Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). typically doesn’t cover a blood pressure monitor but may if a doctor considers it medically necessary or if you’re receiving in-home renal dialysis.
Some Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans help pay for blood pressure monitors through an over-the-counter stipend.
Medicaid may help pay for blood pressure monitors. Coverage will vary based on your state of residence.
Original Medicare Parts A and B typically don’t cover blood pressure monitors, although Part B may provide some coverage if considered medically necessary. Some Medicare Advantage plans include over-the-counter money, which can be used to get items like toothpaste, deodorant and blood pressure monitors. The funds sometimes come loaded on a prepaid debit card to be used at approved locations or via a catalog and you can order the items via phone or the internet.
The American Heart Association estimates that nearly half of adults in the United States have high blood pressure, often referred to as the “silent killer” because it increases the risk of heart attacks and strokes.
High blood pressure is treatable but can’t be treated unless it is diagnosed. That’s where blood pressure monitors come in.
While Original Medicare doesn’t typically cover blood pressure monitors, some states’ Medicaid programs may provide coverage. Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age.
Who usually needs a home blood pressure monitor?
Suppose a doctor believes you may have high blood pressure and considers it medically necessary to confirm a diagnosis. In that case, Part B may cover the rental of an Ambulatory Blood Pressure Monitor (ABPM). An ABPM records your blood pressure periodically over 24 to 48 hours to test the validity of a single blood pressure reading taken once in a doctor’s office.
Part B also typically covers a blood pressure monitor among the durable medical equipment it covers if you are receiving in-home renal dialysis. Usually in that case, you can purchase a blood pressure monitor covered by Medicare.
If covered by Part B, a Medicare blood pressure monitor will be covered the same way as other durable medical equipment. The means Part B will cover 80% of the Medicare-approved amount for the purchase of a blood pressure monitor or the rental of an ABPM after you have paid your annual deductible.
Medicare Advantage replaces Parts A and B of Original Medicare, so it will provide at least as much of the cost of Medicare-approved blood pressure monitors. Some Medicare Advantage plans also may help cover costs beyond what Part B covers. A GoHealth licensed insurance agent can check for you.
Does insurance cover blood pressure monitor?
Will Medicare pay for a blood pressure monitor in any other situation? If medical personnel check your blood pressure during a check-up or in the hospital, Medicare will cover the service as a part of your visit or treatment.
A blood pressure cuff is the rubber bladder that goes around your arm as a part of recording a blood pressure reading. A recent GoHealth survey found that nearly half of Medicare beneficiaries use a blood pressure cuff at home.
While Original Medicare usually doesn’t cover blood pressure monitors, they are relatively affordable if you pay for them out of pocket.