Medicare coverage for a blood pressure monitor is important, especially for beneficiaries with high blood pressure, heart disease, cardiovascular issues, or those on renal dialysis. If your healthcare provider suggests that you need regular blood pressure measurements, investing in a blood pressure monitor could be essential.
Beneficiaries that need ambulatory blood pressure monitoring and meet Medicare’s requirements for coverage will have help getting the necessary supplies. However, there are some limitations to how Medicare covers blood pressure monitors.
You can learn more about the criteria necessary to qualify in the context below.
Are blood pressure monitors covered under Medicare?
Once a year, Medicare will cover an ambulatory blood pressure monitor when ordered by your doctor and medically necessary. Medicare won’t cover a regular blood pressure cuff, with an exception made for those receiving dialysis at home.
Coverage is available when a doctor suspects “white coat hypertension” or “masked hypertension.” Those with only Medicare should expect to pay 20% of the cost after applicable deductibles are met. Additional health insurance can help lessen the cost of your supplies.
It’s important to verify that the supplier accepts the Medicare-approved amount. Otherwise, you could pay a higher cost. Those with a Medicare Advantage plan will pay the plan’s rate for supplies. But, a Medigap plan could pay the 20% coinsurance, leaving you with little to no out-of-pocket costs.
Talk to your doctor if you believe you need an ambulatory blood pressure monitor.
Can you get a free blood pressure monitor from Medicare?
While Medicare won’t provide you with a free home BPM, there are a few ways to get a reading for free. For example, public blood pressure monitors are in most pharmacies.
Some apps can check your blood pressure, but doctors say the apps can be inaccurate.
Some senior housing communities have a nurse who can do a blood pressure check. In select states, Medicaid may pay for home blood pressure monitors.
Can I rent an ambulatory blood pressure monitor?
Medicare Part B covers ambulatory blood pressure monitoring once a year if “masked hypertension is suspected. For 24 hours, you’ll wear the monitor.
While wearing the monitor, a series of readings will be taken. The readings will be used by the doctor to possibly diagnose hypertension and provide you with treatment options.
Is a blood pressure monitor a Durable Medical Equipment?
Yes, blood pressure monitors are considered Durable Medical Equipment. Some types of monitors won’t be included in the coverage. Medicare only covers Durable Medical Equipment when the doctor and the supplier both accept “Medicare Assignment.”
Part B may only cover the rental of a blood pressure monitoring device if they approve your request. Keep in mind that blood pressure cuffs are not considered Durable Medical Equipment, and Medicare won’t cover them. Talk to your doctor about your options.
Will Medicare cover at-home blood pressure monitors?
Medicare will only cover an at-home blood pressure monitor if you receive kidney dialysis. However, if you already have a blood pressure monitor at home, Medicare may cover some expenses related to its use.
How much does a blood pressure monitor cost with Medicare?
An ambulatory blood pressure monitor will fall under the scope of Part B coverage. The cost with Original Medicare will be 20% of the approved Medicare amount after applicable deductibles are met.
Medigap plans can cover the 20% Medicare doesn’t cover; in some cases, the plan will cover your deductible.
Does Medicare Part C cover blood pressure monitors?
A Medicare Advantage plan must cover at least as good as Medicare. But the cost could be different with Part C. Also, some Part C plans will cover an allowance for over-the-counter items, such as an adult blood pressure monitor.
Do I need a prescription to get a blood pressure monitor?
You don’t need a prescription to buy an over-the-counter blood pressure monitor for at-home use. A blood pressure monitor can be purchased online or in a pharmacy. Prescription drug plans won’t cover a blood pressure monitor. Part D can help with the cost of medications you may need if you do have high blood pressure.
Can I self-pay for a blood pressure monitor?
Yes, since a blood pressure monitor is an over-the-counter item, you can self-pay. Talk to your doctor about the type that will work best for your wellness needs.
Is a blood pressure monitor considered durable medical equipment?
Yes, a blood pressure monitor is considered durable medical equipment.
Are blood pressure monitors covered by Medicare?
Yes, Medicare Part B will cover blood pressure monitors.
How to get additional Medicare coverage for blood pressure monitors
Medicare Supplement insurance can benefit those with high blood pressure because it can cover some of the deductibles, coinsurances, and copayments Medicare would otherwise leave you to pay.
If your doctor says you need an ambulatory blood pressure monitor and fall into Medicare’s guidelines for coverage, a Medigap plan will be beneficial.
To see the insurance plans available in your area, call us at the number above. Or fill out an online rate form to get started now.
Our licensed insurance agents can help you with enrollment in supplemental Medicare insurance that makes the most sense for your situation.