Oxygen and Equipment
Oxygen and equipment benefits cover the cost of oxygen tanks, concentrators, and related respiratory equipment for individuals with chronic or temporary breathing difficulties. These devices are considered medically necessary when prescribed by a physician.
How It Works
Health insurance plans usually reimburse a percentage of eligible oxygen-equipment costs, up to annual or lifetime limits, and some plans also cover replacement parts or accessories such as tubing and masks if those items are listed as eligible expenses. A private Canadian health and dental plan may cover oxygen equipment rental and CPAP supplies only when ordered in writing by a physician, and may exclude the cost of the oxygen itself. That coverage can be capped by both an annual per-person maximum and a separate lifetime maximum, and CPAP supplies may carry a waiting period. Public programs can help too: under Ontario's Assistive Devices Program, qualifying residents with a valid health card who meet medical eligibility criteria such as hypoxemia at rest get help paying for home oxygen, equipment, and supplies, with the program covering most of the cost and the resident paying the rest. Under the federal Non-Insured Health Benefits program for First Nations and Inuit, home oxygen may be covered once the client's condition is stabilized, coverage is authorized for the primary residence, and prescriptions are initiated by recognized prescribers of supplemental oxygen therapy. Veterans Affairs Canada's Program of Choice 9 reimburses approved oxygen and respiratory equipment such as oxygen concentrators, compressors, CPAP, APAP, BiPAP machines, and ventilators, after benefits available under a provincial or territorial public health system have been accessed first.
Example:
Suppose an Ontarian with a chronic respiratory condition is prescribed a home oxygen concentrator. They might first qualify under Ontario's Assistive Devices Program, which covers most of the cost of home oxygen therapy, leaving a share for the patient to pay. A private health plan's oxygen-equipment benefit could then help with the remaining rental cost or with CPAP supplies, provided a physician orders them in writing and the claim stays within the plan's annual and lifetime maximums. Any unreimbursed amounts they pay out of pocket may also count toward the federal Medical Expense Tax Credit at tax time.
What to Watch For:
A physician's prescription is typically required, and a private plan may cover the equipment rental and CPAP supplies while excluding the cost of the oxygen itself. Watch the limits, since oxygen-equipment coverage in a private plan can be capped by both an annual per-person maximum and a separate lifetime maximum, and CPAP supplies may carry a waiting period. Public coverage has its own conditions: Ontario's Assistive Devices Program requires a valid health card and medical eligibility such as hypoxemia at rest, while Veterans Affairs Canada's Program of Choice 9 expects you to access provincial or territorial public benefits first. Keep your receipts, because for Canadian income-tax purposes the cost of renting or purchasing oxygen-therapy equipment can qualify as a medical expense for the Medical Expense Tax Credit when prescribed by a medical practitioner.
