Hyperbaric oxygen therapy (HBOT) is a medical treatment that delivers pure oxygen to your body under increased atmospheric pressure. This process helps your blood carry more oxygen, promoting faster healing and fighting infection. But, will Medicare help cover this therapy? Let’s explore!
Does Medicare Cover Hyperbaric Oxygen Therapy?
Medicare Part B may cover hyperbaric oxygen therapy if you meet specific conditions. Generally, Medicare covers HBOT when it is performed in a chamber and treats one of the following conditions:
- Decompression illness
- Gas embolism
- Gas gangrene
- Acute carbon monoxide poisoning
- Acute traumatic peripheral ischemia
- Progressive necrotizing infection
- Crush injury and suturing of a severed limb
- Acute peripheral arterial insufficiency
- Preparation and preservation of compromised skin grafts
- Cyanide poisoning
- Chronic refractory osteomyelitis (unresponsive to other treatments)
- Soft tissue radionecrosis (as part of conventional treatment)
- Osteoradionecrosis (as part of conventional treatment)
- Actinomycosis (when not responsive to antibiotics and surgery)
Diabetic Wounds and Medicare Coverage
Medicare may also cover HBOT for people with diabetes if:
- You have either type 1 or type 2 diabetes.
- You have a lower extremity wound caused by diabetes.
- The wound is classified as Wagner grade III or higher.
- Standard wound care hasn’t been effective.
Cost of Hyperbaric Oxygen Therapy with Medicare
Understanding the costs can help you plan better. Here’s a quick look:
| Treatment Type | Estimated Cost (2022) | Medicare Coverage |
|---|---|---|
| Single HBOT Session | $595.86 | 20% after deductible |
| Diabetic Foot Ulcers / Delayed Radiation Injuries (40 sessions) | $17,875.80 – $35,751.60 | 20% after deductible |
| Crush Injuries | $2,383.40 – $8,342.04 | 20% after deductible |
| Total for 40 Treatments | $23,834.40 | 20% after deductible |
Note: With Medicare Part B, you typically pay 20% of the Medicare-approved amount after meeting your Part B deductible, which is $257 in 2025.
Steps to Get Medicare Coverage for HBOT
- Consult Your Doctor: Make sure your doctor believes HBOT is medically necessary.
- Ensure Medicare Enrollment: Be enrolled in Medicare Part B.
- Use Approved Facilities: Get treated at a Medicare-approved facility.
- Provide Documentation: Submit necessary medical records proving the need for HBOT.
Tips for Reducing Costs
- Medicare Supplement Plans: Consider a Medicare Supplement Plan (Medigap) to cover out-of-pocket expenses.
- Medicare Advantage Plans: Some plans may cover more than Original Medicare.
- Financial Assistance: Check for state or local programs that offer help.
Final Thoughts
Hyperbaric oxygen therapy can be life-changing for those with certain medical conditions. Understanding Medicare’s coverage options and planning accordingly can ease the financial burden. Always consult with your healthcare provider and insurance specialist to make informed decisions.
Disclaimer: The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Minseos.com Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Minseos.com Media does not recommend or endorse any third parties that may transact the business of insurance.
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