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. 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 (American Airlines, United Airlines and Alaska Airlines, as of this writing) assess per-flight segment setup charges for oxygen service.
Airlines may, however, allow passengers to bring portable oxygen concentrators (POCs) onto airplanes, as explained in Federal Aviation Administration (FAA) Advisory Circular Number 120-95 and Special Federal Air Regulation (SFAR) 106. 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, U.S. and Canadian rules – and you should contact your airline to be sure you understand all the procedures you must follow.
Approved Portable Oxygen Concentrators
If you need supplemental medical oxygen and plan to fly, you'll need to make sure your POC is on the FAA's approved list, which is published in SFAR 106. As of January 7, 2009, the FAA has approved the following portable oxygen concentrators for in-flight use:
- AirSep Lifestyle
- AirSep Freestyle
- Delphi RS-00400
- Inogen One
- Invacare XPO2
- Respironics EverGo
- SeQual Eclipse
Portable Oxygen Concentrator Use
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.
In order to bring your POC onto the airplane with you, you'll need to furnish a copy of a physician's statement to your airline. You should 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, like American, AirTran and Delta, expect you to use their form. If you're flying on a code share flight, be sure you know the procedures for both your ticketing airline and the air carrier actually operating your flight.
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.
FAA regulations also describe where passengers using POCs may sit and where they must stow their POC. 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. You must be able to see the alarm lights on your POC when it is stowed. Ideally, you should keep your POC under the seat in front of you.
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 plan ahead and 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 onboard the aircraft, plus an allowance for gate holds and other delays. You will need to contact your airline to find out what your flight time will be, add in a reasonable estimate for delays and transfer times, and multiply that time by 150 percent.
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, you may wish to bring it along for use at your destination and rent a POC to use in-flight. Two companies that rent FAA-approved portable oxygen concentrators in the U.S. are OxygenToGo and Advanced Aeromedical.
The Bottom Line
The secret to successful travel with a portable oxygen concentrator is advance planning. When you begin to research flights, take a look at each airline's POC requirements. 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 on the length of your flight and be generous with your estimate of possible delays, particularly in winter or during peak travel times, so you will bring enough batteries with you.
By planning ahead and preparing for delays, you'll be able to relax both during your flight and at your destination.