Current Health Insurance Coverage

Medicare

• Medicare Part B (traditional fee-for-service): Home blood pressure monitors used for SMBP are not covered.
• Medicare Part C (Medicare Advantage): Coverage is not mandated but may include supplemental coverage of home blood pressure monitors or additional support programs for enrollees.⁴³

Medicaid

• Coverage varies by state.
• States offering Medicaid expansion plans: Medicaid plans that are offered for non-elderly individuals with annual incomes at or below 133 percent of the federal poverty level—or opting to cover recommended preventive services without cost-sharing in their standard Medicaid benefit package— may cover home blood pressure monitors as per the United States Preventive Services Task Force (USPSTF) recommendation.⁴⁴
• Select state Medicaid agencies cover SMBP as part of their experimental, pilot, or demonstration projects^45,46,47

Commercial

• Non-grandfathered private insurance plans may cover home blood pressure monitors as per the USPSTF recommendation.⁴⁸
• Decision to cover home blood pressure monitors and additional support is made by individual private health insurance plans.

  Some private insurance plans provide these benefits only for beneficiaries enrolled in disease-management programs for high blood pressure or other medical conditions that increase the risk for heart disease and stroke.⁴⁹