A power outage plan for a household that uses medical equipment

The short answer

• Start with each device. Ask the maker or supplier how long it runs without wall power, what happens if it stops, and what backup they recommend.
• Match the backup to the risk: charged batteries, oxygen tanks that need no electricity, a cooler for refrigerated medicine, and a place with power you can reach.
• Tell your utility and sign up for alerts. In California, PG&E's Medical Baseline and Self-Identified Vulnerable programs bring extra warnings before planned shutoffs. Neither program keeps your power on.
• Run generators only outdoors, at least 20 feet from doors, windows and vents, with battery-powered carbon monoxide (CO) alarms inside.
• Decide your "time to go" point in advance, such as when the last battery or oxygen tank starts, not when it runs out.

Write your plan on the blank medical equipment outage worksheet and keep it with the equipment. This page is general information; your clinician, pharmacist and supplier know your settings.

Step 1: List everything that needs power or cold

With the person who uses the equipment and anyone who helps, list each device and each medicine kept in the refrigerator. For each device, the U.S. Food and Drug Administration (FDA) suggests asking the maker, supplier or clinician questions like these:

• How long does the backup battery last, and can the device run on another power source, such as an external battery or a generator?
• Could the person be harmed if it stops for a short time? After how long?
• If power cuts out mid-treatment, do you restart or resume?
• Does it need a surge protector, extra supplies for at least three days, or storage at a set temperature?

Ask how long the battery lasts at the settings the person actually uses. Then, if the maker or supplier says it is safe, run the device on battery for a short, supervised time while the power is on, to learn how to switch over. PG&E suggests labeling equipment with the owner's name, contact information and simple instructions, and teaching helpers to run it and its backups.

Step 2: Set up backup power, and use it safely

Batteries and portable power stations. Confirm with the device maker that the battery will run your device. Keep it charged, follow the maker's instructions, keep flames away, never seal it in an enclosed space, and do not run cords under rugs.

Generators. Generator exhaust contains carbon monoxide, a gas you cannot see or smell that can kill in minutes.

• Run a generator only outdoors, at least 20 feet from windows, doors and vents. Never run it inside a home, garage, basement, crawlspace or shed, or on a porch, even with doors and windows open. Do not run it in the rain, and do not store fuel in the house.
• Do not wire a generator into your home yourself. PG&E warns never to connect one to another power source, including its power lines, and to make sure power cannot flow back ("backfeed") into them. For a permanent connection, PG&E suggests a professional installer, says to have any change to your house wiring inspected by your city or county building department, and asks to be told about it. Otherwise, plug equipment into the generator with extension cords of the right size, and do not exceed what the generator can supply.
• Never leave a car running in a garage, even with the door open. If you use a car to charge equipment, run it outside in an open, well-ventilated place.

Carbon monoxide alarms. Put battery-powered or battery-backup CO alarms near sleeping areas and on every floor. Test them monthly, and replace them as the maker directs or every five years.

Oxygen and fire. Oxygen makes things burn faster. Use battery-powered flashlights or lanterns, never candles, gas lanterns or torches, and keep oxygen at least 6 feet from heaters, stoves and open flames.

Step 3: Keep medicines cold, and know when to replace them

Keep a cooler, ice or frozen gel packs, and a refrigerator thermometer ready. During an outage, keep the refrigerator and freezer closed. The Federal Emergency Management Agency (FEMA) says a closed refrigerator keeps food cold for about 4 hours and a full freezer for about 48 hours. If the outage will last longer, or you have to leave, move refrigerated medicine to the cooler and follow each label's storage instructions.

Insulin. FDA says insulin is normally stored in a refrigerator at about 36°F to 46°F. Vials and cartridges from the manufacturer, opened or not, can stay unrefrigerated at 59°F to 86°F for up to 28 days and still work. Some products have different limits, so check yours.

• Keep insulin as cool as you can, but never let it freeze, especially when using ice. Do not use insulin that has frozen. Keep it out of direct sun. Throw away insulin in a pump that got hotter than 98.6°F.
• In an emergency you may still need insulin that got warmer than 86°F, FDA says. Replace it as soon as you can, and watch blood sugar closely, because overheated insulin can work less well.
• Do not switch to a different insulin without a clinician's advice. If you cannot reach one, follow FDA's emergency insulin guidance and get care as soon as you can.
• Heat and humidity can damage glucose meters and test strips. Run the quality-control check in your meter's instructions.

Other refrigerated medicines. FEMA's rule of thumb is to replace refrigerated medicine if the power has been out for a day or more, unless the label says otherwise. FDA says to check the storage instructions or ask a pharmacist, clinician or the manufacturer. If a medicine is needed to stay alive and no replacement is available, FDA says it may be used until you get a new supply.

Supplies. Keep a current list of medicines, doses, conditions, allergies and equipment, with copies of prescriptions; see Maintaining an Accurate Medication List. If you expect trouble reaching a pharmacy, ask for early refills and how to keep an emergency supply. For storing medicines in hot weather, see medicines that can raise your risk in a heat wave.

Step 4: Tell the right people, and get warnings early

Your utility. FDA advises telling your electric company and fire department that someone at home uses a medical device that needs power. Ask your utility what it offers, and keep your contact details current.

In California, PG&E customers have three options. Other utilities may offer similar programs, so ask yours.

• Medical Baseline lowers the price of some of your energy and adds warnings before a Public Safety Power Shutoff (PSPS), a planned shutoff during high wildfire risk. PG&E aims to alert customers 48 hours and 24 hours ahead and again just before the shutoff; Medical Baseline customers may also get repeated calls or texts, or a doorbell ring. Answer or reply so PG&E knows you got the alert. For eligibility and how to apply, see Medical Baseline: lower utility rates if someone at home relies on medical equipment.
• Self-Identified Vulnerable status is for people whose health or safety would be at risk without power but who do not qualify for Medical Baseline. You enroll yourself in your online account, and it lasts a year. It brings outreach during shutoffs, and a doorbell ring or door hanger if you miss alerts.
• Address Alerts send PSPS alerts by phone or text for any address you choose, such as a parent's home.

Two limits matter. During a PSPS, everyone on an affected line loses power, including Medical Baseline customers, and PG&E's application form says it cannot guarantee uninterrupted service. And because forecasts change, the first alert can come the same day as the shutoff, which can last hours or several days.

Local emergency services. Sign up for your county's emergency alerts; in California, each county's sign-up is linked at CalAlerts.org. Ask your county emergency office or fire department whether it keeps a voluntary list of people who rely on power, how it would reach you, and where you could go with your equipment. Local plans vary, and officials may not be ready for specialized needs, so your plan has to work without them.

About emPOWER. The federal HHS emPOWER Program uses Medicare claims to show health departments how many people in an area rely on electricity-dependent equipment; in a disaster, an authorized state or territorial health agency can request limited individual information for outreach. Its individual outreach data cover only people with Medicare (Original Medicare or Medicare Advantage), and it is not a sign-up list, so it does not replace telling your utility and local officials.

Your people. Choose at least one person who will check on you during an outage and can run your equipment. Keep phones charged, with another way to recharge them; FEMA notes that landlines fail if the lines are damaged.

Step 5: Decide where you will go, and when

Write down two places with power and how you will get there.

• Family or friends outside the likely outage area.
• PG&E Community Resource Centers open during the day in counties affected by a PSPS or a longer outage. All offer medical equipment charging, device charging, Wi-Fi, water and an accessible restroom; indoor centers add air conditioning or heat and ice. Medical equipment charging comes first when demand is high, and PG&E's partners can arrange accessible rides.
• 211, a free, around-the-clock service, can connect you with local help, including rides and lodging. Call 211, or text PREPARE to 211-211.

Emergency planners note that home oxygen users often go to hospitals to charge concentrators during outages, so line up somewhere else to charge equipment. But if someone is having trouble breathing, or life-sustaining equipment will run out before you can reach power, go to the emergency department or call 911. Extreme heat or cold during an outage adds risk, so know where you could go to stay cool or warm.

When the power comes back

While the power is out, unplug or switch off appliances and electronics so a surge does not damage them when it returns. Then:

• Check for water before plugging anything in. Do not plug in a wet cord or device.
• Check the device's settings. Some devices return to default settings after losing power.
• Do not use supplies with torn packaging, or that got wet, hotter or colder than their labels allow.
• Check refrigerated medicine against its label, and ask your pharmacist about anything you are unsure of.
• Recharge batteries, ask your supplier to refill oxygen tanks, restock, and fix whatever went wrong in the plan.

California backup power programs, as of October 26, 2026

These programs change often and can close when funds run out, so check each program's page. "Safety-setting outages" are outages caused by PG&E's Enhanced Powerline Safety Settings, used to help prevent wildfires.

Sources

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