You can bring all your medication and medical devices through TSA and onto any US flight—keep prescription and over-the-counter meds in your carry-on, and know that they do not count against your carry-on bag limit or the liquids rule. Pills, liquids, injectables, inhalers, CPAP machines, insulin pumps, and mobility devices are all allowed. You don't need a doctor's note for TSA, but declaring liquid medications over 3.4 ounces at the checkpoint and carrying documentation for devices makes everything smoother. Below is exactly how to pack, what to tell TSA, and your rights if a device gets damaged or delayed.
Pack medication in your carry-on—never in checked bags
The single most important rule: keep every medication and essential device with you in the cabin. Checked bags get lost, delayed, and exposed to extreme temperatures in the cargo hold. If your bag is delayed and your heart medication or insulin is inside, you're stuck.
TSA allows both prescription and over-the-counter medications through security in reasonable quantities. Solid meds (pills, tablets) have no quantity limit. You can leave them in original prescription bottles or use a daily pill organizer—TSA does not require original packaging, though some states technically require prescription labeling for controlled substances, so keeping the original bottle for those is the safe move.
A few packing habits that save headaches:
- Pack at least a few extra days' worth of medication beyond your trip length, in case of a cancellation or long delay.
- Split critical medication between two bags you carry (a purse and a backpack, for example) so a stolen or misplaced item doesn't wipe out your entire supply.
- Keep a written list of your medications, dosages, and your pharmacy's phone number so a doctor can call in an emergency refill if needed.
- If you're on a tight itinerary with a separate-ticket connection, factor in the higher risk of misconnecting and pack meds accordingly.
Liquid medications and the 3-1-1 rule
The TSA 3-1-1 liquids rule—3.4 ounces per container, one quart-size bag—does not apply to medically necessary liquids. That includes liquid prescription medications, insulin, saline solution, IV bags, liquid nutrition, and gel packs to keep medication cold. You can bring these in quantities larger than 3.4 ounces.
The catch: you must declare them to the TSA officer at the start of screening and remove them from your carry-on bag for separate inspection. Tell the officer, "I have medically necessary liquids to declare." They may test the liquids or ask you to open the container. If you'd rather not have your medication opened or X-rayed, you can request alternative screening, which usually means additional swabbing of your hands and the container.
Ice packs, freezer packs, and gel packs used to keep medication cool are allowed even if they've partially melted or softened. Frozen liquids get the same medical exception.
You are not required to travel with a prescription or a doctor's letter for TSA purposes. But a note or the original pharmacy label can resolve questions quickly, especially for injectable medications, controlled substances, or unusual quantities.
Medical devices: CPAP, insulin pumps, oxygen, and more
Medical devices go through screening too, and most airlines let you bring them in addition to your standard carry-on allowance at no charge—they don't count toward your bag limit.
CPAP and BiPAP machines
Remove your CPAP from its case and place it in a bin for X-ray, like a laptop. You can leave the mask and tubing in the case. If you don't want the machine X-rayed, ask for a visual inspection. CPAPs do not count as a carry-on item on any major US airline. If you want to use it in flight, you'll need an FAA-approved battery (airplane power outlets can't be relied on) and should notify the airline in advance.
Insulin pumps and continuous glucose monitors (CGMs)
You can keep an insulin pump or CGM attached during screening. Tell the officer you're wearing one. Manufacturers of some CGMs (like Dexcom) advise against putting the sensor through the X-ray or full-body scanner—request a pat-down or hand inspection instead if your device's guidance says so. Bring the manufacturer's documentation if you're unsure.
Portable oxygen concentrators (POCs)
Airlines allow FAA-approved POCs in the cabin, but you generally must notify the airline at least 48 hours ahead and bring enough batteries to cover 150% of your expected travel time, including delays. Personal oxygen tanks (compressed or liquid) are not permitted on aircraft.
Mobility devices, wheelchairs, and prosthetics
Under the Air Carrier Access Act (14 CFR Part 382), airlines must let you check wheelchairs and mobility aids for free, and battery-powered wheelchairs are transported as a priority. Prosthetics and orthopedic devices go through screening with you and can be inspected without removal.
Your rights under the Air Carrier Access Act
The Air Carrier Access Act (ACAA) prohibits US airlines from discriminating against passengers with disabilities. This is separate from the general DOT refund rules, and it gives you concrete protections:
- Airlines must allow devices like ventilators, respirators, CPAPs, and POCs (that meet FAA standards) in the cabin.
- Assistive devices and medical equipment don't count toward your carry-on limit.
- Airlines must provide priority storage space in the cabin for one passenger's foldable wheelchair, first-come, first-served.
- Every airline must have a Complaints Resolution Official (CRO) available at the airport or by phone to resolve disability-related issues on the spot. If you hit a wall with a gate agent, ask to speak to the CRO.
The DOT strengthened these rules in 2024 with new requirements around prompt wheelchair assistance and mandatory training for staff who handle mobility equipment. If an airline damages your wheelchair, it must repair or replace it and cannot cap liability at the ordinary baggage limit.
When a device is damaged or your bag is delayed
For ordinary checked baggage, the DOT liability limit is $3,800 for domestic flights. But wheelchairs and other assistive devices are a special case—airlines must cover the full replacement or repair cost of a damaged mobility device, not just the $3,800 cap. If your power wheelchair is broken in transit, the airline is obligated to fix it or replace it with a comparable device, and to provide a temporary loaner meanwhile.
If your checked bag containing non-essential medical supplies is delayed, airlines are required to reimburse reasonable, verifiable expenses for replacing necessities. File the claim at the airport before you leave, keep receipts, and follow up in writing. This is one more reason your essential meds should never be in a checked bag in the first place.
Note that on codeshare flights, the airline that operates the aircraft is generally responsible for handling your equipment and any damage claim—not necessarily the airline whose name is on your ticket. Confirm who's operating each segment when you book.
Before you fly: a quick checklist
- Refill early. Get a supply that covers your trip plus several buffer days.
- Notify the airline 48+ hours ahead if you'll use a POC, CPAP, or need battery-powered equipment in flight.
- Carry documentation for injectables, controlled substances, and devices with manufacturer screening guidance.
- Confirm your ID is in order. The REAL ID requirement is in effect for domestic flights—see our REAL ID guide to make sure yours works.
- Arrive early. Declaring liquids and requesting alternate screening for devices takes extra time.
- Keep meds in your carry-on and split critical doses between two bags you keep with you.
If you have a long connection where you'll need refrigeration or a quiet place to manage a medical routine, our guide on surviving a long layover covers lounges and rest options that make it easier.
Frequently Asked Questions
Do I need a doctor's note to bring medication through TSA?
No. TSA does not require a prescription or doctor's letter for any medication. However, a note or the original pharmacy label helps resolve questions faster for injectable drugs, controlled substances, or large quantities of liquid medication. Some states and destination countries have their own rules for controlled substances, so keep those in labeled bottles.
Does my CPAP or insulin pump count as a carry-on bag?
No. Medical devices and assistive equipment do not count toward your carry-on allowance on any US airline, under the Air Carrier Access Act. You can bring your CPAP, POC, or supplies in addition to your normal personal item and carry-on bag at no extra charge.
What happens if the airline damages my wheelchair?
The airline must repair or replace it at full cost—the $3,800 domestic baggage liability cap does not apply to mobility devices. It must also provide a comparable temporary wheelchair while yours is fixed or replaced. File a claim immediately and ask for the airline's Complaints Resolution Official if you're not getting help at the airport.
Can I keep medication cold with ice packs on a plane?
Yes. Gel packs, ice packs, and freezer packs used to keep medication cool are exempt from the 3.4-ounce liquids rule and are allowed even if partially melted. Declare them to the TSA officer at the checkpoint along with any liquid medication over 3.4 ounces.