If you suffer from abnormal blood pressure, your doctor may suggest that you regularly track your blood pressure with a device called a blood pressure monitor. If you’re on Medicare, you might be wondering if a blood pressure monitor is covered. In this MedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer.... article, we’ll examine when and how Medicare covers in-home blood pressure monitoring equipment.
- Blood pressure monitors are useful devices to have if you are experiencing symptoms of abnormal blood pressure.
- Blood pressure that is either too low or too high can cause various health conditions, so it is good to have a monitor to check your condition.
- Medicare will only cover blood pressure monitors for dialysis patients and people with white coat hypertension.
- Medicare Advantage will cover blood pressure devices under the same conditions as Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage...., but the out-of-pocket cost may differ.
- An average blood pressure monitor will cost between $40 to $100 without Medicare coverage.
- Most pharmacies have a free seated blood pressure monitor, but the accuracy can vary between monitors.
Why Would I Need a Blood Pressure Monitor?
You may need a blood pressure monitor for at-home use if you are regularly experiencing symptoms of abnormally low (hypotension) or high (hypertension) blood pressure. Using a monitor can help you make blood pressure measurements and if it is being affected by your condition and/or lifestyle.
Low Blood Pressure
- Blurred vision
- Inability to focus
High Blood Pressure
Symptoms of high blood pressure are more difficult to detect without a monitor, often only showing subtle early symptoms such as:2Mayoclinic.org, “High blood pressure (hypertension)“, Accessed December 3, 2021
- Shortness of breath
- Heart attacks/heart disease
- Heart failure
- Kidney disease (End-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age....)
- Damaged blood vessels in the eyes
- Metabolic syndrome
- Difficulty with memory or understanding
How Much Does a Blood Pressure Monitor Cost?
Typical blood pressure monitors cost around $40 to $100 without Medicare coverage and can be bought at most local pharmacies. Lower-end blood pressure monitors are typically worn on the fingers or wrist, while higher-end blood pressure cuffs are fitted around your upper arm.8Consumerreport.org, “Blood Pressure Monitor Buying Guide“, Accessed December 3, 2021
Public blood pressure machines are available at most pharmacies at no cost. However, some of these machines can produce inaccurate readings if the cuff is not adjustable and/or if they are not made to the standard of medical-grade monitors.9Mayoclinic.org, “How accurate are the blood pressure machines in grocery stores and drugstores?“, Accessed December 3, 2021
When Does Medicare Cover Blood Pressure Monitors?
Blood pressure monitors for use at home are not generally covered by Medicare. However, there are two exceptions:
- A blood pressure monitor for a patient receiving blood dialysis (hemodialysis or peritoneal dialysis) in the home; and3Medicare.gov, “Dialysis services & supplies“, Accessed December 22, 2021
- An ambulatory blood pressure monitoring (ABPM) device, which takes and stores blood pressure readings in 24-hour cycles, for a patient who, a physician believes, has white coat hypertension (artificially high blood pressure readings when taken in a doctor’s office) based on repeated in-office and out-of-office testing.4CMS.gov, “CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM)“, Accessed December 22, 2021
When approved, Medicare Part B covers the cost of renting the blood pressure monitoring device. The device must be rented through a Medicare-certified medical equipment supplier.5Medicare.gov, “Durable medical equipment (DME) coverage“, Accessed December 3, 2021
Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B)...., also known as Medicare Part C is Medicare's private health plan option. Also known as Medicare Advantage, Medicare Part C plans are a type of Medicare health plan offered by companies that contract with Medicare to provide all..., are required to provide coverage for the same services and supplies as Original Medicare (Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... and Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare... ). While this means that Medicare Advantage plans will cover blood pressure monitors, they will only cover them under the same conditions as Orginal Medicare, as listed above.6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 3, 2021
Medicare Advantage members will also be required to receive these services and supplies from providers within their plan’s network. Your Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments.... with Medicare Advantage can also differ from Original Medicare’s out-of-pocket costs for the same service.6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 3, 2021
While Medicare will pay for a portion of a blood pressure monitor under limited circumstances, in most cases you will have to pay for one out-of-pocket. Thankfully, most blood pressure monitors are within affordable price ranges and are readily available at your local pharmacy.
- 1Mayoclinic.org, “Low blood pressure (hypotension)“, Accessed December 3, 2021
- 2Mayoclinic.org, “High blood pressure (hypertension)“, Accessed December 3, 2021
- 8Consumerreport.org, “Blood Pressure Monitor Buying Guide“, Accessed December 3, 2021
- 9Mayoclinic.org, “How accurate are the blood pressure machines in grocery stores and drugstores?“, Accessed December 3, 2021
- 3Medicare.gov, “Dialysis services & supplies“, Accessed December 22, 2021
- 4CMS.gov, “CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM)“, Accessed December 22, 2021
- 5Medicare.gov, “Durable medical equipment (DME) coverage“, Accessed December 3, 2021
- 6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 3, 2021