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Health insurance for blood pressure monitors

If you’re diagnosed with high blood pressure (hypertension) or low blood pressure (hypotension), you may be advised to monitor at home.

Blood pressure monitors and other aids can be a costly expense and many health insurers reduce the costs you have to pay.

In Australia if you have private health insurance, the majority of Australian health funds offer support to help pay for equipment. It can be included in extras cover for out of hospital services.

Compare Extras cover with over 30 Australian providers

Key 3 things to know

1
You'll find blood pressure monitors in a comprehensive extras policy.
2
The amount you recieve is either a cost limit or a percentage of total cost.
3
Your equipment must be purchased in Australia by a listed provider.

How do blood pressure monitors work?

Blood pressure monitors are appliances that can be used on your wrist or upper arm at any time. When you use a blood pressure monitor it will give you two numbers: the systolic and diastolic blood pressure.

Systolic blood pressure is the pressure when your heart beats. Diastolic is the pressure between heartbeats. As such, systolic naturally tends to be higher.

Systolic Diastolic Category
Below 120 Below 80 Normal blood pressure
Between 120–139 Between 80–89 Prehypertension
Between 140–159 Between 90–99 Stage 1 hypertension
160 or higher 100 or higher Stage 2 hypertension

Source: Mayo Clinic

Are blood pressure monitors covered by health insurance?

If you regularly need to monitor your blood pressure at home, blood pressure monitors may be covered by your private health insurance.

To have cover for blood pressure monitors, you will generally need to have a comprehensive extras policy. If you’re not sure whether you can currently claim costs back, check your policy to see if you’re covered for “health appliances” and “health monitoring equipment” as you can normally find the details in there.

Your level of cover will affect the costs you can claim back.

How do health insurers calculate the cover for blood pressure monitors?

Home blood pressure monitors range from $39 to over $300. The money you will get back from your health fund is generally calculated in one of three ways:

  • Percentage of cost. This is where the health fund will pay you back a percentage of the monitor cost, up to a certain limit. For example 60% up to a $200 limit in year one.
  • Combined annual maximum. When the health fund includes blood pressure monitors on a list of “Appliances”, the limit is the maximum combined amount you can claim for anything in that grouping.
  • Individual or family allowances. Your calculation can be based on a per person or per family basis. The amount you can claim may look higher on the surface, but it could be a combined figure that applies to all members on your policy.

Terminology to watch out for:

Within the calculations, you’ll sometimes see some of the terms below. Make sure you check any conditions on your policy for the following:

  • Sub-limits. A sub-limit is the maximum benefit payable in a 12-month period.
  • Device limits. Appliances are often subject to additional limitations which are either a maximum claim limit over a period of years or a lifetime limit. These often change over the course of a policy, for example you may be eligible to claim an extra 10% back each year you have the cover.
  • Lease and repair cover. Some policies cover the cost of temporarily leasing a blood pressure monitor or paying for device repairs if your current device is damaged.
  • Reimbursement amount. This is the amount that will be paid out for a blood pressure monitor.
  • Waiting periods. The waiting period is the amount of time you will have to hold your policy before you’re able to make a claim, typically 12 months.

Although blood pressure monitors are generally only covered by comprehensive extras plans, there are some more affordable extras policies available that will also include cover for them.

You can also view side by side how each policy stacks up based on the first year’s limit per person for blood pressure monitors.

Compare Blood Pressure Monitors Coverage with Australian health funds

Fund Policy First year limits per person
ACA Health Benefits Fund
  • N/A
  • N/A
ahm Health Insurance
  • Top hospital level 8
  • $100
Australian Unity Health Limited
  • Gold extras
  • $220
Bupa Australia Pty Ltd
  • Silver extras
  • Gold extras
  • Platinum extras
  • 60% up to $125
  • 75% up to $150
  • 85% up to $200
CBHS Corporate Health Pty Ltd
  • Silver extras
  • Gold extras
  • $300
  • $500
CBHS Health Fund Limited
  • Top extras
  • Intermediate extras
  • $300
  • $350
CDH Benefits Fund
  • N/A
  • N/A
CUA Health Limited
  • Total extras
  • Classic extras
  • N/A
Defence Health Limited
  • Premier extras
  • Value extras
  • $300
  • $250
Doctors' Health Fund
  • N/A
  • N/A
Emergency Services Health
  • Lifelong extras
  • N/A
GMF Health
  • Flexi extras
  • Flexi extras mid
  • Flexi extras plus
  • $800
  • $1,000
  • $1,200
GMHBA Limited
  • N/A
  • N/A
Grand United Corporate Health
  • N/A
  • N/A
HBF Health Limited
  • Flexi extras
  • Flexi extras mid
  • Flexi extras plus
  • $800
  • $1,000
  • $1,200
HCF
  • N/A
  • N/A
Health Care Insurance Limited
  • Premium extras
  • 90% of cost up to $500
Health Partners
  • N/A
  • N/A
health.com.au
  • High extras cover
  • AA
HIF
  • Super options
  • Premium options
  • 75% of the cost (max $200)
Latrobe Health Services
  • N/A
  • N/A
Medibank Private Limited
  • Top extras
  • $150
Mildura Health Fund
  • Five star extras
  • Ancillary plus cover
  • Basic Ancillary
  • $200 (every 36 months)
  • $150 (every 36 months)
  • $150 (every 36 months)
National Health Benefits Australia Pty Ltd (onemedifund)
  • Extras plus
  • $400 (sub-limits apply)
Navy Health Ltd
  • Premium extras
  • Healthy living extras
  • $700
  • $400
NIB Health Funds Ltd.
  • Top extras
  • $500
Nurses & Midwives Health
  • Top extras
  • $1,200 (sub-limits apply)
Peoplecare Health Insurance
  • High extras
  • Premium extras
  • $500
  • $700
Police Health
  • N/A
  • N/A
Queensland Country Health Fund Ltd
  • Top hospital cover
  • N/A
Railway and Transport Health Fund Limited
  • Premium extras
  • Smart extras
  • Value extras
  • $1,600 (combined limit)
  • $1,200 (combined limit)
  • $300 (combined limit)
Reserve Bank Health Society Ltd
  • N/A
  • N/A
St.Lukes Health
  • N/A
  • N/A
Teachers Health Fund
  • Top extras
  • $1,200 (sub-limits apply)
Transport Health Pty Ltd
  • N/A
  • N/A
TUH
  • Comprehensive extras
  • Family extras
  • $550
  • $400 combined limit
Westfund Limited
  • Platinum extras
  • Gold extras
  • Sub limit: $150 for both

Does the claim have any requirements?

Yes. All health funds require the following three conditions:

  1. The devices must be purchased in Australia.
  2. Items can only be purchased from an approved and recognised provider.
  3. You can only claim for these items where the cost is not claimable from another source.

What's the process for making a claim?

The procedures for claiming health appliances in particular can be a bit different from claiming for normal extras. Some of the additional conditions may include:

  • You might need to obtain a doctor’s referral or recommendation before you can claim health appliances under your policy.
  • You may need to send in a claims form instead of being able to swipe your health extras membership card.
  • Sometimes benefits will only be payable for certain makes and models of health appliance, for example the Health Partners plan does not include wrist blood pressure units, or units with AC adaptors.

Are other aids and medication included in policies?

Some plans offer aids as part of a combined policy. These are often referred to as appliances and can include:

  • Insulin delivery pens
  • TENS machine nebuliser
  • Glucose monitors
  • Asthma pumps
  • International Normalized Ratio (INR)
  • Blood testing devices (eg Coaguchek)
  • Compression garments
  • Surgical stockings
  • Continuous Positive Airway Pressure (CPAP)
  • Bilevel Positive Airway Pressure (BPAP) devices
  • Hearing Aids

For blood pressure medication, your first stop should be to check if it's covered as part of the Pharmaceutical Benefits Scheme (PBS) – this is a list of prescribed medications, subsidised by the Australian Federal Government.

If your prescribed medicine is not on the list you may be entitled to claim within your private health insurance limits – but your medication will still need to be on an approved lists where the cost is more than $38.40 and is listed on the Australian Register of Therapeutic Goods.

Compare policies from 30+ Australian health funds

Take a side by side look at the cover included in over 600 policies in just a few clicks below. For aids and appliances such as blood pressure monitors, you’ll find these in an extras policy.

Compare policies

Andrew Munro

Andrew writes for finder.com, comparing products, writing guides and looking for new ways to help people make smart decisions. He's a fan of insurance, business news and cryptocurrency.

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