Medical baseline electricity programs, who qualifies and how advocates help

A note from Amanda Ledwich (healthcare adovcate)

Medical Baseline Electricity Programs are offered to people dependent on life-saving medical devices, such as oxygen and ventilators, as well as people with life-threatening illnesses, certain neurological or musculoskeletal diseases, or those who are severely immunocompromised. These programs offer certain discounts and often require an application process that includes medical certification. Advocacy helps with this by determining whether a person’s health condition qualifies and, if so, assisting with completing application(s), making sure the utility company participates in the programs available, and obtaining medical certification in coordination with a person’s health care provider. Advocacy can support the process from start to finish to ensure the proper steps are put into place and nothing is missed.

Introduction

If you or a loved one depends on electricity to manage a health condition, the stakes are high. Power is not just a convenience when you use a ventilator, oxygen concentrator, CPAP, a feeding pump, or a powered mobility device. Even a short outage or an unexpected shutoff can quickly become a health emergency.

Medical baseline electricity programs exist to help. Depending on where you live, these programs can lower the cost of the electricity you need for medically necessary equipment or special heating and cooling needs. Some programs also add practical protections, such as account notes that help utilities recognize medically vulnerable households during communication and planning.

An advocate can help you find the right program, gather the right paperwork, and follow through until the benefit is active. Just as importantly, an advocate can help you build a practical backup plan for outages so you are not figuring it out in a crisis.

Introduction

Many households rely on electricity for life-sustaining or health-supporting medical devices at home. National survey data shows that power outages are common. In a U.S. Census Bureau summary of the 2023 American Housing Survey, about 33.9 million households reported being completely without power at least once in the prior 12 months, and about 23.6 million reported at least one outage that lasted 6 hours or more. The same summary reports that around 14.5 million households had medical devices that require electricity to operate, and that nearly a third of those households were affected by power outages.

If you are managing a chronic condition, recovering from an illness, or caring for someone who uses powered medical equipment, it can help to think of “electricity planning” as part of your care plan. Medical baseline programs are one tool that can make that planning more affordable and more reliable.

What a medical baseline electricity program is

A medical baseline electricity program is a utility assistance option designed for households with medically necessary energy needs. The exact name varies. You may hear terms like:

• Medical baseline
• Medical baseline allowance
• Life-support equipment program
• Critical care customer status
• Medical certificate or medical necessity protection

What these programs can provide

Depending on the rules where you live, a medical baseline-type program may provide one or more of the following:

• An additional amount of electricity billed at a lower residential rate, to help offset the cost of running qualifying medical equipment
• Extra allowances that reflect higher, medically necessary energy use for special heating or cooling
• Account notes or flags that help the utility identify medically vulnerable households for communications and planning
• Disconnection protections or extra steps before shutoff when a household has documented medical need (varies widely by state and utility)

A common example: California’s Medical Baseline Program

California’s Medical Baseline Program is an assistance program for residential customers with special energy needs due to qualifying medical conditions. It is based on medical need (not income) and provides additional electricity and or natural gas billed at the utility’s lowest residential rate.

If you do not live in California, the same concept may exist under a different name. The most helpful starting point is to ask your utility and your state utility regulator what programs exist for households that depend on electricity for medical equipment or medically necessary temperature control.

Why these programs matter for health and safety

When you depend on powered medical equipment, a power disruption can affect:

• Breathing support devices (for example, home ventilators or some oxygen delivery equipment)
• Sleep apnea treatment devices such as CPAP or BiPAP
• Home dialysis systems
• Feeding pumps, infusion pumps, suction machines, or nebulizers
• Temperature control needs that help prevent symptom flares or complications

Power outages are also not rare. For people who rely on electricity-dependent medical devices, that reality makes both affordability and preparedness important.

Peer-reviewed research also shows that some common home medical devices can add meaningful electricity costs over time. One open-access analysis in Scientific Reports estimated that average annual electricity operating costs for several common, high-frequency devices (including oxygen concentrators, CPAP machines, and peritoneal home dialysis machines) can be in the hundreds of dollars per year, and that some devices can cost more than $700 per year to operate. If you are already stretched financially, these extra costs can increase the risk of bill hardship and shutoff, which adds another layer of health risk.

Who may qualify

Eligibility depends on your location and utility. However, most medical baseline electricity programs share a similar core idea: a full-time resident in the home has a medical condition or uses medical equipment that requires extra electricity for health and safety.

Qualifying medical devices and equipment

Programs often prioritize devices that sustain life, support breathing, or are relied on for mobility. Examples that are commonly included across programs include:

• Oxygen concentrator or other home oxygen equipment that depends on electricity
• Ventilator or other breathing support equipment used at home
• CPAP or BiPAP device for sleep apnea
• Nebulizer
• Suction machine
• Infusion pump or feeding pump
• Home dialysis equipment
• Motorized wheelchair or mobility scooter that requires regular charging

Not every program uses the same list, and new devices appear all the time. If your device is not explicitly listed, you can still ask the utility whether it can qualify based on medical necessity.

Qualifying medical conditions and special heating or cooling needs

Some programs include certain diagnoses and functional conditions, especially when a person needs additional heating or cooling to stay medically stable. Examples that may qualify in some programs include:

• A life-threatening illness or a compromised immune system where special heating or cooling is medically necessary
• Multiple sclerosis with special heating or cooling needs
• Scleroderma with special heating needs
• Paraplegia, hemiplegia, or quadriplegia
• Severe asthma or sleep apnea when powered equipment is part of treatment

If your main need is temperature control, your clinician may need to document why heating or cooling is medically necessary for you.

Common non-medical rules that still affect eligibility

Even when eligibility is based on health needs, utilities often apply practical account rules, such as:

• The person with the medical need lives in the home full-time
• The account is residential (not a business account)
• The account holder provides the correct name and address for the service location
• You renew or recertify on a schedule, especially if the condition is not permanent

How to apply

Application steps vary by utility, but this general approach works in many places.

Step 1: Identify the right program name in your area

Start by asking your electric utility customer service team:

• Do you offer a medical baseline or medical baseline allowance program?
• Do you have a life-support equipment program or a “critical care” customer designation?
• Do you offer disconnection protection for medical necessity?

If you are not sure who regulates your utility, your state public utility commission (or similar consumer office) can usually point you to the right program category to ask about.

Step 2: Gather the information you will likely need

Before you start an application, it helps to collect:

• Your utility account number and the exact service address
• The name of the medical device(s) you use and how often you use them
• Your prescribing clinician’s name and office contact information
• Any supporting documentation you already have (for example, a durable medical equipment order or care plan notes)

Step 3: Plan for medical certification

Many programs require a clinician to certify medical need. Depending on the program, certification may come from a physician or other licensed clinician. The form may ask whether the condition is permanent and which equipment is used.

If your clinician is busy, it helps to make the process easy:

• Bring or send the exact form the utility requires
• Highlight which sections need a signature
• Provide a short summary of your device use and why uninterrupted power matters for safety

Step 4: Submit and confirm receipt

When you submit, ask for:

• Confirmation the application was received
• An estimate of processing time
• When the rate allowance or account flag will begin
• Whether you need to reapply or renew later

Keep copies of everything you submit. If you can, write down the date, the name of the person you spoke with, and any reference numbers.

Step 5: Check your next bills

Once approved, verify that:

• The medical baseline allowance or program indicator appears on the account
• Your rate or baseline allotment reflects what you were told to expect
• Any special communication preferences (for example, accessible notices) are in place

If something does not look right, follow up promptly. Billing systems can take time to update, and errors are easier to correct early.

How advocates help

Applying for a medical baseline electricity program can be straightforward, but it often becomes stressful when you are already managing health care, caregiving, and paperwork. An advocate can make the process more manageable by turning it into clear steps and follow-through.

What an advocate can do with you

An advocate can help you:

• Identify which medical baseline or life-support utility options exist in your area
• Make a checklist of required documents and deadlines
• Coordinate with your clinician’s office for certification
• Submit forms correctly and track confirmations
• Follow up with the utility if processing stalls or paperwork is missing
• Review bills to confirm the benefit is active and correctly applied
• Screen for additional supports that can lower energy bills, such as income-based energy assistance or home weatherization, if you want them

Advocacy that supports safety, not just savings

A medical baseline program can reduce cost, but it does not guarantee uninterrupted power. A strong plan also includes preparedness.

An advocate can help you build a practical “power plan,” including:

• A written list of the devices you use, model numbers, and backup options
• A plan for charging batteries and keeping backup power available
• A checklist for what to do during an outage, including when to call emergency services
• A plan for where you can go if power is out for an extended period

Practical safety steps if you rely on electricity for medical care

The right steps depend on your condition and equipment. The guidance below is meant to help you prepare, but it does not replace instructions from your clinician or equipment supplier.

Before a power outage

If you use electricity-dependent medical devices:

• Talk with your clinician about what to do if your device stops working. Ask what symptoms should trigger an emergency call.
• Keep backup supplies when appropriate. For example, home oxygen guidance emphasizes having a backup oxygen source in case an oxygen concentrator cannot run.
• Keep your device instructions and emergency contacts in one place. The FDA recommends keeping key device details available so you can act quickly in an emergency.
• If your device has a battery option, keep batteries charged and check them routinely.
• Consider whether you should notify your utility and local emergency responders that you depend on powered medical equipment. Some guidance for home oxygen includes notifying your electric company and local fire department that oxygen is present in the home.
• Make sure caregivers and family members know where equipment and backups are stored.

During a power outage

If your device stops and you cannot safely go without it:

• Use your backup option right away, if you have one.
• Call emergency services if you are in danger, cannot maintain breathing support, or are unsure what to do.
• If you use a generator, follow safety guidance carefully. Generators can cause carbon monoxide poisoning if used improperly.

After power returns

• Restart devices according to manufacturer and clinician guidance.
• Replace or recharge backup supplies so you are ready for the next outage.
• If an outage affected your health, contact your care team promptly to discuss next steps.

If you are denied or still at risk of shutoff

If your application is denied, you still have options. Steps that often help include:

1. Ask for the specific reason in writing (for example, missing documentation or a form filled out incorrectly).
2. Resubmit with corrected or clearer medical certification.
3. Ask whether there is a separate program for disconnection protection, even if the rate allowance is not available.
4. Contact your state utility consumer assistance office if you cannot get a clear answer or you believe the program rules are not being applied correctly.
5. If cost is the main issue, ask about additional supports such as payment plans, crisis assistance, or weatherization programs.

Related Understood Care resources you can use today

Learn more:

• Utility Assistance https://understoodcare.com/uc-care-types/utility-assistance
• Application Help https://understoodcare.com/care-types/application-help
• Analyze Bills https://understoodcare.com/care-types/analyze-bills
• DME Access https://understoodcare.com/uc-articles/dme-access
• Care Coordination https://understoodcare.com/care-types/care-coordination
• How to prioritize bills when you cannot pay everything https://understoodcare.com/uc-articles/how-to-prioritize-bills-when-you-cannot-pay-everything

This content is for education only and does not replace professional medical advice. If you think you are having a medical emergency, call emergency services.

FAQ

• What is a medical baseline electricity program?
  A medical baseline electricity program is a utility option that can lower the cost of electricity or provide protections when you need power for medical equipment or medically necessary heating and cooling.
• Is “medical baseline allowance” the same as a life support utility program?
  In many areas, yes. The names vary. Some utilities offer a rate allowance (medical baseline) while others focus on a life-support or critical care customer designation.
• Who qualifies for a medical baseline electricity discount?
  Eligibility varies, but it commonly includes households where someone uses electricity-dependent medical equipment such as an oxygen concentrator, ventilator, CPAP, dialysis machine, feeding pump, or powered wheelchair.
• Can sleep apnea qualify for a medical baseline allowance?
  Some programs include CPAP or related equipment as qualifying devices. Your utility may require a clinician to certify medical necessity.
• Do medical baseline programs prevent utility shutoffs?
  Not always. Some programs focus on lowering rates, while others provide shutoff protections or extra notifications. Ask your utility what protections apply in your area.
• What paperwork is needed for a medical baseline electricity program application?
  Many programs require a medical certification form signed by a licensed clinician, along with your utility account information and service address.
• How can a patient advocate help with a medical baseline program?
  An advocate can help you identify the right program, coordinate medical certification, submit paperwork correctly, follow up on delays, and confirm the benefit is applied to your bill.
• What should I do if I rely on a ventilator or oxygen concentrator during a power outage?
  You should follow your clinician’s emergency plan, use backup power or backup oxygen supplies if available, and call emergency services if you cannot safely continue treatment.

References

• https://www.cpuc.ca.gov/consumer-support/financial-assistance-savings-and-discounts/medical-baseline
• https://www.cpuc.ca.gov/-/media/cpuc-website/about-cpuc/documents/transparency-and-reporting/fact_sheets/medical_baseline_101921.pdf
• https://www.census.gov/library/stories/2024/10/power-outages.html
• https://empowerprogram.hhs.gov/
• https://empowerprogram.hhs.gov/About
• https://www.fda.gov/medical-devices/emergency-situations-medical-devices/fda-offers-tips-about-medical-devices-and-natural-disasters
• https://medlineplus.gov/ency/patientinstructions/000048.htm
• https://www.nhlbi.nih.gov/health/ventilator/going-home
• https://www.cdc.gov/carbon-monoxide/prevention/index.html
• https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0268178
• https://www.nature.com/articles/s41598-024-82464-x
• https://www.usa.gov/help-with-energy-bills
• https://www.energy.gov/scep/wap/weatherization-assistance-program
• https://understoodcare.com/uc-care-types/utility-assistance
• https://understoodcare.com/care-types/application-help
• https://understoodcare.com/care-types/analyze-bills
• https://understoodcare.com/uc-articles/dme-access
• https://understoodcare.com/care-types/care-coordination
• https://understoodcare.com/uc-articles/how-to-prioritize-bills-when-you-cannot-pay-everything

This information is for general education and does not replace medical advice from your own clinicians or care team. If you are considering PACE or have questions about PACE program food benefits, talk directly with your local PACE organization or a trusted advocate.