- Medicare generally does not pay for at-home blood pressure monitors, except in certain circumstances.
- Medicare Part B may pay for you to rent an ambulatory blood pressure monitor once a year if your doctor recommends one for you.
- Medicare Part B may pay for a blood pressure monitor if you are undergoing renal dialysis at home.
If your doctor has recommended that you check your blood pressure regularly, you may be in the market for a blood pressure monitor to use at home.
As you compare costs for blood pressure monitors online or from medical equipment suppliers, it’s important to know that original Medicare (parts A and B) only pays for at-home blood pressure monitors in very limited situations.
Read on to learn when Medicare will cover the cost of at-home devices, the different types of monitors available, and tips to help you control hypertension.
Medicare only pays for at-home blood pressure monitors if you are on renal dialysis in your home or if your doctor has recommended an Ambulatory Blood Pressure Monitor (ABPM). ABPMs track your blood pressure over a period of 42 to 48 hours.
If you have Medicare Part A, your benefits will cover any blood pressure monitoring needed while you’re an inpatient at a hospital.
Medicare Part B covers blood pressure checks that take place in your doctor’s office, as long as your doctor is enrolled in Medicare. Your annual wellness visit should include a blood pressure check, which is covered under Part B as preventive care
The two most commonly used at-home blood pressure monitors are blood pressure cuffs and ABPMs. There are a few reasons your doctor might recommend you use one at home.
Inaccurate doctor’s office readings
Sometimes, having your blood pressure checked in a doctor’s office can lead to inaccurate results. This is due to a phenomenon called white coat syndrome. That’s when the trip to the doctor’s office – or just being in a doctor’s office – causes your blood pressure to go up.
Other people experience masked hypertension. This means your blood pressure is lower in the doctor’s office than it is during daily life.
Therefore, monitoring blood pressure at home may provide a more reliable reading if one of these conditions is creating false results.
For those on renal dialysis, accurate and regular blood pressure monitoring is crucial. Hypertension is the second leading cause of chronic kidney disease. And if you have chronic kidney disease, high blood pressure can decrease your kidneys’ ability to filter toxins out of your body. For this reason, it’s important to know if your blood pressure is increasing if you’re on at-home dialysis.
Blood pressure cuffs
Blood pressure cuffs fit around your upper arm. The band around your arm fills with air, squeezing your arm to stop the flow of blood through your brachial artery. As the air releases, blood begins to flow through the artery again in pulsing waves.
How to use one
- If you’re using a manual cuff, place a stethoscope at the inside elbow where can hear the blood flow. Watch the number dial on the device.
- When you hear the blood surge (it sounds like blood pumping) the number you see on the dial is the systolic reading.
- When the pressure is totally released in the cuff and you don’t hear the blood pumping sound anymore, that number you see on the dial is the diastolic reading. This shows the pressure in the circulatory system when the heart is relaxed.
Medicare pays for 80 percent of the cost of a manual blood pressure cuff and a stethoscope if you are on renal dialysis in your home. You will be responsible for the remaining 20 percent of the cost.
If you have a Medicare Part C (Medicare Advantage) plan, talk to your insurance provider to see if your plan covers blood pressure cuffs. They’re required to cover at least as much as original Medicare, and some plans will cover extras, including medical devices.
Ambulatory blood pressure monitors
These devices take your blood pressure periodically throughout the day and stores the readings. Because the readings are taken in your home and at several different points during the day, they give a more accurate picture of your daily blood pressure highs and lows.
White coat syndrome criteria
If your doctor thinks you might have white coat syndrome, Medicare will pay for you to rent an ABPM once a year if you meet the following criteria:
- your average systolic blood pressure was between 130 mm Hg and 160 mm Hg or your diastolic blood pressure was between 80 mm Hg and 100 mm Hg at two separate doctor’s office visits, with at least two separate measurements taken at each visit
- your out-of-office blood pressure measured less than 130/80 mm Hg at least two different times
Masked hypertension criteria
If your doctor thinks you might have masked hypertension, Medicare will pay for you to rent an ABPM once a year, if you meet the following criteria:
- your average systolic blood pressure was between 120 mm Hg and 129 mm Hg or your average diastolic blood pressure was between 75 mm Hg and 79 mm Hg on two separate doctor’s office visits, with at least two separate measurements taken at each visit
- your out-of-office blood pressure was 130/80 mm Hg or higher on at least two occasions
Basic instructions for using an ABPM
The Centers for Medicare and Medicaid Services recommend that you follow these guidelines when using an ABPM:
- Understand how to operate the device before you leave the doctor’s office.
- Ask your doctor to mark your brachial artery in case the cuff slips and you need to fix it.
- Carry out your basic daily activities as normal, but remain still while the device is taking your blood pressure, if possible. Keep your arm level with your heart while it’s operating.
- Note the timing of any medications you take, so it’s easy to track any effects.
- If possible, you should not drive while you’re using an ABPM.
- You should not shower while the ABPM is attached to you.
- When you go to bed at night, place the device under your pillow or on the bed.
Many people buy blood pressure monitors online or from a local store or pharmacy. An expert with the Cleveland Clinic recommends that you follow these guidelines when you buy a blood pressure cuff from a retail source:
- If you’re 50 years or older, look for an arm cuff rather than one for your wrist. Arm cuffs are generally more accurate than wrist models.
- Make sure you buy the right size. An adult size small works for upper arms 8.5 to 10 inches (22–26 cm) in circumference. Adult size medium or average should fit an arm 10.5 to 13 inches (27–34 cm) around. An adult size large should fit an arm 13.5 to 17 inches (35–44 cm).
- Expect to pay between $40 and $60. More expensive versions exist, but if you’re looking for accurate, no-nonsense readings, you don’t need to break the bank.
- Look for a device that automatically reads your blood pressure three times in a row, at intervals of around one minute apart.
- Steer clear of the apps store. While a growing number of blood pressure apps are popping up, their accuracy has not yet been well-researched or proven.
You may also want to look for a device with an easy-to-read display that is well-lit if you want to take readings at night. Once you’ve chosen a device, ask your doctor to confirm its readings. Studies have shown that a high percentage of at-home blood pressure monitoring devices give inaccurate readings.
- Reduce the amount of sodium, caffeine, and alcohol you consume.
- Exercise at least 30 minutes a day.
- Quit smoking.
- Find ways to manage your stress level in daily life.
- Talk to your doctor about prescription medications that lower blood pressure.
Medicare does not pay for at-home blood pressure monitors unless you are undergoing renal dialysis in your home, or if your doctor wants you to take your blood pressure somewhere other than a clinical setting.
If you are on at-home renal dialysis, Medicare Part B will pay for a manual blood pressure monitor and a stethoscope. If you have white coat syndrome or masked hypertension, Medicare will pay for you to rent an ABPM once a year to monitor your blood pressure over a 24- to 48-hour period.
With a Medicare Advantage plan, you’ll need to find out whether your plan covers at-home blood pressure monitors, since each plan is different.
Taking your blood pressure at home is a good idea, especially if you’re concerned about hypertension. You can find inexpensive blood pressure cuffs with a wide range of features online or in retail stores.