While the Air Carrier Access Act obliges air carriers in the U.S. to accommodate passengers with disabilities, there is no regulation requiring airlines to provide medical oxygen during flights. Liquid oxygen is considered a hazardous material and many airlines will not allow passengers to carry it onto an aircraft. Some airlines provide supplemental medical oxygen, but most do not, and the few that do typically charge a fee for oxygen service.
However, U.S. airlines may allow passengers to bring their own portable oxygen concentrators (POCs) onto airplanes, as explained in the Code of Federal Regulations (14 CFR 11, 14 CFR 121, 14 CFR 125, 14 CFR 135, 14 CFR 1, and 14 CFR 382). These documents explain the requirements for POCs and spell out what air carriers may and may not require from passengers who need supplemental medical oxygen during their flights.
If you are flying internationally, you may need to comply with multiple countries' sets of regulations. Contact your airline as soon as you book your ticket to be sure you understand all the procedures you must follow.
Approved Portable Oxygen Concentrators
In June 2016, the Federal Aviation Administration (FAA) overhauled its portable oxygen concentrator approval process. Rather than requiring POC manufacturers to obtain FAA approval for each model of portable oxygen concentrator, the FAA now requires manufacturers to label new models of POCs that comply with FAA requirements. The label must include the following statement in red text: “The manufacturer of this portable oxygen concentrator has determined this device conforms to all applicable FAA requirements for portable oxygen concentrator carriage and use on board aircraft.” Airline personnel can look for this label to determine whether or not the POC may be used on the aircraft.
If your POC is older and does not have a label, it may still be used if the model is FAA approved. Airlines can use the list published in Special Federal Aviation Regulation (SFAR) 106 to determine whether or not the POC may be used during a flight. These POC models do not need an FAA conformance label.
According to its website, the FAA has approved the following portable oxygen concentrators for in-flight use in accordance with SFAR 106:
- AirSep Focus
- AirSep FreeStyle
- AirSep FreeStyle 5
- AirSep LifeStyle
- Delphi RS-00400
- DeVilbiss Healthcare iGo
- Inogen One
- Inogen One G2
- Inogen One G3
- Inova Labs LifeChoice
- Inova Labs LifeChoice Activox
- International Biophysics LifeChoice
- Invacare Solo2
- Invacare XPO2
- Oxlife Independence Oxygen Concentrator
- Oxus RS-00400
- Precision Medical EasyPulse
- Respironics EverGo
- Respironics SimplyGo
- SeQual Eclipse
- SeQual eQuinox Oxygen System (model 4000)
- SeQual Oxywell Oxygen System (model 4000)
- SeQual SAROS
- VBox Trooper Oxygen Concentrator
Taking Your Portable Oxygen Concentrator On Board
When traveling with a POC, be aware that the FAA and the airline may have different requirements. While FAA regulations do not require that you tell your air carrier about your POC in advance, nearly all airlines ask that you notify them at least 48 hours before your flight. Some air carriers, such as Southwest and JetBlue, also ask you to check in for your flight at least one hour before takeoff.
Check to see if you are flying on a codeshare flight, which is "an agreement between partnering airlines to share the same flight," as you will need to be aware of the procedures for both your ticketing airline and the carrier actually operating your flight.
The FAA no longer requires passengers traveling with POCs to obtain a physician's statement, but some air carriers still require you to provide one, while others require you to demonstrate before boarding that you can respond to your POC's alarms.
No matter who you're flying with, check with your airline to determine the procedure. Some carriers require you to fill out a form while others ask for a written statement with your doctor's letterhead, and most update these rules on their websites, including Alaska Airlines. United Airline, American Airlines, and Delta.
If required, the physician's statement must include the following information:
- A statement about your ability to see, hear, and respond to the warning signals on your POC, which are typically flashing lights and audible alarms. You must be able to understand the warning alarms and respond to them without help.
- A description of your oxygen requirements. Do you need medical oxygen during the entire flight, or only under certain conditions?
- A statement describing the maximum oxygen flow rate you require while the aircraft is in flight.
Passengers using POCs may not sit in exit rows, nor may their POCs block another passenger's access to seats or to the airplane's aisles. Some airlines are more specific, such as Southwest, and require POC users to sit in a window seat.
Powering Your Portable Oxygen Concentrator
Air carriers are not required to let you plug your POC into the airplane's electrical system. You will need to bring enough batteries to power your POC for your entire flight, including gate time, taxi time, takeoff, in-air time, and landing. Almost all U.S. air carriers require you to bring enough batteries to power your POC for 150 percent of "flight time," which includes every minute spent on the aircraft, plus an allowance for gate holds and other delays. Others require you to have enough batteries to power your POC for flight time plus three hours.
Contact your airline beforehand to confirm the duration of your flight.
Extra batteries must be carefully packed in your carry-on luggage. You will not be allowed to bring your batteries with you if they are not packed properly. You must ensure that the terminals, or electrical contacts, on the batteries are taped up or otherwise protected from coming in contact with other items in your bag. If your batteries have recessed terminals, they do not need to be taped.
Your POC and extra batteries are considered medical devices. While they will need to be screened by TSA personnel, they will not count against your carry-on baggage allowance.
Renting Portable Oxygen Concentrators
Several companies rent FAA-approved portable oxygen concentrators. If your POC is not on the FAA-approved list and does not bear an FAA compliance label, you may wish to bring it along for use at your destination and rent a POC to use in-flight.
The Bottom Line
As soon as you book your flight, notify your air carrier that you intend to bring a POC with you and make sure you understand how soon before your flight your physician should write the required statement. Some airlines have particularly restrictive rules, so ask a representative to explain the whole procedure to you in full. Include details such as whether the doctor's note has to be written on letterhead and if there is an airline-specific form, Also confirm your flight length with the airline and factor in potential delays, particularly in winter and during peak travel times.
Planning in advance is essential to traveling with a POC.