I am diagnosed with lung disease which requires 24 hours of oxygen use, i get the cylinders of oxygen but they do not last long. There are times when i have 2-3 hour doctor visits, rehab classes, drop and pick up kid from school, shop and other duties in which the tanks do not last. My insurance do not cover the portable and the cost between 2500.00 to 3500.00 which i can not afford, need help
If a new portable unit is still to expensive, many companies sell good used units with low hours.
To qualify for oxygen initially, certain criteria have to be met. From what I understand Medicare will pay for a stationary concentrator, generally for night use, but it can also be used during the day since it's electrically operated.
Tanks are generally provided as a backup in the event of a power failure. But it's never the level required for out of home use.
When someone meets the criteria for oxygen 24/7, as your friend has, Medicare will provide either (a) portable cylinder tanks, or (b) a portable concentrator with back-up batteries, but not both.
What you need to find out is whether your friend meets the criteria for a portable concentrator with batteries, or, alternatively, the cylinder tanks.
She has to have been diagnosed by a pulmonologist as needing oxygen 24/7 to get the portable tanks, so that's the issue on which to focus.
I don't understand, however, why she can't leave her room because she needs oxygen 24/7. If she does, and if that's documented, I would think she has the stationery concentrator, with 25' long tubing and cannulas allowing her to move about throughout the house.
What does she have now and why does it limit her to her room? How does she get to the bathroom or kitchen? Something doesn't make sense about that statement.
As to temporary oxygen, again, it depends on meeting the criteria specified.
Also, again, these are Medicare standards. You'll have to use them as a baseline to find out what Medicaid might pay for. I would think that Medicaid would have the same standards for oxygen qualification, but am not familiar with Medicaid on this issue.
This is what I would do:
1. Contact Medicaid offices in your state and ask if they have the same criteria as Medicare for providing and paying for 24/7 oxygen.
2. If they do, and haven't given specific details, contact Medicare and ask what their criteria are. You could also contact your friend's DME supplier and ask generally what that criteria are. But they won't be allowed to discuss your friend's specific situation.
3. Then your friend should contact her pulmonologist and ask if she's met the standards for portable oxygen equipment, and if that documentation has been provided to Medicaid. If she doesn't meet the standards, she won't be able to get it.
This is unfortunately a highly regulated issue for something that some people need desperately.
This is just a guess, but the fact that she's in a care facility might factor in; DME suppliers would normally do business directly with the facility's management, not individual patients. And there would be the issue of vetting her financial situation to confirm that she can pay.
What you might want to do is speak with the DON or Administrator and ask if she can borrow a tank, on the wheeled rollers, just for the day. The larger tanks (size E I think) have a 6 hour capacity at 2.0 litres.
Just make sure that you or someone else knows how to operate the tan, how to turn the regulator on and off, connect the cannulas, etc.
If that's not possible, I can think of 2 other alternatives:
1. Family can pack up Thanksgiving plates for each of them and for your friend and visit her at the facility. Typically there are private dining rooms, so they could have a special dinner there. And it would be a lot easier on her.
2. I'm not clear on whether she's in rehab or in the facility on a permanent basis, but if it's the former, perhaps the family can have Thanksgiving when she's completed her rehab. It can be a special return home celebration as well.
Good luck; I hope something works out for your friend.
I have a feeling she might have said this in frustration when she was upset about not being able to have Thanksgiving at home.
Another thought occurred to me and that's whether or not she's medically stable enough to leave.
I can't speak to Medicaid and oxygen, and I'm not that familiar with paying for care while Medicaid pending.
I assume this patient isn't able to get Medicare either?
As to organizations in Ohio, perhaps someone here has some insight, but I'm wondering what the basis of the need for oxygen is, and if you've contacted any organizations dealing with that medical condition specifically? Perhaps a call to United Way, or the 211 UW hotline, might help.
In the meantime, if oxygen is the sole issue for remaining in the hospital, has there been any consideration at all of short term rehab, including pulmonary rehab, at a rehab facility? I'm assuming the costs would be lower, and if the patient is Medicaid pending, that might be a possible solution.
I'm a bit surprised as well that a hospital would keep someone solely for that reason, absent any other medical conditions that need treating (I'm assuming here). Rehab facilities have oxygen concentrators and could accommodate someone if that's the primary issue. You might have to do some research to find one with a respiratory therapist, if that's appropriate. Not all rehab facilities have RTs on staff, or RTs who round at different facilities.
Sometimes hospitals can provide outside contracts to provide services for limited time, say, 30 days. I’m sure the hospital social workers & discharge planners are working on this.
Once my father was abruptly discharged w/o my having been told ahead of time. Since the discharge planner never called me, I never brought oxygen from home. And I refused to take him home w/o oxygen.
Someone arranged for us to borrow an E tank from the hospital affiliated DME. I had to return it the same day, but there was no charge.
I wouldn't expect it to be free for a longer period of time, but perhaps you can find out if your hospital's DME, if it has an affiliated one, could honor a script for the oxygen for home care, and bill it through the hospital. That would avoid the patient having to find out of pocket funds, and if Medicaid was approved and the justification was sufficient, it should be covered.
Some nursing homes are affiliated with hospitals, sometimes through joint ventures. Those homes might have similar Hill Burton policies in place. It's worth checking out.
This might help:
needhelppayingbills.com/html/hill-burton_act_free_healthcar.html. If you can't get to the link, google "Hill Burton Act".
See All Answers