Medicare's coverage of home blood pressure monitors
Medicare Part B covers a blood pressure monitor if your doctor orders it as medically necessary and writes an order that meets specific requirements. The monitor must be prescribed by a physician, physician assistant, or nurse practitioner — not purchased on your own. Medicare will pay 80 percent of the approved amount after you meet your Part B deductible, and you pay the remaining 20 percent.
The device must be a manual or automatic cuff monitor that measures blood pressure at the arm. Wrist and finger monitors are not covered. Your doctor needs to document in your medical record why you need home monitoring — for example, if you have uncontrolled high blood pressure, a recent diagnosis, or a condition where tracking readings at home is medically important.
Not all suppliers accept Medicare assignment, which means some may bill you for the full cost upfront and leave you to seek reimbursement. Before ordering, ask the supplier whether they accept Medicare assignment and what your out-of-pocket cost will be.
Key Takeaways
- Your doctor must write an order for the blood pressure monitor — you cannot purchase one yourself and have Medicare pay for it.
- Medicare Part B covers 80 percent of the approved amount after your deductible, and you pay 20 percent.
- Only arm cuff monitors (manual or automatic) are covered; wrist and finger monitors are not.
- Ask the supplier before ordering whether they accept Medicare assignment so you know your exact out-of-pocket cost.
- Your doctor must document in your medical record that home blood pressure monitoring is medically necessary for your condition.
How to get a Medicare-covered blood pressure monitor
Start by talking to your doctor about whether home blood pressure monitoring would help manage your condition. If your doctor agrees it is medically necessary, they will write an order that includes the specific type of monitor and the medical reason for it. Keep a copy of this order — you will need it when you contact a supplier.
Next, find a Medicare-approved supplier. You can search for one using the Medicare Supplier Directory at dmepos.cms.gov (DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies). Enter your zip code and search for "blood pressure monitor" or "sphygmomanometer." The directory shows which suppliers in your area are enrolled with Medicare.
Call the supplier and give them your doctor's order. Ask three things: whether they accept Medicare assignment, what your out-of-pocket cost will be, and how long delivery takes. If they do not accept assignment, you may want to call another supplier on the list.
What happens after Medicare approves the order
Once the supplier submits your order to Medicare, Medicare reviews it to confirm your doctor's order meets coverage rules. This review usually takes a few days to a week. If Medicare approves it, the supplier will ship the monitor to you.
If Medicare denies the order, the supplier must notify you in writing and explain why. Common reasons for denial include that the doctor's order did not document medical necessity clearly enough, or that the monitor type requested is not covered. If this happens, ask your doctor to contact Medicare or resubmit the order with more detail about why you need home monitoring.
Keep your receipt and any paperwork from the supplier. If you have questions about your bill later, you will need these documents to dispute a charge or request a refund.
Out-of-pocket costs and your deductible
Your Part B deductible applies to the blood pressure monitor, just as it does to other medical equipment. In 2024, the Part B deductible is $240, but this amount changes each year. If you have already met your deductible earlier in the year, you will only pay 20 percent of the approved amount.
The approved amount is what Medicare decides the monitor is worth — not necessarily what the supplier charges. If a supplier charges more than the approved amount and does not accept assignment, you may be responsible for the difference. This is why confirming assignment before ordering matters.
If you have a Medigap or Medicare Advantage plan, your coverage of the 20 percent coinsurance may differ. Medigap Plan G, for example, covers the 20 percent coinsurance after your deductible. Medicare Advantage plans vary widely, so check your plan documents or call your plan to learn what you will owe.
When Medicare does not cover a blood pressure monitor
Medicare will not pay for a blood pressure monitor you buy yourself without a doctor's order, even if your doctor recommends home monitoring. The order must come from your doctor in writing before you purchase or order the device.
Wrist and finger blood pressure monitors are not covered under any circumstances, even with a doctor's order. Only arm cuff monitors may have access to. If your doctor recommends a wrist monitor for a specific reason, ask whether an arm cuff monitor would work instead, or whether the wrist monitor is truly medically necessary — in rare cases, your doctor may be able to request a coverage exception.
If you have Original Medicare and your doctor orders a monitor but Medicare denies it, you have the right to appeal. Ask the supplier for the denial notice, which will explain how to file an appeal and the important date for doing so.
Renting versus buying a blood pressure monitor
Medicare covers purchase of a blood pressure monitor, not rental. Once Medicare pays for the monitor, it is yours to keep. You do not have to return it or pay ongoing rental fees.
If you are unsure whether you will use home monitoring long-term, talk to your doctor about starting with a short trial period. Some suppliers will let you borrow a monitor for a few weeks to see if the routine works for you, though Medicare would not cover this trial period. After the trial, if you decide you want to continue, your doctor can write an order for a covered monitor.
What to ask your doctor
Before your appointment, write down your blood pressure readings if you have been checking at home, or note any symptoms like headaches or dizziness that prompted your doctor to suggest monitoring. During the visit, ask your doctor these questions:
- Do you think I need to check my blood pressure at home, and if so, how often?
- Will you write an order for a blood pressure monitor that Medicare covers?
- What type of monitor do you recommend — manual or automatic?
- How should I record my readings, and when should I call you with the results?
- Are there any blood pressure targets I should watch for that would mean I need to contact you right away?
Frequently Asked Questions
Can I use a blood pressure monitor I already own, or does Medicare require a new one?
Medicare only covers a monitor that is ordered by your doctor after your order is submitted to Medicare. If you already own a monitor, you can use it for your own tracking, but Medicare will not reimburse you for it. If your doctor orders a new one through Medicare, you will receive a covered monitor.
What if my doctor says I need a wrist blood pressure monitor?
Wrist monitors are not covered by Medicare. Ask your doctor whether an arm cuff monitor would work for you instead. If your doctor believes a wrist monitor is medically necessary for a specific reason, they can request a coverage exception from Medicare, though this is rarely approved. Your doctor's office can help with this request.
Do I need to pay anything upfront, or does the supplier bill Medicare first?
If the supplier accepts Medicare assignment, they bill Medicare first and you pay your 20 percent coinsurance after Medicare processes the claim. If the supplier does not accept assignment, you may need to pay upfront and then request reimbursement from Medicare yourself. Always ask about this before ordering.
What if Medicare denies my order?
The supplier must send you a written notice explaining why. Common reasons include unclear medical necessity or an order that does not meet Medicare's requirements. Ask your doctor to resubmit with more detail, or contact Medicare directly to understand the denial and discuss next steps.
Can I get a new blood pressure monitor if my first one breaks?
Medicare covers one blood pressure monitor per beneficiary. If yours breaks and is no longer working, contact your doctor and ask them to write a new order explaining that your previous monitor is no longer functional. Medicare may cover a replacement, but this depends on how long you have had the first one and the specific circumstances.