Grand Junction and the Western Slope · Oxygen and Medicare
What Oxygen Level Qualifies for Medicare in Grand Junction?
Medicare covers home oxygen when a blood gas test shows a saturation of 88% or lower, or a PO2 of 55 or lower. That's the same number in Grand Junction as in Florida. But people here often ask whether living at altitude changes it, and Medicare's answer is more interesting than a yes or no.
The short answer
- The main line is 88%. Saturation of 88% or lower, or PO2 of 55 or lower, qualifies. At 89%, you need one of a few added heart or blood findings.
- Medicare has no separate altitude number. Its contractors must take altitude into account, and your chart should document any concern about it.
- You rent for 36 months. You pay 20% after the $283 Part B deductible. Colorado's 2024 average allowed amount for a concentrator was $117.42 a month, so about $23.48.
- Colorado uses far more oxygen than the country. CMS's data work out to about 68 concentrator users per 1,000 people in Original Medicare, against 23 nationally.
The four groups Medicare sorts your test into
Your doctor orders a blood gas study, which is either a finger-clip oximetry reading or an arterial blood draw. If you have both on the same day, the arterial number is the one Medicare uses. The result puts you in one of four groups.
| Group | Test result | What else it takes | Retest |
|---|---|---|---|
| Group I | 88% or lower, or PO2 of 55 or lower | Nothing further on the test itself | No formal retest |
| Group II | 89%, or PO2 of 56 to 59 | Also needs swelling suggesting heart failure, pulmonary hypertension or cor pulmonale, or a hematocrit above 56% | Between days 61 and 90, with a new order |
| Group III | Above those levels | A condition that peer-reviewed research shows oxygen improves, such as cluster headaches | Between days 61 and 90, with a new order |
| Group IV | Above those levels | Doesn't fit another group | Presumed not covered |
Sources: CMS NCD 240.2; Noridian and CGS medical directors' letter, June 2026.
The test also has to happen at the "time of need," during the illness, not during a good week months earlier. If oxygen is first prescribed when you leave the hospital, the test must fall within the two days before discharge.
So does altitude count?
Yes, but not as a number. CMS's national rule says its contractors "must take into account variations in oxygen measurements" from factors including "the altitude level." The local coverage policy moves that into your chart: the record must describe "any concerns for variations in oxygen measurements," altitude included.
I read both documents looking for a separate threshold, such as one for people above a certain elevation, and found none. You may see older advice that says otherwise, so ask your doctor or supplier what they're relying on. In practice, here's what this means for you: if your reading sits right at the edge and you live high up, a sentence from your doctor about your home elevation belongs in the record. Whether you need oxygen is a medical question for your doctor. This only covers how Medicare pays.
| Where you live | Elevation (feet) |
|---|---|
| Moab, UT | 4,026 |
| Grand Junction, CO | About 4,600 |
| Delta, CO | 4,961 |
| Montrose, CO | 5,807 |
| Blanding, UT | 6,099 |
| Cortez, CO | 6,181 |
| Monticello, UT | 7,021 |
Sources: topographic listing for Grand Junction (4,583 feet; other listings run a little higher); Wikipedia town entries for the others. Rounded figures, and your own home may differ.
What the numbers show about Colorado
I ran CMS's 2024 equipment data against its enrollment counts, and the gap surprised me. These are oxygen concentrator rentals in Original Medicare only, so Advantage members aren't counted.
| State | Concentrator rental users | People in Original Medicare | Per 1,000 |
|---|---|---|---|
| Colorado | 33,968 | 496,581 | 68 |
| Utah | 13,706 | 224,520 | 61 |
| Arizona | 19,176 | 745,316 | 26 |
| Florida | 47,593 | 2,252,528 | 21 |
| United States | 776,543 | 33,913,847 | 23 |
Sources: CMS DME by Geography and Service, 2024, code E1390; CMS Monthly Enrollment, 2024. Rates are our arithmetic. CMS assigns users by the state of the referring provider, and someone who used two suppliers could be counted more than once.
Colorado and Utah run close to three times the national rate, while Arizona and Florida sit near it. That lines up with elevation, but the data doesn't prove elevation is the cause, since age, smoking and prescribing habits also differ by state. On the lung side, CDC's county estimates put adult COPD at 5.8% in Mesa County, 5.6% in Grand County, Utah, and 8.0% in San Juan County, Utah.
On oxygen and reviewing your coverage this fall?
We'll look at how your supplier fits with Original Medicare, a Medigap plan or the Mesa County plans we offer, before you change anything. Free, at our Grand Junction office or by phone, no pressure.
Book a call →What you'll pay, month by month
Medicare.gov sets out a five-year cycle. The rental includes the equipment, tubing, delivery, back-up equipment, maintenance and repairs.
- Months 1 to 36: you pay 20% of the approved amount after the $283 deductible. At Colorado's 2024 average of $117.42 for a concentrator, that's about $23.48 a month, or roughly $845 over 36 months. A portable concentrator is a separate rental, and Colorado's average allowed amount was $48.13.
- Months 37 to 60: the equipment payments stop, but your supplier has to keep providing it. If you have a concentrator or a home-fill unit, you may owe coinsurance on a maintenance visit every six months, but only if the supplier actually comes out.
- After five years: you can get new equipment, from the same supplier or a different one, and a new 36-month rental begins.
Those are averages, and your cost will depend on your equipment and flow rate. A Medigap plan such as G or N picks up that 20% after the deductible.
On a Medicare Advantage plan, the plan sets your share. CMS's 2027 benefit file shows these medical equipment coinsurance levels for the 13 general plans in Mesa County: eight at 20%, two at 0% to 20%, two at 18% and one at 12%. All 13 flag prior authorization. That's the whole equipment category, not oxygen alone, and suppliers can be limited to the plan's network, so ask about your exact supplier and equipment.
Three times your oxygen coverage gets tested around here
Your winter trip. During the first 36 months, your supplier must cover or arrange your equipment only for the rest of the rental month you leave in. After that, it's only "encouraged" to help. From months 37 to 60, it has to provide or arrange it wherever you go, as CMS's policy spells out. If you're in the first three years and heading to Arizona, call your supplier well before you leave.
A flight. Airline-furnished oxygen isn't covered, and neither is oxygen outside the United States and its territories.
Open enrollment. Switching from Advantage to Original Medicare by December 7? The medical directors' letter says you don't need a new study, but the record must show your most recent qualifying result, and your supplier needs a valid order. Ask for that paperwork now. CMS's policy also says that when someone returns to fee-for-service after a Medicare HMO, rental payment "resumes where it left off."
A hospital bed, walker or home aide raises different rules, which I cover in does Medicare pay for in-home care. For the plans themselves, see 2027 Medicare Advantage plans in Grand Junction. I've spent more than 22 years helping people with Medicare, and on oxygen, the paperwork usually decides things more than the plan name does.
How we know all this: the Medicare On Main Data Desk frames every article with public data. Here that means CMS's national and local oxygen coverage rules and policy article, the June 2026 letter from the Medicare equipment contractors' medical directors, Medicare.gov's oxygen page, CMS's 2024 equipment and enrollment data, the 2027 plan benefit file and CDC PLACES, all read October 30, 2026. Carrier names are factual reporting, not endorsement. This is education, not medical advice or insurance advice. Talk to your doctor about your oxygen needs, and compare plans with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.
Frequently asked questions
What oxygen level do you need for Medicare to pay for oxygen?
Most people qualify in Group I: a saturation of 88% or lower, or an arterial PO2 of 55 mm Hg or lower, at rest, during sleep or during exercise. A reading of 89% (PO2 56 to 59) can also qualify with certain heart or blood findings. Since 2021, Medicare has also allowed coverage above those levels for conditions that research shows oxygen improves, such as cluster headaches.
Does living at high altitude change the Medicare oxygen requirements?
There's no separate altitude number in Medicare's current national or local coverage rules. CMS tells its contractors to take "the altitude level" into account when reviewing results, and the coverage policy says the medical record must document any concerns about how altitude affected the measurement. So if you live in Grand Junction, Cortez or Monticello and your reading is borderline, ask your doctor to note your elevation in the chart.
How long will Medicare pay for home oxygen?
As long as you need it, in five-year cycles. Medicare makes 36 monthly rental payments, and you pay 20% of each after the Part B deductible. From month 37 through month 60 the supplier must keep providing the equipment and service, with no further equipment rental. At five years you can get new equipment, and a new 36-month rental period starts.
Does Medicare cover a portable oxygen concentrator?
It can, if you're mobile in your home and your qualifying test was done while awake at rest or during exercise. If you only qualified on a sleep test, Medicare denies portable oxygen as not reasonable and necessary. The rental covers the type of equipment your doctor orders and your supplier provides, so ask about a concentrator before you sign with a supplier.
Will Medicare pay for oxygen on an airplane?
No. CMS's oxygen policy says oxygen furnished by an airline isn't covered and is your responsibility, not your supplier's. Medicare also doesn't cover oxygen used outside the United States and its territories. Check with the airline about its rules for a portable concentrator before you book.
Do I need a new oxygen test if I leave a Medicare Advantage plan?
Not necessarily. The medical directors' June 2026 letter says a person moving to fee-for-service Medicare doesn't need a new blood gas study, but the record has to show the most recent qualifying study and the supplier needs a valid order. Ask your doctor's office to find that result before your coverage changes on January 1.
Sources
- CMS — National Coverage Determination 240.2, Home Use of Oxygen
- CMS — Local Coverage Determination L33797, Oxygen and Oxygen Equipment
- CMS — Policy Article A52514, Oxygen and Oxygen Equipment
- Noridian and CGS medical directors — Home Oxygen Initial Qualification Testing (revised June 2026)
- CMS — Medicare Provider Compliance Tips: Oxygen and Oxygen Equipment
- Medicare.gov — Oxygen equipment and accessories
- CMS — Medicare Durable Medical Equipment, Devices and Supplies by Geography and Service (2024)
- CMS — Medicare Monthly Enrollment (2024 annual)
- CDC PLACES — County data, COPD among adults (2023)
- CMS — 2027 Plan Benefit Package benefits file (ZIP)
- Topographic listing — Grand Junction, Colorado elevation
