Medicare provides coverage for an Ambulatory blood pressure monitor to use once a year when your doctor recommends it. It does not cover “cuff” blood pressure monitors except in the condition of dialysis of the beneficiary at home. 

Ambulatory Blood Pressures Monitor (ABPM)

An ambulatory blood pressure monitor (ABPM) is equipment that assesses and saves blood pressure readings throughout the day and night at specific intervals. This process comprises a cuff you put on your arm and a measuring device attached to your belt or dress. During your daily routine, you may wear the device for a full 24 or 48 hours. You wear it during any activity and sleep. Since blood pressure varies in the daytime due to activity levels, emotions, etc., with ABPM, health professionals can check on blood pressure levels throughout the day and night.

Does Medicare Cover Home Blood Pressure Monitors?

If a doctor suspects “white coat hypertension” or “masked hypertension” in a patient, your healthcare provider may prescribe an ABPM. Blood pressure readings above 130/80 are known to be high. Even if just a single digit is more or less than the standard of reading (130/80)-it is considered high.  

Usually, multiple high readings indicate hypertension in patients. If the readings reported in ABPM are mostly high, the doctor may suspect high blood pressure, also called hypertension.

  • White coat hypertension: This means when blood pressure recorded readings are high in the healthcare clinic but mostly in the safe range at other times. This typically happens when a patient’s discomfort from being in a therapeutic environment (such as a hospital or doctor’s office) triggers increases in blood pressure further than the patient’s range elsewhere.
  • Masked hypertension: This means when the healthcare clinic’s blood pressure levels are in the safe range, but at other times mostly high.

Medicare will provide coverage for ABPM in case of “white coat hypertension” or suspected case of “masked hypertension.”

Hypertension Helpful Tips

It’s essential to monitor your blood pressure at home, especially if you’re worried about hypertension. There are things you can do to lower it if the blood pressure is too high:

  • Reduce the amount of alcohol, caffeine, and sodium that you consume.
  • Exercise for 30 minutes a day at least.
  • Quit smoking.
  • Find ways in everyday life to control the level of stress.
  • Consult with a doctor about prescription blood pressure-lowering drugs.

How Much Medicare Provides Coverage For An Ambulatory Blood Pressure Monitor (ABPM).

Medicare Part B supports 80% of the Medicare-approved rent cost for ABPM, while the remaining 20% is your responsibility. Ensure the device is obtained from a Medicare-approved medical equipment provider. Other providers may bill more than the amount approved by Medicare, and you may ultimately pay the extra cost.

Medicare Advantage plans (Part C) provide coverage for ABPMs too. You should contact your plan provider to know what your costs would be. 

If you think you may require an ambulatory blood pressure monitor, discuss with your healthcare provider now and with your Medicare plan provider to know how your plan covers ABPM.

Conclusively for At-home blood pressure monitors, Medicare does not pay unless you are doing renal dialysis at home. Or if your doctor needs your blood pressure to be measured anywhere other than in a hospital setting.

It is a great idea to take your blood pressure at home, especially if you’re worried about hypertension. With a wide variety of retail stores or online features, you can find low-price blood pressure cuffs.

Reach out Today at NewMedicare.