Key takeaways:
Medicare and private insurers often cover medically necessary cardiac monitoring devices for home use.
You don’t need a prescription for consumer-grade heart monitoring devices, but health insurance doesn’t typically cover them.
Ask your healthcare provider if a cardiac monitoring device could improve your heart health.
Heart monitors record your heart’s electrical activity over time to help your care team diagnose problems with the way your heart beats. Cardiac monitors come in many shapes and sizes, from a big computer screen at the hospital bedside to a sleek smartwatch on your wrist.
Heart monitors designed for home use are particularly helpful: They can track and monitor heart rate and —in some cases —heart rhythm, while a person is going about their day-to-day life.
They are part of what’s known as digital health or digital medicine, software and devices that can help people prevent, treat, or manage their health conditions outside of the doctor’s office.
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Here’s what we know about commercial insurance and Medicare coverage of heart monitors and related digital health for use at home.
How do cardiac monitoring devices improve heart health?
“They aid in the diagnosis and management of arrhythmias, which [is] just a fancy word for saying abnormal heart rhythm,” Dr. David Cho, chair of the American College of Cardiology’s Health Care Innovation Section, told GoodRx Health.
Electrocardiogram (also known as an ECG or EKG) monitoring devices help providers identify people with a heart rhythm problem such as atrial fibrillation.
There are two main groups of cardiac monitoring devices for at-home use: medical-grade and personal at-home monitors.
Medical-grade devices, such as the ZioXT, are FDA approved to diagnose or monitor heart rhythm issues. They must be prescribed by a physician.
Personal at-home monitors, which can include smartwatches and bands, don’t require a doctor’s prescription. They’re not necessarily approved or cleared by the FDA, though.
What kinds of heart monitoring devices can you use at home?
Let’s take a deeper dive into the different types of cardiac monitoring devices available for home use:
Medical-grade at-home devices
Medical-grade devices must be prescribed by a physician to investigate or monitor a heart condition. A medical-grade cardiac monitoring device might be prescribed to investigate palpitations, an irregular heart beat, skipped heart beats, or other heart-related symptoms like breathlessness, dizziness, and falls.
Perhaps the most well-known medical-grade cardiac monitoring device is a Holter monitor. It’s a portable device prescribed by a physician to analyze your heart’s rhythm. You wear a Holter monitor like a shoulder bag, with leads attached to your chest. It can record heart signals for 24 to 48 hours. The recording needs to be reviewed and interpreted by a cardiologist.
Ambulatory monitors — such as “patch” monitors — are a more modern version of a Holter monitor. They are smaller, more compact, and can be worn for weeks at a time. For example, the ZioXT — also called a “Zio Patch” — contains a digital monitor and sensor that attaches with adhesive to your chest. It’s much easier to wear than a traditional Holter monitor.
You can also report any symptoms you feel, like shortness of breath or chest pain, by pressing a button on the monitoring device and recording your symptoms either in a symptom log booklet or via an app that can be downloaded to your cellphone. The device collects data and either transmits it to a healthcare provider in real time or stores it for later download.
Both the Holter monitor and ZioXT are FDA cleared to detect and monitor cardiac arrhythmias in nonhospitalized adults. You need a cardiologist to review and interpret the devices’ results.
Personal at-home devices
Consumer-grade devices come in several categories to consider. But before you spend money on an expensive instrument, check with a healthcare provider to make sure it makes sense for your needs.
AliveCor’s KardiaMobile Card, as small as a credit card, is also FDA cleared for ECG monitoring of six common arrhythmias. This is a device you can get without a prescription. It costs $179, which includes a one-year membership that’s required for use.
Smartwatches
Several brands of smartwatches that can collect data on your heart health have various combinations of functions. But none can tell you if you’re having a serious event such as a heart attack or a stroke.
For example, six leading brands detect heart rate, and about half detect blood oxygen levels. Samsung, Apple, and FitBit products can report atrial fibrillation. A few can detect blood pressure, but it doesn’t appear to mean much yet. For accurately measuring blood pressure, you’re still better served with an automatic arm cuff at home or in the doctor’s office.
Smart scales
Even the humble bathroom scale has gotten a digital makeover for people who want more options besides a weight reading. Some smart scales can track your heart rate, among other features.
You shouldn’t use a smart scale if you have a pacemaker or other implantable device because of the painless electrical currents the scale sends through your feet to collect data. A smart scale won’t provide continuous monitoring of your heart rate when you’re not on it.
What’s the average cost of a cardiac monitoring device?
Out-of-pocket costs vary dramatically for consumer monitoring devices. Cho said he’s seen some devices cost as little as $90, while others can be as expensive as the most up-to-date Apple Watch, which can cost from $400 to $800. There may also be additional costs for subscriptions or add-on services.
For medical-grade equipment that your cardiologist loans you, Medicare or private insurance typically covers the bulk of the costs. But you likely will need to sign an agreement that you will pay for any lost or broken parts upon returning the device to your healthcare provider or the manufacturer. The cost of replacing missing pieces can range from $5 to $25 for a phone case or charger to $1,000 or more for the entire kit.
People who are uninsured or underinsured can sometimes get a price break through manufacturer financial assistance programs such as the one that iRhythm offers for its Zio monitors. Contact the company’s customer care at 1-888-693-2401 for more information.
Will private insurance cover the cost of a cardiac monitoring device?
A healthcare provider needs to prescribe medical-grade cardiac monitoring devices. Major commercial health plans usually cover these FDA-cleared monitors because they are used to diagnose or treat a condition.
Private insurance also typically covers the cost of the doctor’s interpretation of the data. It’s always best to check with your individual insurance plan about your coverage. You may have to pay a deductible, copay, or coinsurance.
Personal cardiac monitoring devices — or devices not prescribed by a physician — are usually not covered by insurance. This is usually because there is not enough evidence that the device is necessary for a patient’s care.
Will Medicare cover cardiac monitoring devices?
It depends. The rules vary based on the kind of monitor it is. If Medicare considers the device to be reasonable and necessary, then it is likely to be covered under Part B, whether you have traditional Medicare or Medicare Advantage. A cardiac monitoring device can be covered if there is a documented medical necessity.
For example, Medicare doesn’t routinely cover blood pressure monitors for home use. But it typically covers Holter and event monitors to detect arrhythmia.
After you meet your Part B deductible ($233 for 2022), you will be responsible for paying 20% of the Medicare-approved amount. The amount you pay can be affected by other insurance you have, the doctor’s fees, and if your doctor accepts Medicare. Your out-of-pocket costs will be much lower if you have supplemental insurance such as Medigap.
Private insurers and Medicare Advantage plans also may help cover the cost of smartwatches and wearable devices such as a Fitbit or Apple Watch as part of their wellness incentives, or as medical monitoring for specific patients. Check with your health plan.
A growing body of research suggests wearables have a role to play in remote monitoring. They’re not typically eligible for reimbursement from a health savings account (HSA) or flexible spending account (FSA), unless you have a letter of medical necessity from your healthcare provider.
Which type of heart monitoring device is best for you?
For medical-grade devices, your provider will recommend the device that’s best for you, depending on your symptoms and health plan.
For consumer-grade devices, it will depend on your age, health conditions, what you are trying to achieve, and, of course, the cost.
“Don't make an impulse purchase,” Cho said. Even though there is a lot of information available about cardiac monitoring, it’s most helpful to talk with a provider about which device is the right fit and how the device can help you.”
Older people, for example, might benefit from the data gleaned by the latest Apple Watch — for atrial fibrillation detection, for example. But if the screen is too small to see, or the technology is too complicated, they may not be able to make use of the data.
“Make sure that you understand what it is you're trying to measure, rather than just saying [the device is] cool,” Cho said. And “make sure that they're at least FDA approved for what they're stating that they're trying to do.”
Remember: With medical-grade devices, your heart activity data will automatically transfer to an expert for interpretation. Personal devices will collect information but typically will not forward your data to your physician. In other words, a personal heart monitoring device is never a substitute for a specialist. So, if you have questions about your heart data, be sure to ask your healthcare team.
The bottom line
Medicare and private insurance typically cover cardiovascular monitoring devices for home use if they’re medically necessary and prescribed by a physician. Personal cardiac monitoring devices, however, are typically not covered.
If you have concerns about your heart, it’s a good idea to speak with a medical professional before investing in a personal cardiac monitoring device. If you do buy one for home use, get an FDA-cleared device, which means its accuracy and reliability for a particular function have been verified. And be aware that all devices have their limits. Make sure you choose one that does what you need it to do.
Why trust our experts?
Written by:
Amy Trent
Amy Trent is a Virginia-based journalist who specializes in translating medical jargon. She has more than 25 years of experience in journalism.
Edited by:
Kristen Gerencher, MSOT
Kristen Gerencher is an award-winning writer who has reported on healthcare, medicine, and insurance for a variety of national publications. Before contributing to GoodRx, she was a healthcare and personal finance reporter for MarketWatch.
Reviewed by:
Sophie Vergnaud, MD
Sophie Vergnaud, MD, is an experienced and dedicated pulmonologist and hospitalist who spent a decade practicing and teaching clinical medicine at academic hospitals throughout London.
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GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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