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.
Key 3 things to know
You'll find blood pressure monitors in a comprehensive extras policy.
The amount you receive is either a cost limit or a percentage of total cost.
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.
|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.
Hospital policies that provide cover for blood pressure monitors
|Provider||Policy||Benefit||Limit||Price per month||Apply|
|top hospital gold||1 of each appliance per person every 3 continuous financial years||$100||$168.90||Go to Site|
*Quotes are based on a single male living in Sydney, NSW.
Extra policies that provide cover for blood pressure monitors
|Provider||Policy||Limit||Price per month||Apply|
|Go to Site|
*Quotes are based on a single male living in Sydney, NSW.
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.
Does the claim have any requirements?
Yes. All health funds require the following three conditions:
- The devices must be purchased in Australia.
- Items can only be purchased from an approved and recognised provider.
- 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.
Speak to a health insurance advisor
What you'll get:
- 100% free expert advice
- Pay the same as going direct
- Instant advice if you call 1300 594 882