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Does Medicare Cover High Blood Pressure?

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High blood pressure is often called “the silent killer” according to the American Heart Association (AHA) because there are usually no obvious symptoms. Many people with high blood pressure don’t know they are affected by the condition. According to AHA, almost half of the adults living in the United States have high blood pressure. Without proper treatment, high blood pressure can lead to life-threatening conditions.

The good news is that Medicare may cover screening, diagnosis, and certain high blood pressure treatments. Here’s what you need to know about Medicare Part A, Part B, and high blood pressure.

How is high blood pressure treated?

According to the National Heart, Lung, and Blood Institute (NHLBI), your doctor may treat your high blood pressure with a combination of prescription medications, and diet and lifestyle changes such as:

  • Eating a low-sodium diet rich in whole grains, fruits, vegetables, and lean protein
  • Participating in regular physical exercise
  • Achieving a healthy weight
  • Reducing your stress levels
  • Quitting smoking

The AHA also recommends reducing your alcohol intake to one drink or fewer per day for women, and two or fewer per day for men.

High blood pressure medications may be prescribed if diet and lifestyle changes alone aren’t enough to keep your blood pressure low. These medications generally fall into four different types, or classes:

  • ACE inhibitors, which keep the blood vessels from narrowing
  • Angiotensin-II receptor blockers (ARBs), which is another class of drug that prevents narrowing blood vessels
  • Calcium channel blockers, which relax the walls of the blood vessels
  • Diuretics, which flush excess fluid and sodium from the body

Your doctor may need to try several different high blood pressure medications and combinations of medications before you find the prescription drug therapy that works best for you.

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.

Original Medicare typically doesn’t cover any medications you take at home for high blood pressure. However, if you have a Medicare Part D Prescription Drug Plan, most high blood pressure medications are covered. You may have an annual deductible and copayment or coinsurance amounts, depending on your plan and the type of medication you take. You can get Medicare Part D prescription drug coverage through a stand-alone plan that goes together with Original Medicare, or a Medicare Advantage plan, that includes your Medicare Part A, Part B, and Part D benefit in one convenient plan.

Do you have any more questions about Medicare coverage of high blood pressure? Feel free to use the eHealth plan finder tool on this page to browse Medicare plan options in your location. Or, if you prefer to get personalized assistance, contact eHealth to speak with a licensed insurance agent. We can help you find Medicare plan options that address your Medicare needs.

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