Cms Expands Medicare Coverage Of Blood Pressure Monitoring Device
The CMS announced Tuesday it has extended coverage of blood pressure monitoring devices to all Medicare beneficiaries suspected of reporting abnormal blood pressure levels when administered in clinical settings.
The agency previously only covered the use of the device, which monitors blood pressure periodically over a 24-hour period, for patients with suspected elevated blood pressure levels due to anxiety from being in a clinical setting. The device can now also be used for patients suspected of having lower than usual blood pressure measurements when inside a doctor’s office. Medicare will cover the use of the device once a year per patient.
The devices, called ambulatory blood pressure monitoring, is helpful for clinicians with patients who are nervous in clinical settings, affecting the accuracy of their blood pressure results. The devices track patient’s blood pressure throughout the day and the accrued data allows doctors to understand patient’s blood pressure during normal activity.
CMS Administrator Seema Verma said in a statement that the agency “is dedicated to improving cardiovascular health in the Medicare population. decision reflects CMS’ commitment to continually updating our policies to ensure that more Medicare beneficiaries have access to the latest technology and appropriate evidence-based healthcare.”
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Why Would I Need A Blood Pressure Monitor
There are two commonly used home blood pressure monitors: Blood pressure cuffs and ambulatory blood pressure monitors . The primary reasons youd need to use a blood pressure monitor at home are:
- The readings in your doctors office are inaccurate. Perhaps youre feeling nervous just being at the doctor, which can cause your blood pressure to go up. Or vice versa, your blood pressure is lower at the doctors office than it normally is. This is also called white coat hypertension or masked hypertension. If your doctor cant get an accurate reading during your visit, they may suggest taking your blood pressure at home for a more reliable reading.
- Youre on renal dialysis. Those on renal dialysis must have accurate and regular blood pressure readings because if you have chronic kidney disease, high blood pressure can decrease your kidneys ability to filter toxins out of your body. Its important to monitor if your blood pressure is increasing if youre on dialysis at home.
An ABPM is often recommended for those who have high blood pressure induced by anxiety or stress from going to the doctor. These monitors measure your blood pressure in 24-hour cycles and store the blood pressure measurements on the device.
Does Medicare Cover Medical Equipment And Devices Like Scooters Hospital Beds And Blood Sugar Monitors
Updated on Monday, January 14 2019| by Bryan Ochalla
Original Medicare helps older Americans pay for a lot of things, but does it help them pay for these and other medical devices, equipment, and supplies? Read this article to find out.
Medicare is a lot of things, but it isnt always clear.
Specifically, it isnt always clear which kinds of medical equipment and supplies the program does and doesnt cover.
For example, does Medicare cover blood glucose meters or blood pressure monitors? Or does Medicare cover hospital beds, walkers, wheelchairs, or scooters?
Dont feel bad if you have no idea whether or not Medicare helps enrollees pay for those pieces of equipment. Youll be fully educated on the subject by the time you finish reading this article.
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Will Part C Cover Blood Pressure Monitors
Advantage plans must cover the same services as Medicare. So, all Advantage plans cover ambulatory blood pressure monitors and home monitors for dialysis patients.
But, your cost may be different from Medicare Advantage than with Medicare. If you have Medicare Advantage, contact your plan to see about blood pressure monitors.
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- Medicare will only cover a portion of the costs of blood pressure cuffs and monitors if you meet specific requirements.
- If you exhibit signs of having white coat hypertension, or if you exhibit signs of having masked hypertension, then Medicare will cover the costs.
- Additionally, Medicare will only cover two types of monitors: a manual blood pressure monitor with stethoscope, or an ambulatory blood pressure monitoring device.
Having a blood pressure monitor for use at home is medically necessary for many Americans. Because of this need, Medicare does cover a portion of the costs of renting a blood pressure monitor.
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Controlling High Blood Pressure: Ages 18 To 85
High blood pressure, or hypertension, increases the risk of heart disease and strokethe leading causes of death in the United States. Controlling high blood pressure is an important step in preventing heart attacks, strokes, and kidney disease. It also reduces the risk of developing other serious conditions.
Explore the percentage of adults with a diagnosis of hypertension whose blood pressure was adequately controlled in each state. Higher rates are better on this measure.
The purple dashed line represents the median, or middle, of all values reported.
This measure reports state performance on the percentage of adults ages 18 to 85 diagnosed with hypertension with adequately controlled blood pressure, defined as less than 140/90 mm Hg, during the measurement year.
This measure aligns with the Centers for Disease Control and Preventions 6|18 Initiative focus on blood pressure control. The 6|18 Initiative focuses on six common and costly health conditions or health behaviors, including high blood pressure, and highlights evidence-based interventions that can prevent or control those conditions. For information on how to drive improvement on this measure, visit: www.cdc.gov/sixeighteen.
States voluntarily report on Controlling High Blood Pressure as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.
Notes:
Unless otherwise specified:
How Does Medicare Cover Scooters And Wheelchairs
Like it does with almost all other DMEs, Medicare will pay 80 percent of the approved amount of your wheelchair or scooter purchase. You will pay your Part B deductible and then 20 percent of the approved amount.
If you have a MedSup or Medigap plan, it may help you pay some of your portion of this bill. Look at your policy documentation or contact the company that sold you this coverage to find out if this is the case or not.
Pick up the phone or send an email to your insurer, too, if you have a Medicare Advantage plan. It may require you to take different steps than the ones mentioned above or to use specific suppliers to buy your new scooter or wheelchair.
Finally, you don’t have to buy your wheelchair or scooter. You can rent it instead. This could save you a lot of money, especially if you don’t think you’ll need the device for very long.
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Tips For Buying An At
If youre buying a blood pressure monitor for home, here are a few tips to follow:
- If youre 50 years old or older, choose an arm cuff that goes on your upper arm rather than one for your wrist.
- Be sure to buy the right size.
- Choose a device that automatically reads your blood pressure three times in a row at intervals of around one minute apart for the most accurate readings.
- Look for a device with an easy-to-read display thats well-lit.
After youve purchased a blood pressure monitor, its important to ask your doctor to confirm its readings. Your doctor will likely also ask you to share the results, which allows them to gauge how well treatment is working and whether it is sufficient to manage your high blood pressure.
How Much Does A Blood Pressure Monitor Cost
If the blood pressure monitor is covered by Medicare for an eligible reason, Medicare would pay for 80% of the Medicare-approved amount and you would be responsible for the other 20% co-insurance. The Part B deductible would apply .
The monitor must come from a Medicare-certified DME supplier otherwise, you could end up owing additional out-of-pocket costs.
You can also buy a blood pressure monitor online or from your local pharmacy. The cost ranges from about $40 to $100, though they could be more if they are more high-tech. More expensive doesnt necessarily mean better, though, so choose one that fits your needs and your budget. You can also ask your doctor for their recommendation.
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Questions To Ask Your Doctor About Blood Pressure Monitoring At Home
- What is my target blood pressure?
- How often and at what time of day should I check my blood pressure?
- Are there blood pressure numbers I should tell you about right away?
- What lifestyle changes would you recommend for me?
- Is there a type of blood pressure monitor you recommend? Should I bring it to my doctor visits to check for accuracy?
If youre a UnitedHealthcare member, view our network of health care providers to help you find a doctor.
Ambulatory Blood Pressures Monitor
An ambulatory blood pressure monitor 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.
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What Documentation Do You Need For Blood Pressure Monitors
When it comes to obtaining your Medicaid to fund any DME, you must supply all of the necessary papers.
This includes the following:
- Official diagnosis from your doctor as to why you require the blood pressure monitor
- A treatment plan, which may include medication
- If the patient is under the age, a pediatricians prescription is required.
The documents required may differ from state to state, since each state has the authority to govern Medicaid as they see suitable. This is why you should check with your Medicaid or health insurance provider to see whether you are qualified for a blood pressure monitor.
Secondary High Blood Pressure
Secondary high blood pressure may be due to specific reasons such as kidney problems, certain type of tumors, hormonal imbalances, aorta malformation, sleep apnea or medication side effects. When high blood pressure is detected by your doctor, they usually look for secondary reasons in case they can be corrected.
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How Does Medicare Cover High Blood Pressure
Medicare Part B generally covers an annual preventive visit and wellness exam at no cost to you if your provider accepts assignment. High blood pressure screening is typically part of this visit. If you are diagnosed with high blood pressure, Medicare Part B also covers all medically necessary doctor visits and outpatient tests and procedures to treat and manage your condition. You generally pay 20% of allowable charges after you meet your Part B deductible.
Medicare Part B may also pay for weight loss counseling sessions and smoking cessation sessions if performed by a qualified professional who accepts Medicare assignment.
If you have high blood pressure and another qualifying chronic condition such as asthma, diabetes, or heart disease, for example, Medicare Part B may also cover chronic care management services, which include regular phone checks, personalized care coordination between your doctors, pharmacists, and other health care professionals, and 24-hour emergency access to a qualified health professional. There is a monthly fee for these services.
If you are admitted to the hospital to manage your high blood pressure, Medicare Part A generally covers your inpatient care. You pay your Part A deductible, and depending on the length of your stay, a daily coinsurance amount.
Blood Pressure Measurement At Home
Anyone who signs up for the program will receive a Bluetooth blood pressure cuff to wear, along with a device to contact the Holistic Healing Heart Center if needed. By regularly monitoring patients readings, we can determine if treatment is needed urgently, and adjust their medication on a more minute level. This level of oversight is of immense benefit to both the patient and the health care provider. The patient is able to see positive change over time, and any spikes in blood pressure can be medicated appropriately. We, the health care provider, get a better insight into the mechanical facts of the patients condition, and thus that patients needs. Over a six month period, a trial involving these personal health monitoring devices observed that patients average blood pressure dropped by 4.7mm Hg, and blood pressure among refractory hypertensives dropped by 11.5mm Hg.
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How Do You Use An At
When using an at-home ambulatory blood pressure monitor or ABPM, it’s important to follow the physician’s instructions to ensure accurate readings at all times. Some helpful tips include:
- Remain still when the device is recording blood pressure
- Make sure the cuffed arm is level with the heart when the device is taking the reading
- Document or track effects on blood pressure due to prescription medication
- Do not shower when using or wearing the device
- Place the device beneath a pillow or directly on the bed when resting at night
- Avoid driving when using or wearing the monitor
Do Medicare Advantage Plans Cover Blood Pressure Monitors
Medicare Part C plans are health insurance plans offered by private insurance companies that cover everything Original Medicare does and more. Common additional benefits include vision, dental, hearing, and prescription drug coverage .
Because MA plans must cover everything Medicare does, they will cover at-home blood pressure monitors if youre on renal dialysis or an APBM if recommended by your doctor. However, they may offer additional coverage for blood pressure monitors under their durable medical equipment benefits. Check with your plan to learn more.
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Can I Rent An Ambulatory Blood Pressure Monitor
Medicare Part B covers ambulatory blood pressure monitoring once a year if masked hypertension is suspected. For 24 hours youll wear the monitor.
While youre wearing the monitor, a series of readings will be taken. The readings will be used by the doctor to possibly diagnose hypertension and provide you with treatment options.
How Much Will Medicare Pay
After careful determination that blood pressure monitoring is covered under Medicare, the actual amount of coverage will be determined under Medicare Part B. This covers medical services and supplies that have been deemed necessary by a doctor to treat your condition. Medicare Part B also covers out-patient care, home health and rehabilitative services. Another condition is that the blood pressure monitoring equipment must be rented from a Medicare-certified supplier.
Medicare pays 80 percent for the cost of renting the blood pressure monitoring device, while the remaining 20 percent is paid by the patient. Blood monitoring equipment must be rented from a Medical-certified supplier. Renting from a participating supplier ensures that costs are within Medicare approved amounts.
For patients with Medicare Advantage or Medicare Part C, they are equally eligible for everything that is included in Original Medicare Part A and Part B plans. Holders of Medicare Advantage plans can also enjoy coverage extras that translate to larger amounts of coverage or more covered items. Medicare Advantage plans also offers different co-payment options, depending on the type of plan and variables.
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How Can You Manage Hypertension
High blood pressure or hypertension can potentially lead to complications such as heart disease, risk of stroke and kidney damage if not controlled and/or treated with medication. Here are some healthy tips for individuals diagnosed with hypertension to consider implementing into their routines.
- Take blood pressure medication as prescribed
- Overweight individuals should do their best to lose weight and follow heart-healthy diets
- Reduce alcohol intake
- Participate in activities that help lower stress levels such as yoga, meditation or simply relaxing when necessary
- Monitor blood pressure at home on a regular basis
How To Get Additional Medicare Coverage For Blood Pressure Monitors
Medicare Supplement insurance can be beneficial for those with high blood pressure because it can cover some of the deductibles, coinsurances, and copayments Medicare would otherwise leave you to pay.
If your doctor says you need an ambulatory blood pressure monitor and you fall into Medicares guidelines for coverage, a Medigap plan will be beneficial.
To see the insurance plans available in your area, give us a call at the number above. Or fill out an online rate form to get started now.
Our licensed insurance agents can help you with enrollment in supplemental Medicare insurance that makes the most sense for your situation.
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