Does Medicaid Cover Self-Measured Blood Pressure?

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Entrusted Legacy Law

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Mar 03, 2023

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Pennsylvania - Greater Pittsburgh Area

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According to the American Heart Association, high blood pressure contributes to many significant health conditions, including heart attack, heart failure, stroke, and kidney failure. In the United States, 121.5 million adults suffer from high blood pressure, also known as hypertension. 

While half of these individuals have improved their conditions, others have uncontrolled blood pressure, which can harm their health. Self-monitoring one’s blood pressure can help control this condition. Depending on your state, Medicaid may cover part of the cost.

What Is Self-Measured Blood Pressure (SMBP)? 

Medical care is an important part of blood pressure management. Yet, you can also help your doctor treat you by monitoring and recording your symptoms at home. This is called self-measured blood pressure (SMBP). When combined with a doctor’s support, SMBP might improve your health. 

You can use a manual blood pressure cuff or an automated blood pressure device to monitor your BP. With at-home measurements, you can record your blood pressure levels over time. Your doctor can use this information to help treat you. 

The Benefits of Monitoring Blood Pressure at Home

Some evidence suggests that SMBP with clinical support may be more effective than medical care alone. 

  • When you measure your blood pressure at home, you can assess your condition regularly. You don't have to wait for a medical professional to evaluate your BP. If your blood pressure becomes dangerously high, you can inform your doctor and seek emergency treatment. 
  • By keeping track of the fluctuations in your blood pressure at home, you can give your doctor detailed information to help with your treatment. For instance, your doctor can use the information to decide what kind of medication and dosage to prescribe. 
  • Sometimes, blood pressure levels change depending on the situation. SMBP can identify forms of hypertension that present differently. At-home measurements can reveal white-coat hypertension (when a patient’s BP is high at the doctor’s office, but at a healthy level at home) and masked hypertension (when BP readings appear normal in a doctor’s office but are high in other settings, such as at home or work). 

Why Might Medicaid Beneficiaries Need Coverage for SMPB?

Per Medicaid.gov, one-third of all Medicaid beneficiaries have high blood pressure. With uncontrolled hypertension disproportionally affecting low-income, non pregnant adults, SMBP coverage and reimbursement through Medicaid can be beneficial for many.

Does Medicaid Cover Home Blood Pressure Monitoring?

Medicaid covers SMBP in certain states. Yet not all states have coverage. Continue reading for more information.

What Does SMBP Medicaid Coverage Include? 

Depending on your state, Medicaid’s coverage for self-measured blood pressure could include the following: 

  • Provider reimbursement for medical support
  • BP measurement devices for you to use at home (manual blood pressure cuffs or automated blood pressure devices)

In most states with SMBP coverage, Medicaid takes care of medical care as well as devices. Other states cover just one or the other. The American Medical Association outlines what Medicaid provides in each state.

Which States Cover Medical Support and BP Measurement Devices?

The following states provide coverage to some extent for both medical support and devices: 

  • Arizona
  • Colorado
  • Delaware
  • Hawaii
  • Idaho
  • Indiana
  • Michigan
  • Nebraska
  • New Jersey
  • New Mexico
  • North Carolina
  • North Dakota
  • Ohio
  • Oregon
  • Texas
  • Virginia
  • Wisconsin
  • Wyoming

These states only cover durable medical equipment (manual blood pressure cuffs or automated blood pressure devices):

  • Alaska
  • Arkansas
  • California
  • Connecticut
  • D.C.
  • Illinois
  • Iowa
  • Kansas (only covers manual blood pressure cuff)
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Mississippi
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Utah
  • Vermont
  • Washington

The following states reimburse providers for supporting patients with SMBP. However, Medicaid doesn't pay for at-home devices. 

  • Georgia
  • Kentucky
  • Montana
  • Rhode Island

Speak With an Attorney 

If you have high blood pressure, self-measurement might help. Consult with an attorney to learn more about whether you could be eligible for Medicaid coverage in your state.

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