Medicare does not cover the cost of a blood pressure monitor for use at home. Coverage is available when blood pressure checks are carried out by a healthcare professional.
Medicare covers blood pressure checks when healthcare professionals perform them, but there is no cover for monitors used at home
This article looks at the cover options for blood pressure monitoring and any available help with healthcare costs.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare does not cover blood pressure monitors for home use.
If a person has Medicare Part A, coverage is available for blood pressure monitoring during an eligible hospital stay as part of a care plan.
Medicare Part B will cover routine blood pressure checks performed by a Medicare-approved physician. A blood pressure check is considered preventive care by Medicare when performed during a doctor visit.
If a person has a Medicare Advantage (Part C) plan, it may be necessary to contact the private insurance company administering the policy to see if there is a benefit for home blood pressure monitoring.
Medicare Advantage plans are required to cover the same amount of health care services and supplies as original Medicare, and many policies cover additional services and supplies.
Hypertension happens when there is consistently a high amount of pressure pushing against the walls of the arteries. Nearly one-half of U.S. adults have high blood pressure, and many people do not know they have it.
- Planning: A person should not eat, smoke, exercise, or consume any caffeinated drinks 30 minutes before using a blood pressure monitor.
- Urinate: The bladder should be empty.
- Comfort: An individual should sit in a supportive chair with a straight back and rest for five minutes before using the monitor. A dining chair may work well.
- Legs and feet: A person’s legs should remain uncrossed, and their feet should rest flat on the floor.
- Arm: Supporting the arm on a flat surface is recommended. A dining table could work well. The arm that has the cuff should rest on the table at chest-level.
- Cuff placement: An individual should place the cuff on an extended arm, and ensure the bottom of the cuff is placed just above where the elbow bends. Once the cuff is in place, keeping still will help to get more accurate results.
- Frequency: A person should measure their blood pressure twice a day, at the same time each day, taking two or three readings, one minute apart, during a session.
Blood pressure measurements should not be taken over clothing, as this may affect accuracy. An individual can roll up their shirt sleeves if needed.
People should record their results in a notebook or online tracker. Some blood pressure monitors have a memory function to store readings.
A person may wish to take their results with them to their next visit to the doctor’s office. These appointments are usually covered by Medicare Part B, as either outpatient medical or preventive services.
What if my reading is high?
If a blood pressure reading is suddenly high (exceeding 180/120 mm Hg), a person should wait five minutes and try the test again.
If the result is still high, it may be necessary to contact the doctor immediately. Remaining calm is helpful in this situation as added stress may have a further negative impact.
Also, if a person’s blood pressure is higher than 180/120 mm Hg, occasionally they may experience one or more of these symptoms:
- chest pain
- shortness of breath
- back pain
- change in vision
- difficulty speaking
In these instances, a friend or family member should call 911 immediately.
Medicare Part B usually covers ground ambulance costs. Out-of-pocket costs include the Part B deductible and a 20% coinsurance.
According to advice from the American Heart Association, an automatic, cuff-style, upper-arm monitor is best.
Monitors placed on the wrist or finger may give less accurate readings, so they are not recommended.
Blood pressure monitors should be validated. This means that the device has been tested and meets the regulated standards of the Association for the Advancement of Medical Instruments (AAMI), the British Hypertension Society (BHS), and the European Society of Hypertension (ESH).
If a person is unsure if the blood pressure monitor they are considering is validated, they should ask their doctor or pharmacist for advice.
The validating of a blood pressure monitor can also be specific to certain age ranges or pregnancy. Checking for particular validation may be useful.
Before purchasing a blood pressure monitor, take a flexible tape measure, and measure around the upper arm. Writing down the measurement should ensure a monitor has the correct size cuff for an individual’s needs.
A person may like to bring their blood pressure monitor with them to their next doctor’s appointment.
The doctor will be able to ensure that the person is using the monitor correctly, and getting similar results to the in-office device. Bringing the monitor to the doctor’s office at least once a year should ensure that the readings remain accurate.
Medicare does not cover the purchase of blood pressure monitors for at-home use.
When using an at-home monitor, a person should measure their blood pressure twice daily, at the same time each day, if possible.
They should take two or three readings, one minute apart, and keep track of the readings to take to the doctor’s office if they are concerned.
A single high reading is not necessarily a cause for alarm, and checking again after a few minutes may be helpful.
An automatic, cuff-style, upper-arm monitor is best, according to the American Heart Association.
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