State oxygen funding
Neither the Medicare Benefits Schedule nor the Pharmaceutical Benefits Scheme fund oxygen therapy. Oxygen therapy is funded either directly via state and territory schemes or through federal agencies including the Department of Veteran Affairs (DVA), or the Department of Health for patients in residential aged care facilities.
Each state and territory use medical criteria to decide who is eligible to receive a home oxygen subsidy. In some states, a central organization is responsible for subsidies and in other states the subsidies are managed by local health services or hospital boards
Federal oxygen funding
The Department of Veterans’ Affairs provides oxygen equipment funding for war veterans. The following links are useful:
The Department Human Services administers payment of oxygen supplements to aged care facilities.
Oxygen supplement for aged care Australia
Approved residential and home care providers can get this primary supplement to help with the costs of supplying oxygen. Find out if your care recipient is eligible and how to apply.
Applies to
This supplement is for providers of Home Care Packages and residential aged care.
What is the supplement?
The oxygen supplement is a primary supplement. It supports care recipients who have a medical need for continual oxygen therapy.
Eligibility
Care recipients who have a long-term medical need for continuous oxygen are eligible for this supplement.
The supplement is not payable for an emergency or for short-term illnesses, such as bronchitis.
The residential or home care provider must have hired, have borrowed or own the equipment used to provide the oxygen.
You will need a certificate from a doctor stating the care recipient’s:
oxygen requirements
continual need for the administration of oxygen.
Higher oxygen supplement
A higher oxygen supplement is available when the cost of administering oxygen is 125% of the standard supplement amount or more.
This may happen when a care recipient needs:
an oxygen flow rate higher than 4.2 litres per minute and a single concentrator is not enough
cylinder oxygen on top of concentrator oxygen.
The higher supplement is not available when the higher cost is due to more expensive supplies.
Other government payments
A home care recipient who needs oxygen therapy may also be eligible for the Essential Medical Equipment Payment. The home care recipient will need to apply for this.
Care recipients who are eligible for the oxygen supplement may no longer be eligible for state and territory government aids and equipment schemes. Those care recipients should contact their state-based aids and equipment scheme provider to check.
How to apply
Apply for the oxygen supplement online with Services Australia.
You can also submit the form and supporting evidence by:
emailing Services Australia
posting to one of the addresses on the form.
The oxygen supplement does not transfer between providers. You must apply for each eligible care recipient, even if their previous provider received the supplement.
Payment
The supplement will be paid from the date you receive approval. Notification of approval will be on your Medicare payment statement.
Payments may be backdated to whichever date is the latest, of either:
the date of medical certification
the date the person entered care.