Medicare does not usually cover the cost of a blood pressure monitor for use at home. However, it may cover ambulatory blood pressure monitoring or a blood pressure monitor for people who are receiving dialysis.
Medicare may cover blood pressure monitoring in a doctor’s office.
In some cases, a doctor may recommend that a person monitor their blood pressure at home. This means a person will need a home blood pressure monitor. Most likely, they will need to pay for the device.
This article looks at the coverage options for blood pressure monitoring and any available help with healthcare costs.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Original Medicare does not usually cover self-measured blood pressure monitoring, which means it will not cover the cost of a blood pressure monitor for home use.
However, there are a few exceptions. Medicare may provide coverage for ambulatory blood pressure monitoring (ABPM). It may also cover a manual blood pressure monitor for people who are receiving dialysis at home for end stage renal disease (ESRD).
If a person has a Medicare Advantage plan, they may need to contact the private insurance company administering the policy to see whether there is a benefit for home blood pressure monitoring.
Medicare Advantage plans are required to cover the same amount of healthcare services and supplies as Original Medicare, and many policies cover additional services and supplies.
Medicare Part B may cover ABPM once per year.
For Medicare to cover ABPM, a person must have either suspected white coat hypertension or suspected masked hypertension.
In either case, the person must have at least two visits to a doctor’s office or clinic. During each visit, a healthcare professional must take at least two separate measurements, and the measurements must indicate suspected white coat hypertension or suspected masked hypertension.
If Medicare covers an ABPM device, the device must be able to measure blood pressure for 24 hours. During this time, the person will wear a cuff, which will take blood pressure readings at regular intervals.
The healthcare professional will test the device in their office and provide the person with clear instructions on how to use it.
After monitoring, the healthcare professional will interpret the results.
If a person is receiving dialysis at home, Medicare may pay for a manual blood pressure monitor.
It will not cover the cost of an automatic blood pressure monitor.
Learn about Medicare coverage for dialysis.
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 may cover routine blood pressure checks performed by a Medicare-approved physician. This may include blood pressure monitoring.
According to the National Association of Community Health Centers, a home blood pressure monitor may cost anywhere from $30 to $207.
Medicaid may help cover the cost of a blood pressure monitor for home use
Medicaid provides health coverage for:
- people in a low income household
- pregnant people
- children
- people with disabilities
Some people may be eligible for both Medicare and Medicaid. Eligibility requirements for Medicaid differ by state. A person can contact Medicaid to find out about requirements in their area and whether their state offers help with the cost of home blood pressure monitors.
According to the
Monitors for the wrist or finger may give less-accurate readings.
Blood pressure monitors should be validated. This means they have undergone testing and they meet the regulated standards of the Association for the Advancement of Medical Instruments, the British Hypertension Society, and the European Society of Hypertension.
If a person is unsure whether the blood pressure monitor they are considering purchasing is validated, they should ask their doctor or pharmacist for advice.
Blood pressure monitors can also be validated for use in people of certain age ranges or for use during pregnancy. Checking for a particular validation may be useful.
Fitting the blood pressure monitor
Before purchasing a blood pressure monitor, a person should use a flexible measuring tape to measure around their upper arm or the upper arm of the person who will be using the monitor. Writing down the measurement can help a person ensure that a monitor has the correct size cuff for their needs.
A person may want to bring their blood pressure monitor to their next doctor’s appointment.
The doctor will be able to make sure the person is using the monitor correctly and that it is providing similar results to an in-office device. A person should bring the monitor to the doctor’s office at least once per year to make sure the readings remain accurate.
Learn more about checking blood pressure at home.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Medicare does not usually cover the purchase of blood pressure monitors for at-home use. However, it may provide coverage for ambulatory blood pressure monitoring or for a blood pressure monitor for someone who is receiving dialysis.
Medicaid may provide help with the cost of a home blood pressure monitor in some states. Some people may be eligible for both Medicaid and Medicare.
If a person purchases a home blood pressure monitor, it is best to choose an automatic upper arm monitor with a cuff.