the following basics:

  • If you use an oxygen concentrator, change the filters regularly. Your DME supplier can help with this task and will supply the right filter for your oxygen therapy system.
  • Change your nasal canula, tubing, and face mask regularly.
  • If you use a humidifier with your oxygen therapy system, wash it at least once a week. Fill the humidifier with distilled water only.
  • Schedule a yearly maintenance appointment with your DME supplier for your stationary and portable oxygen therapy systems.

In addition, for as long as you have your oxygen therapy systems, follow these safety precautions:

  • Do not smoke or allow others to smoke around you (for example, in your home or car).
  • Avoid open flames, such as from candles, bonfires or fire places, cigarette lighters, pilot lights, and gas stoves.
  • If you use oxygen tanks, store them at least 10 feet away from any source of fire in a well-ventilated area out of direct sunlight.
  • Don’t use electric razors, hair dryers, and similar appliances that can cause sparks while you’re using oxygen.
  • Contact your DME immediately if you notice a crack in an oxygen tank. Don’t try to fix problems with your oxygen therapy system yourself.
  • Place a sign on the front door of your home to let visitors know that you use oxygen in your home.
  • Change the batteries in your smoke detectors every 6 months, and keep fire extinguishers in your home.
  • Let your power company and local fire department know that you have an oxygen therapy system in your home. Ask for your home to be a priority service listing.
  • Don’t use petroleum-based moisturizers on your face or chest (for example, Vaseline) or petroleum- or wax-based lip balm (for example, ChapStick).

Oxygen therapy FAQs

  • Is oxygen addictive?

    We all need oxygen to survive, so you can’t become addicted to it. You can, however, use too much oxygen. Like any medication, follow your health care provider’s instructions when using your oxygen equipment. Call your provider if you feel lightheaded, confused, or sleepier than usual or if you develop a headache after using your oxygen equipment.

  • What does my oxygen therapy prescription include?

    When your health care provider prescribes oxygen therapy, that prescription should tell you:

    • How often you should use oxygen therapy;
    • How you use your therapy (nasal cannula or mask for example);
    • How much oxygen you need based on your activity level; and
    • The type of oxygen therapy system that best fits your needs.

  • Are there activities I won’t be able to do while using my oxygen therapy system?

    You may find that some activities, such as swimming, are more difficult with your oxygen therapy system. Talk to your health care provider if you have questions or concerns about your oxygen therapy system.

  • What does Medicare pay for?

    For complete information about what Medicare pays for oxygen therapy, refer to the Paying for Oxygen Therapy section.
    Also, visit the Medicare.gov Oxygen equipment & accessories page.

  • I’m moving. How do I continue my oxygen equipment deliveries?

    For complete information about what to do when you change where you live, either permanently or temporarily, refer to the What to Do if You Move booklet.

Equipment and supplies

  • How do I measure my oxygen levels?

    At the clinic or hospital, your health care provider has several sophisticated tools and tests for measuring your oxygen levels. For example, your provider can run blood tests to see how much carbon dioxide (a waste product of breathing) and oxygen are in your blood.

    pulse oximetry device

    At home, you can use a tool called a pulse oximeter to measure your oxygen levels. This tool typically consists of a little monitor you place on your finger that measures two things: your heart rate (which should be between 60 and 100 beats per minute) and the amount of oxygen in your blood (a good level is anything over 92%). Pulse oximeters give you an idea of your oxygen levels, but the readings can vary based on the quality of the device you use, which finger you put the monitor on, whether your hands are cold or hot, and other factors.

  • Do I need a humidifier?

    Oxygen therapy—especially high-flow oxygen—can cause your nasal membranes to dry out, leading to headaches and even nosebleeds. If you experience such side effects, call your health care provider to ask whether you need a humidifier with your oxygen therapy system. A disposable humidifier is not recommended when the prescribed flow rate is >6 liters per minute.

    Medicare will pay 80% of the cost of a humidifier that is part of your oxygen therapy. You must pay 20% of the Medicare-approved amount.

    For more information, visit the Medicare.gov Humidifiers page.

  • What’s the difference between pulse- or demand-flow oxygen and continuous-flow oxygen?

    Pulse- or demand-flow oxygen therapy systems have a sensor that can tell when you inhale. They deliver oxygen only when you breathe in.

    Continuous-flow oxygen therapy systems provide oxygen constantly, even when you’re not breathing in.

    Your health care provider will prescribe the system that best meets your needs.

  • Who owns the oxygen therapy equipment at the end of my 5-year Medicare contract?

    The DME supplier that delivers your oxygen therapy equipment owns that equipment. The DME supplier always owns the equipment, title never transfers.

  • Can I get emergency supplies? How are those supplies paid for?

    he disposable items you use with your oxygen therapy system, such as nose pieces (called nasal cannulas) and tubing, are included in the monthly reimbursement to your DME supplier. Monthly visits are not required. Your oxygen supplier will provide supplies to you on a regular basis. If additional supplies are needed, contact your oxygen supplier. It’s rare that you would need emergency supplies, but if you do, your available options depend on your DME supplier.

    Some DME suppliers may provide such disposable items at no cost. Some suppliers may charge a minimal fee. Still other suppliers don’t allow cash sales at all and work only with Medicare and insurance companies.

    It’s always a good idea to have extra supplies. However, if you ever do need emergency supplies, you can purchase some components at medical supply stores. Be aware, however, that you probably won’t be reimbursed for such purchases by Medicare or your insurance company.

Durable Medical Equipment (DME) suppliers

  • Can I choose the durable medical equipment (DME) supplier that delivers my oxygen therapy equipment?

    Yes, but you must make sure that the DME supplier is an approved supplier for Medicare or your insurance company. To find a Medicare-approved DME supplier, visit the Medicare.gov Find a Supplier page.

  • Can my durable medical equipment (DME) supplier give me used equipment?

    Medicare considers the parts of an oxygen therapy system that aren’t disposable to be durable medical equipment—that is, equipment that can be used over and over again. To help prevent the spread of disease, however, oxygen system supplies such as the tubing, nose pieces (called nasal cannulas), filters, and other disposable items for use with your oxygen therapy system must be new with your set-up. They should be continuously changed and/or cleaned, as outlined by your DME supplier. For example, nasal cannulas should be changed, and the permanent filters should be cleaned on the schedule outlined by your DME supplier

  • What if my durable medical equipment (DME) supplier stops carrying a supply I need?

    The DME supplier that delivers your oxygen therapy equipment is required to provide everything ordered on your oxygen therapy prescription for the entire 5-year rental period. If your DME supplier stops carrying equipment you need, ask the supplier if there is an alternative that meets your medical needs. If necessary, and if you’re on Medicare, you can file a complaint on the Medicare.gov How to file a complaint (grievance) page.

  • What if my durable medical equipment (DME) supplier goes out of business or leaves the Medicare program?

    If your DME supplier goes out of business or leaves the program, the company must give you 90 days notice in writing. The notice must include the date the DME supplier will stop service. When you receive this notice, call the DME supplier. The company should help you find a new supplier in your area. Also, Medicare maintains a Find a Supplier page. When you have a new supplier, ask the old supplier to transfer your contract to the new provider in writing.

  • What happens at the end of my 5-year Medicare contract?

    Your DME provider will notify you when your 5-year contract is about to run out. Before the contract ends, contact your health care provider so that he or she can write a new certificate of medical necessity. Contract end is also an opportunity to talk to your health care provider about changes to your oxygen therapy or to change DME providers

Who should I contact?

Call your durable medical equipment (DME) supplier if:

  • My oxygen therapy system isn’t working right.
  • I need to return broken oxygen therapy equipment.
  • The delivery driver is late delivering my oxygen therapy equipment.
  • Some supplies were left out of my monthly DME delivery.
  • I lost the wrench from my backup/rescue oxygen tank.

Call your health care provider if:

  • I think I need to change the amount of oxygen therapy I’m on.
  • I get nosebleeds after I use my oxygen therapy system.
  • My 5-year Medicare contract is about to run out.

Financing options for oxygen therapy

Medicare

If you’re 65 years of age or older or on federal disability, Medicare Part B is most likely your primary insurance provider.

Medicare covers oxygen therapy in 5-year contract cycles. For the first 36 months of each cycle, Medicare Part B pays the rental feel for the system and accessories your health care provider has prescribed. Medicare covers the:

  • Oxygen therapy system;
  • Containers (such as tanks) that store oxygen; and
  • Tubing and other accessories you use with your oxygen therapy system.

Medicare also pays for:

  • The oxygen in your storage containers;
  • Regular maintenance to your oxygen therapy system; and
  • Oxygen system repairs when something goes wrong.

You must pay 20% of the Medicare-approved amount and your Medicare Part B deductible.

For the last 24 months of the 5-year cycle:

  • The durable medical equipment (DME) supplier that delivers your supplies is required to maintain and repair your oxygen therapy system for the entire length of the 5-year contract at no charge to you.
  • Your DME supplier is required to furnish oxygen therapy supplies and accessories for the entire length of the 5-year contract at no charge to you.
  • If the oxygen you use is stored in tanks delivered to your home, Medicare will continue to pay 80% of the cost of delivery of these tanks. You must pay the remaining 20%.
Note:

If your saturated oxygen (SaO2) levels—that is, the amount of oxygen your hemoglobin (the protein in red blood cells) holds—are above 88% while you’re awake or fall by less than 5% while you’re asleep, Medicare may not pay for oxygen therapy or may limit your coverage to 3 months, depending on your diagnosis. (After 3 months, you would need to requalify.) Talk to your health care provider to make sure you meet the criteria to qualify for oxygen therapy.

For more information, visit the Medicare.gov Oxygen equipment & accessories page.

Other ways to pay

If you’re under 65 years of age or have private (non-Medicare) insurance, check with your insurance company about what it covers. If your insurance company won’t pay for your oxygen therapy, you still have options.

CareCredit

In 2017, medical finance company CareCredit and portable oxygen contractor manufacturer OxyGo created a partnership to help people without insurance purchase an oxygen therapy system. CareCredit works like a credit card for health care–related expenses. If you qualify, you can use CareCredit to purchase an oxygen therapy system. Several monthly repayment options are available to meet your budget.

For more information, visit CareCredit’s website.

Borrow from your retirement savings account

If you’re under 59.5 years of age and withdraw money from your individual retirement account (IRA), you will have to pay an early withdrawal penalty. But, under some circumstances, you may be able to withdraw money from your IRA without paying the penalty:

  • You are unemployed and need the money to pay for health insurance.
  • You are disabled, as verified by your health care provider.
  • You have medical expenses that exceed 7.5% of your adjusted gross income.

Before you decide to use IRA money, be sure to talk to your financial planner, retirement account administrator, attorney, or accountant about the risks, penalties, and options.

Trip planning guide

Just because you need oxygen therapy doesn’t mean you can’t travel or spend extended time away from your primary home. Here are some tips to make sure you can travel safely while still getting the oxygen therapy you need.

Trip Planning Guide: Traveling with Oxygen Therapy

Trip Planning Guide: Traveling with Oxygen Therapy

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Talk to your health care provider

Before you start planning a trip, make an appointment with your health care provider to make sure it’s safe for you to travel. During that appointment, talk to you provider about:

  • How you’ll be traveling—car, plane, train, or cruise ship;
  • How long you’ll be gone;
  • What the climate and elevation will be at your destination or during your journey;
  • Whether you’ll need extra supplies for your oxygen therapy system while you’re away;
  • Whether you’ll need emergency medication, such as corticosteroids or inhalers;
  • The names of health care providers, hospitals, and durable medical equipment (DME) suppliers at your destination;
  • What medical, insurance, and personal information you should take with you;
  • What you should do if you have trouble breathing while you’re away; and
  • A letter authorizing you to travel with an oxygen therapy system or a copy of your oxygen therapy prescription.

Plan for your trip

After you’ve talked to your health care provider, put together information you’ll need in a folder. This folder should contain:

  • Names and phone numbers of important contacts, such as your health care provider and people to call in case of emergency;
  • Important health insurance information, including all up-to-date insurance cards;
  • The name and number of local health care providers and hospitals at your destination; and
  • A list of all the medications you take.

Before you leave for your trip, be sure to refill all your prescription medications. If you’re traveling alone, arrange to check in with a friend or family member regularly so that that person knows you’re alright. If you’re traveling with someone, make sure that person knows the medication you take and how to use your portable oxygen therapy system, including recharging or changing batteries.

Make sure your oxygen needs are met while you’re traveling

Before you leave for your trip, create a plan to meet your oxygen needs while you’re away. Work with your DME supplier to make sure you have a portable oxygen therapy system and extra accessories, such as nasal cannulas and tubing, for the whole time you’ll be away.

Note:

Your DME supplier is required to supply oxygen at your destination, but you are responsible for supplying your own oxygen while you’re traveling.

When you and your DME supplier have a plan, write the plan details down, and then send it in an email or certified letter to the supplier.

If your DME supplier is part of a national chain, ask for the contact information of a local office. Then, contact that officer a few days before you arrive to make sure everything is in place or ready to go when you get there. If your DME supplier is independent, work with your contact person to find a local supplier in your destination city. If you’ll be staying in a resort or hotel, let the concierge know that oxygen and oxygen supplies will be delivered to your room and that it’s OK to sign for them.

Traveling by car

If you plan to drive to your destination, you should take these steps:

  • Plan the route you’ll take in advance, including rest stops.
  • Check your mobile phone provider’s coverage map to make sure you’ll have mobile phone access along your planned route in case of emergency—for example:
  • If your car has a 12-volt DC outlet and you use a portable oxygen concentrator (POC), you should be able to charge the POC as you travel. If not, you’ll need to know where you can stop to recharge your POC along the way.
Note:

If your vehicle doesn’t have a 12-volt DC outlet, talk to your mechanic or the vehicle manufacturer about modifying your car’s electrical system (for example, the car’s battery and alternator) so that you can use your car to recharge your POC’s battery. Be aware that neither Medicare nor your insurance company will pay for this modification.

  • If you use portable liquid oxygen tanks, make sure you bring along more tanks than you’ll need for the drive. Secure the tanks in the vehicle, and don’t store them where they’ll get hot, such as in the trunk or in the bed of a pickup.
  • If you’re driving to or through high-altitude areas, be aware that high altitude means less oxygen in the air. So, plan to use more oxygen in these areas.

Traveling by train

Traveling by train with oxygen is probably the easiest travel option. In the United States, Amtrak has the following restrictions:

  • When you travel with oxygen, you can’t book your trip on the Amtrak website. Instead, call 1-800-USA-RAIL (1-800-872-7245), and let the operator know that you will be traveling with oxygen. Make your reservation well in advance of the date you plan to travel.
  • If you’re traveling with a POC, it must be able to run on battery power for 4 hours.
  • If you’re traveling with liquid oxygen tanks, you’re limited to two 50-pound tanks or six 20-pound tanks.
  • All oxygen therapy system equipment must be Underwriter’s Laboratory (UL) or Factory Mutual (FM) listed.

If you’re traveling on a rail service other than Amtrak, call the rail company directly to make your reservation and learn about any restrictions or requirements.

Traveling by cruise ship

If you’re planning a cruise, contact the cruise line well in advance of your trip. Many cruise lines must approve your plans before you can bring oxygen equipment aboard the ship. Most cruise lines will not work with DME suppliers directly: You must make arrangements with the supplier yourself to deliver oxygen to the cruise ship.

Traveling by plane

If you’ll be flying in the United States, the Federal Aviation Administration (FAA) allows you to use a battery-powered POC during the flight. Each airline keeps a list of approved POC, so you’ll need to check the list for your chosen airline or talk to an airline agent to make sure you’re allowed to use your POC. If your POC isn’t on the airline’s list, ask the airline agent if the airline will supply you with oxygen during the flight. (Many do for an additional fee.) Otherwise, you can rent an approved system for the flight. Talk to your DME supplier if you’ll need to rent a POC.

Important:

FAA doesn’t allow liquid oxygen tanks on flights in the United States. For more information about FAA-approved POCs, visit the FAA website.

Most airlines have a special form that your health care provider must fill out before your trip. You may need to present this form when you check in for your flight.

Also, take advantage of electrical outlets in airports to keep your POC fully charged.

Note:

Consider arranging for a wheelchair or other transportation within the airport to save POC battery and avoid becoming short of breath.

The following list provides websites and phone numbers for some of the major airlines in the United States:

Traveling outside the United States

Laws governing oxygen use vary from country to country. If you’ll be traveling outside the United States, work with your travel agent, airline, rail service, local hotel or resort, or the US Department of State to make sure your oxygen therapy system meets the requirements and laws of the country you’re traveling in or through. For example, the State Department has a helpful website for people with disabilities traveling abroad: See the Travelers with Disabilities page.

The following websites may be helpful, as well:

It is possible to travel with oxygen therapy. With proper planning, you can have a great trip!

Resources for clinicians

Do you treat patients that have been diagnosed with a pulmonary and or cardiac condition that is causing hypoxemia? If so, the next step may be to determine whether oxygen therapy is an appropriate treatment option. This guide can help you. Not only does it outline oxygen therapy systems and liter flows, it also helps you navigate Medicare guidelines and reimbursement requirements.

Does Your Patient Need Oxygen Therapy?

Does Your Patient Need Oxygen Therapy?

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