Travel to high altitude with lung condition: Need to take precautions?

Posted by sistertwo @sistertwo, Sep 23, 2020

We are planning a road trip to CO to see our daughter (who is isolated and Covid free) and I am wondering what people do when a person has COPD when going to a higher elevation (7240 ft). We have been there several times before, but not since he had an ablation on his heart a couple years ago. His heart is good now, but his oxygen level is typically around 91-92. Thank you.

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It was very helpful to have the portable oxygen machine when we went from MN to CO, both in the car and during the nights. The VA allows them to be used twice a year (you may want to check with your insurance if you are not a veteran), but not out of country or in the air. Since our Colorado trip, he has his machine hooked to a CPAP at level 3. It helps at night, but him walking from the car to the house it drops to 83 or lower. After sitting a couple minutes it goes back to 93 (his new good norm).
I am hoping we can buy one of those Inogen One machines or another TSA approved one even if Medicare or his supplement insurance doesn't cover it. If anyone has experience (good or bad) or suggestions in that area, I'd love to hear them. Thank you.
And, wishing you the best of luck, Rob. I hope you are able to go.

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@sistertwo

It was very helpful to have the portable oxygen machine when we went from MN to CO, both in the car and during the nights. The VA allows them to be used twice a year (you may want to check with your insurance if you are not a veteran), but not out of country or in the air. Since our Colorado trip, he has his machine hooked to a CPAP at level 3. It helps at night, but him walking from the car to the house it drops to 83 or lower. After sitting a couple minutes it goes back to 93 (his new good norm).
I am hoping we can buy one of those Inogen One machines or another TSA approved one even if Medicare or his supplement insurance doesn't cover it. If anyone has experience (good or bad) or suggestions in that area, I'd love to hear them. Thank you.
And, wishing you the best of luck, Rob. I hope you are able to go.

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Medicare does not cover purchases of POCs or continuous oxygen machines. Medicare does cover rentals of both however so long as your doctor certifies the need for it (providing the level of need). For Medicare rentals once certified, there would be the usual Medicare deductible (it is under Part B for durable medical equipment). Medicare sets what the rental rate would be and that is what the provider is paid for the term. Under Medicare rules there is a 5 year period. The provider is paid for 3 of the years and the last 2 they must continue to service (or replace) under a no payment warranty. Inogen has historically been good on this as we did it directly with them. After the 5 year period you can get recertified for another 5 year period. Inogen now requires a contract and not all of their POCs are rented (despite what their online advertising implies). If you are certifed for 5L they will not rent such a machine either for continuous or the POC. The contract that Inogen requires you to sign does not state what equipment you will get, the term, or the rate, but has the patient sign it in advance assigning their Medicare benefits to them. Medicare (CMS) is of no help in this regard as they state they have no authority over provider contracts- which is nonsense to me. Effectively, Medicare has a rule (eg 5 year rule) which the provider contractually can ignore. Whether Inogen will follow through regardless of what its contracts states is another matter (they are under new management). Apparently CMS is considering getting rid of the certification process as it exists today and just have the doctor do so without any filings. Presently this is just a proposal. We have purchased continuous and 5 flow Inogen At Home machine from a third party provider as they were cheaper than Inogen. Due to chip shortages Inogen increased its pricing as of Sept 1 2021. I assume others may be doing the same. Respironics (which has had the CPAP problem) produced a 5 flow continuous machine (not POC) and it is OK (Everflo 5 flow).

REPLY
@ibw295

Medicare does not cover purchases of POCs or continuous oxygen machines. Medicare does cover rentals of both however so long as your doctor certifies the need for it (providing the level of need). For Medicare rentals once certified, there would be the usual Medicare deductible (it is under Part B for durable medical equipment). Medicare sets what the rental rate would be and that is what the provider is paid for the term. Under Medicare rules there is a 5 year period. The provider is paid for 3 of the years and the last 2 they must continue to service (or replace) under a no payment warranty. Inogen has historically been good on this as we did it directly with them. After the 5 year period you can get recertified for another 5 year period. Inogen now requires a contract and not all of their POCs are rented (despite what their online advertising implies). If you are certifed for 5L they will not rent such a machine either for continuous or the POC. The contract that Inogen requires you to sign does not state what equipment you will get, the term, or the rate, but has the patient sign it in advance assigning their Medicare benefits to them. Medicare (CMS) is of no help in this regard as they state they have no authority over provider contracts- which is nonsense to me. Effectively, Medicare has a rule (eg 5 year rule) which the provider contractually can ignore. Whether Inogen will follow through regardless of what its contracts states is another matter (they are under new management). Apparently CMS is considering getting rid of the certification process as it exists today and just have the doctor do so without any filings. Presently this is just a proposal. We have purchased continuous and 5 flow Inogen At Home machine from a third party provider as they were cheaper than Inogen. Due to chip shortages Inogen increased its pricing as of Sept 1 2021. I assume others may be doing the same. Respironics (which has had the CPAP problem) produced a 5 flow continuous machine (not POC) and it is OK (Everflo 5 flow).

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Thank you very much. This is very helpful!

REPLY
@ibw295

Medicare does not cover purchases of POCs or continuous oxygen machines. Medicare does cover rentals of both however so long as your doctor certifies the need for it (providing the level of need). For Medicare rentals once certified, there would be the usual Medicare deductible (it is under Part B for durable medical equipment). Medicare sets what the rental rate would be and that is what the provider is paid for the term. Under Medicare rules there is a 5 year period. The provider is paid for 3 of the years and the last 2 they must continue to service (or replace) under a no payment warranty. Inogen has historically been good on this as we did it directly with them. After the 5 year period you can get recertified for another 5 year period. Inogen now requires a contract and not all of their POCs are rented (despite what their online advertising implies). If you are certifed for 5L they will not rent such a machine either for continuous or the POC. The contract that Inogen requires you to sign does not state what equipment you will get, the term, or the rate, but has the patient sign it in advance assigning their Medicare benefits to them. Medicare (CMS) is of no help in this regard as they state they have no authority over provider contracts- which is nonsense to me. Effectively, Medicare has a rule (eg 5 year rule) which the provider contractually can ignore. Whether Inogen will follow through regardless of what its contracts states is another matter (they are under new management). Apparently CMS is considering getting rid of the certification process as it exists today and just have the doctor do so without any filings. Presently this is just a proposal. We have purchased continuous and 5 flow Inogen At Home machine from a third party provider as they were cheaper than Inogen. Due to chip shortages Inogen increased its pricing as of Sept 1 2021. I assume others may be doing the same. Respironics (which has had the CPAP problem) produced a 5 flow continuous machine (not POC) and it is OK (Everflo 5 flow).

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Have you ever used it for air travel?

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My wife used a POC for air travel when she last could fly. I do not recall what manufacturer it was. Best to get a HAST test before you fly. In any case, take an oximeter with you and use it regularly during the flight to be sure you are at a liter flow level that will avoid hypoxia, as you could have no symptoms during the flight but could be dangerously impacted in any case.

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