Does Medicare cover blood pressure monitors?

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Dear Connie,

My husband was recently diagnosed with high blood pressure, and we’ve been told that we should monitor it. I don’t want him to take high blood pressure medicine, so we’re doing what we can to change our diet and lifestyle.

We’d like to monitor his blood pressure to see if these are working enough, but the cost is a factor. I just don’t know how much one of these monitors might cost. We’re wondering, does Medicare pay for blood pressure monitors?

Worried about my husband’s health,
Amy from Sacramento, California

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Dear Amy,

Thank you for reaching out to us to ask this vital question. Our blood pressure is a critical indicator of our overall circulatory system health. It informs us how well our blood is carrying oxygen and other crucial nutrients throughout our body.

According to the Centers for Disease Control and Prevention, 70 percent of U.S. adults 65 and older have high blood pressure, also known as hypertension. So, many others are asking the same question.

You’re also proactive in considering lifestyle changes and monitoring, which is more than many people do. Kudos to your family. Like you, loved ones are essential in helping maintain healthy blood pressure levels. Unfortunately, only 48 percent of older Americans with high blood pressure check their pressure regularly.

Now, to your question. Does Medicare cover blood pressure monitors? The answer is yes and no because Original Medicare covers different types of blood pressure monitors and circumstances.

1. Ambulatory blood pressure monitor (ABPM)

Original Medicare Part B and Medicare Advantage plans may cover a once-annual ambulatory blood pressure monitor (ABPM) if your doctor orders. An ambulatory blood pressure monitor consists of a cuff worn for either 24 or 48 hours continuously, tracking blood pressure during various activities throughout the day and night, including sleep. Using an AMPM device, your physician can monitor your blood pressure at different times, considering factors such as activity levels, emotions, and the time of day.

Your husband’s doctor may recommend an annual ABPM if “white coat hypertension” or “masked hypertension” is suspected. With “white coat hypertension,” also known as white coat high blood pressure or white coat syndrome, blood pressure readings are high at the doctor’s office but mainly in a healthy range at other times. White coat hypertension can be caused by the anxiety of being in a clinical setting, such as a doctor’s office.

“Masked hypertension” or masked high blood pressure is the opposite of white coat hypertension. This occurs when blood pressure is within normal limits during medical visits but consistently elevated outside those visits.

Original Medicare and Medicare Advantage plans will cover a once-annual ambulatory blood pressure machine if you are suspected of white coat or masked hypertension.

Original Medicare Part B will pay 80 percent of the Medicare-approved amount to rent the ambulatory blood pressure machine (ABPM). You would be responsible for paying the 20 percent coinsurance of the Medicare-approved amount. To ensure you aren’t faced with a higher out-of-pocket expense, always ensure the device comes from a Medicare-approved durable medical equipment supplier.

Medicare Advantage plans (Medicare Part C) also cover ambulatory blood pressure machines. However, the coverage is different than Original Medicare Part B, and you should contact your plan provider to discover what your cost could be.

Agent tip:

“Medicare Advantage plans sometimes offer blood pressure cuffs and other durable medical equipment at a lower cost than Original Medicare. If you have a Medicare Advantage plan contact your insurance carrier to learn about their coverage and costs.“

2. Blood pressure monitoring cuff for at-home renal dialysis

Are you aware that high blood pressure is the second leading cause of chronic kidney disease? And that if you have chronic kidney disease, hypertension can decrease your ability to filter toxins from your body. For these reasons, monitoring your blood pressure during at-home dialysis is essential.

If your husband is doing at-home dialysis, a blood pressure monitoring cuff could be covered by Original Medicare Part B and Medicare Advantage plans. Original Medicare covers 80 percent of the cost of a Medicare-approved manual blood pressure cuff and stethoscope if you do renal dialysis at home. You would pay the 20 percent coinsurance of the Medicare-approved amount. To save money, be sure that you get supplies from a Medicare-approved durable medical equipment supplier.

If you’re enrolled in a Medicare Advantage plan, contact your insurance provider to see if your plan covers blood pressure cuffs. Medicare Advantage plans must cover what Medicare Part B covers, but a Medicare Advantage plan may provide extra benefits, including less expensive or free medical devices, like blood pressure cuffs.

3. At-home blood pressure monitoring

If you want an at-home blood pressure machine or cuff to monitor your husband’s blood pressure, Original Medicare does not cover these. You would need to pay out-of-pocket. The good news is that a blood pressure monitor shouldn’t break the bank. They are a relatively low-cost piece of durable medical equipment (DME).

If you have a Medicare Advantage plan, you may want to consider contacting your insurance carrier to see if a blood pressure cuff or machine is a durable piece of equipment they provide. Medicare Advantage plans often have more benefits than Original Medicare.

When you purchase a blood pressure monitor, it’s recommended that you buy an arm cuff rather than a wrist cuff. That’s because arm cuffs provide more accurate readings. Here are some other things to look out for when choosing among blood pressure monitoring devices.

• Cuff size: Choose the right blood pressure cuff size for you. Cuffs are not one-size-fits-all. An adult small is for an upper arm 8.5 to 10 inches in circumference. Adult-size medium fits an upper arm of 10.5 to 13 inches in circumference. Adult large size is for an upper arm circumference of 13.5 to 17 inches. An adult extra-large fits an upper arm circumference of 17.7 to 20.5 inches.
• Cost: There are a lot of blood pressure monitors with bells and whistles, but you don’t need to break the bank for a monitor. If you want an accurate, no-nonsense reading, you can pay between $40 and $60 out-of-pocket.
• 3-interval reading: A blood pressure monitor that automatically reads your blood pressure three times a row is optimal. These readings should be in intervals of about one minute apart. This is helpful because your reading will be the average of the three readings instead of only one. With this type of blood pressure monitor, you’ll get a more reliable reading.

Thank you for writing to ask whether Medicare covers blood pressure monitors. As you can see, it can be yes – or no, depending on your health circumstances. Because some Medicare Advantage plans provide extra benefits compared to Original Medicare, you may want to look into your plan options.

And while a blood pressure monitor is a relatively inexpensive piece of durable medical equipement, other equipment can creep up in price. A Medicare Supplement plan paired with Original Medicare or a Medicare Advantage plan could help reduce your coinsurance and out-of-pocket costs faced with only Original Medicare.

If you have additional questions about blood pressure monitors or Medicare plans, Connie Health’s local licensed agents are happy to help.

Speak with a local licensed agent today—call (623) 223-8884. We’re here to support you throughout your Medicare journey.

Frequently Asked Questions

Does Medicare cover blood pressure cuffs?

Original Medicare will cover blood pressure cuffs when doing at-home renal dialysis. Medicare Part B would cover the durable medical equipment, and you would need to pay the 20% coinsurance. In most cases, Original Medicare will not pay for an at-home blood pressure cuff unless you have renal disease. You can check with your doctor.

You should check with your insurance provider if you have a Medicare Advantage plan. This is because Medicare Advantage plans often come with extra benefits, and you may be able to get a low-cost or free blood pressure cuff through your Medicare Advantage plan.

Will Medicare pay for blood pressure machine?

Original Medicare will pay for the rental of an ambulatory blood pressure machine if your doctor suspects either “white coat” or “masked” hypertension or high blood pressure. It will also cover an at-home blood pressure cuff and stethoscope if you are doing at-home renal dialysis.

For both of these, Medicare Part B provides coverage at 80%, while you would be responsible for the 20% coinsurance cost. In most other cases, Original Medicare does not cover a blood pressure machine or cuff if you want to monitor your blood pressure at home.

Medicare Advantage plans provide equal coverage to Original Medicare but often with greater benefits. If you’d like a blood pressure cuff at home, contact your Medicare Advantage insurance provider to learn if they cover it and other durable medical equipment.

Does Medicare Part C cover blood pressure monitors?

Yes, Medicare Part C, Medicare Advantage plan, covers the rental of an ambulatory blood pressure monitor if your doctor suspects “white coat syndrome” or “masked hypertension” or a blood pressure cuff if you do at-home renal dialysis.

Because Medicare Part C plans often have extra benefits that Original Medicare doesn’t provide, these plans could also cover a blood pressure monitor for other reasons. If you have a Medicare Advantage plan, you should contact your insurance provider to discover what types of blood pressure monitors are covered at what cost.

Is a blood pressure monitor considered durable medical equipment?

Yes, a blood pressure monitor is considered durable medical equipment (DME). Original Medicare Part B covers durable medicare equipment, and Medicare Advantage often matches Original Medicare’s coverage with more significant benefits, lower coinsurance, and a cap on out-of-pocket expenses.

Are blood pressure monitors covered by Medicare?

Yes, blood pressure monitors are covered by Original Medicare, and Medicare Advantage plans if you receive renal dialysis at home. You could also rent an ambulatory blood pressure monitor if you have “white coat hypertension” or “masked hypertension.”

Both would be covered under Original Medicare Part B at 80%, and you must pay 20% of the Medicare-approved amount. Original Medicare usually doesn’t provide blood pressure monitors for reasons outside these two.

Medicare Advantage plans provide the same level of coverage as Original Medicare Part B, plus they often offer extra benefits for additional coverage. If you have a Medicare Advantage plan, you should call them to check on your blood pressure monitor benefits and costs.