Does Medicare Cover Blood Pressure Monitoring Machines? 

When we visit a doctor’s office or urgent care, one of the first things that happens is a blood pressure check. The doctor or nurse will consider it a part of “checking your vitals,” which makes sense because maintaining healthy blood pressure is, indeed, vital.

For many seniors, controlling blood pressure is of vital importance. Blood pressure that is too high or too low can indicate or lead to significant health problems. Although blood pressure medications combined with a healthy diet and exercise can often alleviate blood pressure concerns, checking your blood pressure often is usually a good idea if you or your doctor are concerned.

How do you check your blood pressure?

Blood pressure is measured by checking blood flow against your pulse. This is done in a doctor’s office using a blood pressure machine that uses a cuff that goes around your arm. The cuff inflates to squeeze your arm, and as the cuff deflates, a medical provider listens to your pulse using a stethoscope to derive the systolic and diastolic values that give a complete reading of your blood pressure.

Although many healthcare professionals still utilize this method of listening to a patient’s pulse through a stethoscope, innovative blood pressure machines use digital technology to measure blood pressure. These machines work in a similar fashion to the stethoscope method, but they don’t require a healthcare provider to listen to your pulse. Instead, these machines measure your pulse and time to provide the systolic and diastolic values.

You can also purchase blood pressure machines for use at home. These machines range in complexity, but newer models utilize the digital method of checking blood pressure. While a doctor’s reading should be the value that holds weight, it may still be a good idea for seniors who have blood pressure concerns to check their blood pressure at home based on a doctor’s recommendation.

Does Medicare cover blood pressure machines?

Medicare benefits provide coverage for blood pressure screenings when Medicare recipients visit a healthcare provider who accepts Medicare, but the program does not typically cover blood pressure machines for home use. Medicare coverage does, however, apply toward healthcare expenses that have been deemed medical necessities. Medicare covers durable medical equipment (DME) under the outpatient benefits of Medicare Part B. There are many types of equipment considered within the DME benefit that may be purchased or rented. 

It may be possible to obtain Medicare coverage for a blood pressure machine if your doctor believes that such a machine is medically necessary to keep you healthy and avoid severe medical problems. A waiver may need to be filed with the Centers for Medicare & Medicaid Services (CMS) in order to gain an exception for coverage of such machines.

The cost of a blood pressure machine under Medicare

If Medicare agrees to cover a blood pressure machine under the DME provision of Part B, you can expect to pay 20% of the cost. This is the standard coinsurance for Part B costs. You will also need to meet your deductible. In 2024, the standard Part B deductible is $240.

When purchasing a blood pressure machine covered by Medicare benefits, the machine must come from a Medicare-approved supplier in order to qualify for coverage. If you purchase a blood pressure machine on your own from a provider that has not been approved by Medicare, you are responsible for the full cost even if you have gained authorization from Medicare to purchase a blood pressure machine.

Ambulatory blood pressure monitor coverage and Medicare

Although Medicare does not cover blood pressure machines in most circumstances, the program does cover ambulatory blood pressure machines. These are machines that are taken home by someone who requires blood pressure monitoring by a doctor.

These devices are typically only used for 24-48 hours, and results are reported back to your doctor for analysis. If your doctor orders an ambulatory blood pressure machine, Medicare Part B will cover the cost at 20%. You must still meet your deductible before Medicare benefits apply.