TriCare Prime and Oxygen Concentrator

I have a rental 02 concentrator, but am looking to buy one. My pulmonologist wrote for an Inogen At Home (GS-100) for me, but I am wondering if anyone has successfully been able to obtain one and have TriCare pay for at least part of it?

You are going to have to request your "Evidence of Coverage" (EOC). That is the actual contract between you and your insurer. You've never seen it unless you know to ask for it. It may be available online or you may have to call TriCare Prime and ask for a copy to be sent to you. In most states they must provide you with a copy by law within 7 to 14 days (depending on the state) of a written request.

Insurance plans can vary, so asking here might not be the right answer for your specific policy, that's why you need to request the EOC that's specific to your plan. Although Tri Care is federal, they often use other entities as intermediaries to administer the policies, e.g. Care Centrix.

The EOC will tell you whether it's possible to purchase the oxygen concentrator or if it's a perpetual rental. When you obtain a copy of the EOC, look up "Durable Medical Equipment" and it will spell out exactly what the policy is. There are three possibilities: perpetual rental, capped rental (where you rent for a period of time and then your insurer will purchase it for you--that's how Medicare does it as long as you are not on an Advantage plan), or the option to purchase rather than rent.

Don't take your DME's word for anything, they are not trustworthy in telling you what your insurer will or will not pay for. They may prefer you to rent perpetually when you have the option of a purchase.

greensled wrote: ↑

Wed Jul 12, 2023 10:19 am

I have a rental 02 concentrator, but am looking to buy one. My pulmonologist wrote for an Inogen At Home (GS-100) for me, but I am wondering if anyone has successfully been able to obtain one and have TriCare pay for at least part of it?

Is it TriCare or TriCare For Life? They are diff companies.
Also are you eligible for the VA? People get a lot of DME supplies from the VA.
Then you could have two?

Jan has some excellent advise. Always speak directly with your insurance, Always.