Does Medicare Cover Blood Pressure Monitors?

Medicare is a federal health insurance program serving individuals aged 65 or older. It also provides coverage for certain younger people with disabilities or specific medical conditions, such as permanent kidney failure or amyotrophic lateral sclerosis (ALS).

Understanding Medicare Parts and Coverage Basics for Medical Equipment

Medicare Part B (Medical Insurance) covers Durable Medical Equipment (DME). DME includes items that withstand repeated use, serve a medical purpose, are appropriate for use in the home, and are expected to last for three years or more.

For Medicare to cover DME, it must be deemed medically necessary by a healthcare provider. A doctor or other authorized practitioner, such as a nurse practitioner or physician assistant, must prescribe the equipment for a medical condition or injury. The equipment must also be obtained from a supplier enrolled in Medicare that accepts Medicare assignment.

Specific Coverage Criteria for Blood Pressure Monitors

Original Medicare generally provides limited coverage for blood pressure monitors. It typically does not cover standard home blood pressure cuffs for routine or general wellness use. However, an exception exists for individuals undergoing home kidney dialysis; in these cases, Medicare Part B may cover a manual blood pressure monitor and stethoscope as part of their essential treatment supplies.

Medicare Part B does cover Ambulatory Blood Pressure Monitors (ABPMs) when medically necessary. An ABPM is a device that records blood pressure at regular intervals over 24 to 48 hours while the patient conducts their normal activities. Coverage for an ABPM is typically granted once per year for beneficiaries with suspected “white coat hypertension,” where blood pressure readings are high in a clinical setting but normal outside of it, or “masked hypertension,” where readings are normal in the office but high in daily life. These devices must meet specific technical requirements, such as producing standardized plots of measurements, and their interpretation must be performed by a physician.

Medicare Advantage Plans, also known as Part C, are required to cover everything that Original Medicare covers. However, these private plans may offer additional benefits not covered by Original Medicare, which could include some coverage for blood pressure monitors. Over-the-counter (OTC) blood pressure monitors are generally not covered by Original Medicare, but some Medicare Advantage plans might provide an allowance benefit that can be used for such items.

How to Obtain a Covered Blood Pressure Monitor

To obtain a blood pressure monitor covered by Medicare, the first step is securing a physician’s order or prescription. This order must clearly state that the blood pressure monitor is medically necessary for your condition. The healthcare provider’s documentation in your medical record must sufficiently support the medical necessity for the specific type of monitor prescribed.

Once you have the necessary physician’s order, you must find a Medicare-approved supplier for Durable Medical Equipment. It is beneficial to choose a supplier that accepts Medicare assignment, as this ensures they will not charge you more than Medicare’s approved amount for the equipment. You can contact Medicare directly or use their online tools to locate approved suppliers in your area.

Regarding costs, after you meet the annual Medicare Part B deductible, Medicare typically pays 80% of the Medicare-approved amount for covered DME. For 2025, the standard Medicare Part B deductible is $257. You are responsible for the remaining 20% coinsurance. It is important to confirm with your supplier that they accept assignment to avoid unexpected additional charges.