Does insurance cover hyperbaric oxygen therapy?
Whether insurance pays for hyperbaric oxygen therapy comes down to one question: is it being used to treat a recognized medical condition, under a physician?
Medical HBOT: often covered, with conditions
Medicare and many private insurers cover HBOT for a defined list of conditions, which closely follows the recognized medical uses. Examples include:
- Decompression sickness and gas embolism
- Acute carbon monoxide poisoning
- Certain diabetic foot ulcers (Medicare covers deeper wounds that haven't improved after at least 30 days of standard wound care)
- Delayed radiation injury
- Chronic bone infection that hasn't responded to other treatment
- Compromised skin grafts and flaps
Coverage usually requires:
- A physician's order and documentation that you meet the criteria
- Treatment in an approved facility, typically a hospital or wound-care center
- Prior authorization, for many private plans
- Regular progress reviews
Even when HBOT is covered, you may owe deductibles, copays or coinsurance, and a long course can add up.
Wellness HBOT: usually self-pay
Sessions for general wellness or recovery are generally not covered by insurance. That's true at most wellness centers, including ours.
HSA and FSA accounts
Whether you can use a health savings account or flexible spending account depends on whether the session counts as medical care, which often requires a letter of medical necessity from your doctor. Check with your plan administrator before assuming it qualifies. We're happy to provide itemized receipts.
Questions to ask your insurer
- Is HBOT covered for my diagnosis?
- Do I need prior authorization?
- Which facilities near me are in network?
- How many sessions are covered, and what will I pay per session?
- What documentation does my doctor need to send?
Comparing costs
If you're paying yourself, prices vary widely by setting and chamber type. Hospital-based sessions cost much more than wellness sessions, partly because they involve physicians and higher pressures. Always ask what pressure the chamber reaches and what's included in the price. See Mild vs. medical HBOT.