My oxygen provider says I need yearly re-evaluations for oxygen coverage, but my last one lapsed and now they are charging me. I’ve been with them since 2017. Please help.

Question

Mark Bilgere · Accepted Answer

Ask “Am I being billed because Medicare denied medical necessity, or because paperwork simply expired?” If the paperwork has expired, ask the supplier exactly what they need. Then, contact your physician to get the required prescription or testing that is being requested. If it is just paperwork, that issue can usually be solved fairly quickly. If it is a Medicare denial, you may have more testing and documentation necessary.

Answered by Mark Bilgere on May 12, 2026

Broker Licensed in TX, AR, IN & LA, MN, NE & OK

Answered by Mark Bilgere Medicare Insurance Agent

Ann Sanfelippo · Answer

Medicare does require periodic documentation and recertification for oxygen coverage, especially continued proof that the oxygen remains medically necessary. If the required yearly re-evaluation or physician documentation was missed, the supplier may temporarily stop billing Medicare and charge you directly until updated records are provided.

Since you’ve had oxygen since 2017, you may already be beyond Medicare’s standard 36-month rental period, but documentation requirements can still apply for continued service and supplies. Contact your doctor immediately to schedule the re-evaluation and have updated chart notes and oxygen testing sent to the supplier.

You should also ask the supplier for a detailed explanation of the charges and whether they can rebill Medicare once the updated documentation is received.

Cheri Rogers · Answer

Work with your doctor and insurance company to get the required evaluation and then get reinstated with your oxygen provider. It is imperative you know your insurance policy, benefits and requirements. Always use a licensed/certified Agent to assist you with finding the right coverage for your specific needs.

Answered by Cheri Rogers on May 12, 2026

Broker Licensed in NM & TX

Answered by Cheri Rogers Medicare Insurance Agent

Priscilla Ramos · Answer

If you’ve had oxygen equipment since 2017, Medicare usually considers you past the initial 36-month rental period, but you still must meet ongoing medical necessity requirements — including periodic doctor re-evaluations and updated documentation.

If your recertification lapsed, the supplier may temporarily bill you until updated paperwork is completed. Contact your doctor ASAP for an oxygen re-evaluation and ask the supplier if charges can be reversed once documentation is submitted retroactively.

You can also call Medicare directly or request help from your local SHIP counselor if the supplier is refusing to work with you.

Vernon Jones · Answer

This is a frustrating situation, but it happens, particularly in states like North Carolina with strict continuous insurance requirements. If you have been with them since 2017 and have proof of continuous coverage (even if there was a clerical error), you can fight these charges

Answered by Vernon Jones on May 11, 2026

Broker Licensed in NC & SC

Answered by Vernon Jones Medicare Insurance Agent

Karen Chiaruttini · Answer

Call your dr office and ask if they got any requests from oxygen people. Maybe they can complete a current o2 recertification  visit soon

Richard Allen · Answer

Call your provider and let them know what Medicare plan you are enrolled in to keep their system updated.

Jackie Welch · Answer

First, let’s schedule the re-evaluation asap. Medicare coverage most often needs to show “medical necessity.” Next, did Medicare deny the claim or is the provider holding billing until the documentation is resolved? Many times, once the proper documentation is updated the original billing can resume. Also, since it has been over 5 years the provider may not choose to proceed. In that case, a new provider will be needed and the proof of “medical necessity” will be required.

Answered by Jackie Welch on May 11, 2026

Broker Licensed in TX & AZ

Answered by Jackie Welch Medicare Insurance Agent

My oxygen provider says I need yearly re-evaluations for oxygen coverage, but my last one lapsed and now they are charging me. I’ve been with them since 2017. Please help.

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My oxygen provider says I need yearly re-evaluations for oxygen coverage, but my last one lapsed and now they are charging me. I’ve been with them since 2017. Please help.

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