While the Air Carrier Access Act obliges air carriers in the US to accommodate passengers with disabilities, there is no regulation requiring airlines to provide medical oxygen during flights. Oxygen is considered to be a hazardous material, and airlines will not allow passengers to carry it onto an airplane. While airlines may, if they wish, provide supplemental medical oxygen, most do not, and the few who do assess per-flight segment setup charges for oxygen service.
US airlines may, however, allow passengers to bring portable oxygen concentrators (POCs) onto airplanes, as explained in the Code of Federal Regulations, specifically in 14 CFR 11, 14 CFR 121, 14 CFR 125, 14 CFR 135, 14 CFR 1 and 14 CFR 382. These documents spell out the requirements for POCs and explain what air carriers may and may not require from passengers who need supplemental medical oxygen during all or part of their flights.
If you are taking an international flight, you may need to comply with two sets of regulations – for example, US and Canadian rules – and you should contact your airline to be sure you understand all the procedures you must follow.
Approved Portable Oxygen Concentrators
In June 2016, the 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.
Older POC models that have already been approved by the FAA may still be used, even though they do not bear a label. 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.
As of May 23, 2016, the FAA had approved the following portable oxygen concentrators for in-flight use in accordance with SFAR 106:
AirSep FreeStyle 5
DeVilbiss Healthcare iGo
Inogen One G2
Inogen One G3
Inova Labs LifeChoice
Inova Labs LifeChoice Activox
International Biophysics LifeChoice
Oxlife Independence Oxygen Concentrator
Precision Medical EasyPulse
SeQual eQuinox Oxygen System (model 4000)
SeQual Oxywell Oxygen System (model 4000)
VBox Trooper Oxygen Concentrator
Taking Your Portable Oxygen Concentrator On Board
While FAA regulations do not require that you tell your air carrier about your POC in advance, nearly all airlines ask you to notify them at least 48 hours before your flight that you intend to bring a POC onboard. Some air carriers, such as Southwest and JetBlue, also ask you to check in for your flight at least one hour before takeoff.
The FAA no longer requires passengers traveling with POCs to furnish a physician's statement to airlines, but some air carriers, such as Alaska Airlines and United, still require you to provide one. Others, such as American Airlines, require you to demonstrate that you can respond to your POC's alarms before you can board your flight. Delta requires you to fax or email a battery approval request form to their oxygen provider, OxygenToGo, at least 48 hours before your flight.
Check with your airline to find out whether you'll need to use a special form. Most air carriers require the statement to be written on your doctor's letterhead. Some expect you to use their form. If you are flying on a code share flight, be sure you know the procedures for both your ticketing airline and the carrier actually operating your flight.
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, such as Southwest, 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 US 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.
You will need to contact your airline to find out what your flight time will be.
Extra batteries must be carefully packed in your carry-on luggage. You must ensure that the terminals on the batteries are taped or otherwise protected from coming in contact with other items in your bag. (Some batteries have recessed terminals, which do not need to be taped.) You will not be allowed to bring your batteries with you if they are not packed properly.
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
The secret to successful travel with a portable oxygen concentrator is advance planning. Notify your air carrier that you intend to bring a POC with you as soon as you book your flight. Make sure you understand how soon before your flight your physician should write the required statement (United has particularly restrictive rules) and whether it has to be on letterhead or an airline-specific form. Check the length of your flight and be generous with your estimate of possible delays, particularly in winter and during peak travel times, so you will bring enough batteries.
By planning ahead and preparing for delays, you'll be able to relax both during your flight and at your destination.