If you’re an older adult with high blood pressure, heart disease or another condition that warrants regular monitoring of your blood pressure, you may be in the market for a blood pressure monitor you can use at home.
An at-home blood pressure monitor makes it much easier to keep tabs on your numbers and see your progress over time, without the headache and potential stress of going into a drugstore or your doctor’s office. Indeed, regularly monitoring blood pressure has been shown to help people with high blood pressure better manage their condition.
While you can get a typical blood pressure monitor for anywhere from $30 to $80, high-end wireless monitors can run as high as $200. Even at the low end, that could be a deal-breaker if you’re an older adult on a budget.
That’s why if you’re 65 or older, you may be wondering if Medicare would cover the cost of a blood pressure monitor or other health monitoring devices.
Unfortunately, the answer is typically no, at least with original Medicare (parts A and B). Medicare only pays for at-home blood pressure monitoring devices in a small number of situations, including when your doctor has ordered ambulatory blood pressure monitoring, you’re on renal dialysis at home or you’re enrolled in an eligible remote patient monitoring program. Even in these scenarios, Medicare may not cover the full cost of the devices.
Read on to learn more about which parts of Medicare cover which types of blood pressure monitoring and whether you may qualify for an at-home blood pressure monitor that’s partially covered by Medicare.
Does Medicare cover blood pressure monitors?
Generally speaking, no, Medicare does not cover at-home blood pressure monitors. While there are a few scenarios in which Medicare will cover the cost of an at-home blood pressure monitor for its beneficiaries, Medicare usually only covers blood pressure monitoring that takes place either in your doctor’s office or while you’re an inpatient at a hospital.
- Medicare Part A, which covers hospital expenses and other inpatient costs such as at skilled nursing facilities, covers blood pressure monitoring only during hospital stays in which your blood pressure is monitored as part of your care.
- Medicare Part B, meanwhile, covers outpatient care such as doctor’s visits, so if your doctor accepts Medicare and you have your blood pressure checked at their office as part of an exam or annual wellness visit, the cost should be covered.
Unfortunately, neither of these scenarios is helpful for someone with high blood pressure or who otherwise wants to keep tabs on their blood pressure from home.
And while Medicare Part C, which covers the same care as Parts A and B as well as additional services, may cover some of the cost of health devices like at-home blood pressure monitors, it’s not guaranteed. You’ll have to check with your insurance provider.
When does Medicare cover blood pressure monitors?
There are only a few situations in which original Medicare will cover the cost of an at-home blood pressure monitor. Your doctor must recommend you use a blood pressure monitor at home as part of your care plan and you must have a qualifying condition to have some of the cost covered.
Ambulatory blood pressure monitoring
If your doctor thinks the blood pressure reading they’re seeing at the clinic is inaccurate – perhaps you have higher blood pressure due to anxiety or “white coat syndrome” or your doctor suspects your blood pressure is typically higher than what is showing at the clinic – they may order ambulatory blood pressure monitoring.
Ambulatory blood pressure monitors are small blood pressure monitors that you wear around your waist and upper arm as you go about your everyday life. Your blood pressure is measured for up to 24 hours to allow your doctor to get a better sense of where your blood pressure stands on an average day and how it changes over the course of the day. After 24 hours, you return the monitor.
If your doctor orders this type of blood pressure monitoring, it will be covered once per year by Medicare Part B.
If you are receiving treatment for kidney failure and are on renal dialysis in your home, original Medicare will cover 80% of the cost of a blood pressure monitor. You may be responsible for the remaining 20% depending on whether you have supplemental coverage and, if so, what it covers.
It’s worth noting, however, that this coverage only applies to manual blood pressure monitors and the stethoscope required to take an accurate measurement. Digital, automatic blood pressure monitors are not included.
Remote patient monitoring
If you’re enrolled in a remote health monitoring program at your doctor’s office or via a provider like myNurse and have been diagnosed as having a qualifying health condition like high blood pressure, you can get an at-home digital blood pressure monitor (even one that automatically forwards measurements to your doctor) to help you track your health without visiting the clinic.
As is the case with renal dialysis patients, Medicare Part B covers 80% of the cost of blood pressure monitoring devices for eligible patients in a remote monitoring program. If you have an eligible Medicare Supplemental Insurance plan (Medigap), the remaining 20% may also be covered, but applicable copayments or deductibles will vary based on your plan.
|If you’re an older adult looking for a helping hand as you tackle high blood pressure, diabetes or other health issues, you may qualify for a myNurse membership as a Medicare-covered benefit. Membership comes with remote health monitoring, connected health testing devices and one-on-one coaching. See how it works and check if your insurance covers the program.|
Unfortunately, Medicare typically doesn’t cover the cost of at-home blood pressure monitors. However, if you have a specific health condition like kidney failure or your doctor orders ambulatory blood pressure monitoring or ongoing remote monitoring of your blood pressure, you should have at least 80% of the cost covered by original Medicare. Depending on your coverage remaining 20% may also be covered, but you’ll need to check with your insurance provider to be sure.
That said, whether or not a blood pressure monitor is covered in your specific situation, an at-home blood pressure monitor is a wise investment, especially considering you can get a digital monitor to take care of the basics for as little as $30. And if you think you’d benefit from additional help while you tackle your high blood pressure from home, ask your doctor if you might be a good candidate for remote monitoring – if you’re eligible and part of a qualifying program, you could get the majority of the cost of an at-home blood pressure monitor covered while enjoying support and proactive intervention from a chronic care specialist.