Why Medicare doesn't pay for them
Part B covers durable medical equipment (DME) your doctor orders for use at home, such as oxygen equipment, CPAP machines, hospital beds, walkers and wheelchairs. To count, equipment must, among other things, be primarily and customarily used to serve a medical purpose and generally not be useful to someone who isn't sick or injured.
- Air conditioners: CMS's National Coverage Determination 280.1 lists them as environmental control equipment, not primarily medical, and denies them. Air cleaners are treated the same way.
- Generators: a home generator is useful to anyone when the power goes out, so it doesn't meet the DME definition. Medicare doesn't pay for one, or for electric bills.
What Medicare does cover in heat and outages
- Emergency room care and medically necessary ambulance rides (Part B).
- Inpatient hospital stays (Part A), with a $1,736 deductible per benefit period in 2026.
- Medical equipment that runs on power, such as oxygen concentrators, when you qualify. Ask your supplier about backup oxygen tanks for outages.
- Repair or replacement of covered equipment damaged in a disaster, usually, through a Medicare-approved supplier.
Heat stroke is an emergency. Confusion, a very high body temperature, hot skin or fainting in the heat means call 911.
Texas protections if you rely on power
If you live in a part of Texas with retail electric competition, the Public Utility Commission of Texas (PUC) lets you register for one of two designations. If your power comes from a city-owned utility or an electric cooperative, ask it what options it offers.
- Critical care residential customer: a doctor certifies you depend on an electric-powered medical device to sustain life.
- Chronic condition customer: a doctor certifies a serious medical condition that needs electric medical equipment, or heating or cooling, to avoid a major impairment of a life function.
Your doctor fills out the PUC-approved application (available in English and Spanish) and sends it to your electric utility, which tells you by mail whether it's approved. The PUC says registering entitles you to notice of interruptions or suspensions of your service and certain protections against disconnection, but it doesn't guarantee continuous power. Also consider the State of Texas Emergency Assistance Registry (STEAR), at stear.texas.gov or by dialing 2-1-1, so local emergency planners know about your needs.
Get help
A licensed insurance agent with Benefits Life can review what your Medicare coverage pays for emergency and hospital care, at no cost to you, at (512) 265-6565, TTY 711. See extreme heat and Medicare and hurricanes, floods and Medicare.
Related questions
What happens to my Medicare plan after a hurricane?
Plan rules during declared disasters.
Does Texas Medicaid pay Medicare premiums?
Help with Medicare costs in Texas.
Medicare phone numbers in Texas
Official numbers for Medicare and Texas programs.
Sources
- CMS — National Coverage Determination 280.1, Durable Medical Equipment Reference List
- Medicare.gov — Medicare Coverage of Durable Medical Equipment and Other Devices
- Medicare.gov — Emergencies and disasters
- Public Utility Commission of Texas — Application for Chronic Condition or Critical Care Residential Customer Status
- Public Utility Commission of Texas — Chronic medical condition and critical care electricity customers
- 16 Texas Administrative Code §25.497 — PUC rule on critical care and chronic condition residential customers
- Texas Department of Housing and Community Affairs — Help for Texans (utility bill payment help)
- Texas Division of Emergency Management — STEAR
Frequently asked questions
Will a doctor's prescription get Medicare to pay for an air conditioner?
No. CMS's National Coverage Determination 280.1 lists air conditioners, air cleaners and similar items as environmental control equipment that is not primarily medical in nature, and Medicare denies them for everyone.
What is a critical care customer in Texas?
Under Public Utility Commission of Texas rules, a critical care residential customer is someone a doctor certifies depends on an electric-powered medical device to sustain life. A chronic condition customer has a serious condition that needs electric medical equipment, or heating or cooling, to avoid serious harm. Your doctor fills out and sends the PUC application to your electric utility.
Does critical care status keep my power on during an outage or grid emergency?
No. The PUC's application form says the designation doesn't guarantee an uninterrupted power supply and doesn't excuse unpaid bills. It does entitle you to notice of service interruptions and certain protections against disconnection. Have a backup plan for powered medical equipment.
Where can I get help with summer electric bills in Texas?
The Comprehensive Energy Assistance Program (CEAP), run through local agencies for the Texas Department of Housing and Community Affairs, can help households with limited income pay utility bills and, in some cases, repair heating and cooling units. Find your local provider through TDHCA's Help for Texans page.
Medicare in your Texas county
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