Talk to your PH care team early in your planning process about concerns or changes needed for your supplemental oxygen during air travel. Depending on your care facility, your doctor might order a high-altitude simulation test, which mimics the atmospheric pressure of a commercial airplane cabin. The test can determine how much oxygen you need at high altitude. You might need a higher oxygen flow on the plane.

If you don’t use oxygen regularly, ask your PH doctor if you need oxygen while traveling.

Ask for a medical certificate that states why oxygen is medically necessary and the flow rate per minute you need (allowable range = 0.5-6 liters/minute). The certificate must state the oxygen user can physically and cognitively use the oxygen and respond to warnings/alarms. Some airlines require specific forms. Check online whether the airline requires its own form.

When booking your flight, tell the airline that you need supplemental oxygen in flight. Airlines might require you to notify them 48 hours in advance and/or check in at least an hour before your flight so they can accommodate your oxygen needs. If possible, reserve a seat by the window to prevent your tubing or equipment from getting tangled in the aisle.

If traveling by train in the U.S., call Amtrak to reserve your ticket. You can’t make online reservations if you’re bringing oxygen equipment aboard.

Amtrak also requires you to:

• Bring enough power to operate oxygen equipment, including concentrators, for at least four hours (without using electric outlets onboard), in case of a power disruption.
• Ensure your equipment is Underwriter’s Laboratory (UL)- or Factory Mutual (FM)-listed.
• Bring no more than two 50-pound tanks or six 20-pound tanks. The total weight of your tanks can’t exceed 120 pounds.

Taking a cruise? Most cruise lines require you to give them at least four weeks’ notice about your oxygen needs, but will allow you to provide your own oxygen concentrator or portable system. Before you go, arrange portable system refills at ports of call.

Try to arrive at the airport at least three hours before your flight to get through security checkpoints and reach your departure gate well before boarding time.  

Pack enough batteries and back-up batteries to provide power for one and half times the expected flight duration (e.g., three hours of battery life for a two-hour flight), as required by U.S. law. Batteries and back-up batteries must be in your carry-on luggage. The Department of Transportation prohibits lithium batteries in checked baggage.

At the airport, look for an outlet or charging station to plug in your concentrator and spare batteries at the gate so they will be fully charged when you board.

Call TSA Cares (855-787-2227) 72 hours before your flight to ask for a passenger support specialist at the security checkpoint. You will have to remove your concentrator and put it through the x-ray machine, or you can keep it on and wait for an agent to pat you down and inspect your concentrator and other mobility equipment.

Ask your durable medical equipment company about renting a portable oxygen concentrator and carry-on equipment.

Check whether your oxygen provider will deliver oxygen to your destination. If not, ask whether you can use the same portable tank throughout the trip that you would use on the plane. Otherwise, contact an oxygen or DME supplier at your destination to arrange additional oxygen and equipment.

Ask your supplier if you can get a portable concentrator with extra batteries.