Will Medicare Pay for a Home Blood Pressure Monitor?
- Find out if Medicare pays for home blood pressure monitors and learn about the specific criteria that must be met for recipients to receive coverage.
In general, Medicare does not cover the costs of home monitors. However, there are certain exceptions in which recipients may qualify for coverage, including when someone is dealing with white coat syndrome, masked hypertension or renal dialysis.
White Coat Syndrome
White Coat Syndrome is a condition that causes people to receive higher than normal blood pressure readings when their blood pressure is taken in a medical setting such as a doctor's office or emergency room. White coat syndrome can also occur in dental offices when blood pressure readings are required before administering anesthesia. In this situation, a physician may request that the person monitor their blood pressure at home and record the results to ensure normal or lower readings in non-medical settings.
For those with white coat syndrome, Medicare Part B may provide coverage for a specific type of ambulatory blood pressure monitoring device that both monitors and stores recorded readings throughout 24-hour cycles. Recipients must meet certain criteria for the exception to be made, which include:
- Blood pressure readings of 140/90mm Hg or lower on three separate doctor's visits and two instances of at-home readings or in non-medical settings
- No signs or symptoms of end-stage organ damage
Masked Hypertension
Those with suspected masked hypertension tend to have lower blood pressure readings in medical settings and higher readings in non-medical settings.
If a physician suspects someone may have this condition, they may prescribe at-home blood pressure monitoring. In cases of masked hypertension, Medicare Part B will pay for the cost of monitor rental once a year. To receive this coverage, recipients must meet certain criteria that include:
- Blood pressure readings of 120 to 129/75 to 79mm Hg occurring during two separate doctor's office visits
- Documented blood pressure readings of 130/80mm Hg or higher on two separate occasions, taken in non-medical or out-of-office settings
Renal Dialysis
In certain situations, Medicare Part B may also cover at-home blood pressure monitors for those receiving at-home renal dialysis for kidney disease. In this case, Medicare will cover 80% of the costs for equipment. However, the program will only provide coverage for manual monitors that require stethoscopes to take the readings. Digital monitors are not eligible for coverage.
Medicare Advantage Plans
Medicare Advantage or Medicare Part C plans may offer coverage for at-home medical monitoring devices, but it depends on the specific benefits in the recipient's Medicare Advantage plan. Per Medicare, potential recipients should inquire with Medicare Advantage to determine their benefits and eligibility.
How Do You Use an At-Home Blood Pressure Monitor?
When using an at-home ambulatory blood pressure monitor or ABPM, it's important to follow the physician's instructions to ensure accurate readings at all times. Some helpful tips include:
- Remain still when the device is recording blood pressure
- Make sure the cuffed arm is level with the heart when the device is taking the reading
- Document or track effects on blood pressure due to prescription medication (higher or lower readings before or after taking medication, etc.)
- Do not shower when using or wearing the device
- Place the device beneath a pillow or directly on the bed when resting at night
- Avoid driving when using or wearing the monitor
How Can You Manage Hypertension?
High blood pressure or hypertension can potentially lead to complications such as heart disease, risk of stroke and kidney damage if not controlled and/or treated with medication. Here are some healthy tips for individuals diagnosed with hypertension to consider implementing into their routines.
- Take blood pressure medication as prescribed
- Overweight individuals should do their best to lose weight and follow heart-healthy diets
- Reduce alcohol intake
- Participate in activities that help lower stress levels such as yoga, meditation or simply relaxing when necessary
- Monitor blood pressure at home on a regular basis
What Is the Best Blood Pressure Monitor to Use?
If you are prescribed a blood pressure monitor, whether you're getting help paying for it or not, you may wonder which one is right for you. It depends on your preferences and goals in monitoring your blood pressure. Ask your doctor for recommendations and then read reviews for various machines to find one that works for you.
