diff --git a/homeassistant/components/medcom_ble/config_flow.py b/homeassistant/components/medcom_ble/config_flow.py
index fc5bab1734b..21951ab221b 100644
--- a/homeassistant/components/medcom_ble/config_flow.py
+++ b/homeassistant/components/medcom_ble/config_flow.py
@@ -93,7 +93,7 @@ class InspectorBLEConfigFlow(ConfigFlow, domain=DOMAIN):
             self._discovery_info = self._discovered_devices[address]
             return await self.async_step_check_connection()
 
-        current_addresses = self._async_current_ids()
+        current_addresses = self._async_current_ids(include_ignore=False)
         for discovery_info in async_discovered_service_info(self.hass):
             address = discovery_info.address
             if address in current_addresses or address in self._discovered_devices:
diff --git a/tests/components/medcom_ble/test_config_flow.py b/tests/components/medcom_ble/test_config_flow.py
index b470245978d..2fdda9af867 100644
--- a/tests/components/medcom_ble/test_config_flow.py
+++ b/tests/components/medcom_ble/test_config_flow.py
@@ -7,6 +7,7 @@ from medcom_ble import MedcomBleDevice
 
 from homeassistant import config_entries
 from homeassistant.components.medcom_ble.const import DOMAIN
+from homeassistant.config_entries import SOURCE_IGNORE
 from homeassistant.const import CONF_ADDRESS
 from homeassistant.core import HomeAssistant
 from homeassistant.data_entry_flow import FlowResultType
@@ -226,3 +227,51 @@ async def test_user_setup_unable_to_connect(hass: HomeAssistant) -> None:
 
     assert result["type"] is FlowResultType.ABORT
     assert result["reason"] == "cannot_connect"
+
+
+async def test_user_setup_replaces_ignored_device(hass: HomeAssistant) -> None:
+    """Test the user initiated form can replace an ignored device."""
+    entry = MockConfigEntry(
+        domain=DOMAIN,
+        unique_id="a0:d9:5a:57:0b:00",
+        source=SOURCE_IGNORE,
+        data={},
+    )
+    entry.add_to_hass(hass)
+
+    with patch(
+        "homeassistant.components.medcom_ble.config_flow.async_discovered_service_info",
+        return_value=[MEDCOM_SERVICE_INFO],
+    ):
+        result = await hass.config_entries.flow.async_init(
+            DOMAIN, context={"source": config_entries.SOURCE_USER}
+        )
+    assert result["type"] is FlowResultType.FORM
+    assert result["step_id"] == "user"
+
+    # Verify the ignored device is in the dropdown
+    assert "a0:d9:5a:57:0b:00" in result["data_schema"].schema[CONF_ADDRESS].container
+
+    with (
+        patch_async_ble_device_from_address(MEDCOM_SERVICE_INFO),
+        patch_medcom_ble(
+            MedcomBleDevice(
+                manufacturer="International Medcom",
+                model="Inspector BLE",
+                model_raw="Inspector-BLE",
+                name="Inspector BLE",
+                identifier="a0d95a570b00",
+            )
+        ),
+        patch(
+            "homeassistant.components.medcom_ble.async_setup_entry",
+            return_value=True,
+        ),
+    ):
+        result2 = await hass.config_entries.flow.async_configure(
+            result["flow_id"], user_input={CONF_ADDRESS: "a0:d9:5a:57:0b:00"}
+        )
+    assert result2["type"] is FlowResultType.CREATE_ENTRY
+    assert result2["title"] == "InspectorBLE-D9A0"
+    assert result2["data"] == {}
+    assert result2["result"].unique_id == "a0:d9:5a:57:0b:00"