Are Medical Alert Systems Covered by Insurance in 2024?

• Medical alert systems allow you to get emergency help with the push of a button in the event of a fall or other incident.
• These devices usually include the equipment fee, monthly subscription fees and additional costs, such as installation and activation fees.
• Original Medicare doesn’t pay for medical alert systems, but Medicare Advantage, Medicaid and long-term care insurance may help cover the costs.
• The Department of Veterans Affairs, AARP and other organizations offer discounts on medical alert systems from approved providers. Some may also cover the cost in full.
• Many companies offer free shipping, discounts or special deals for veterans and other groups.

Each year, more than three million older adults end up in the emergency room with fall injuries, according to the Centers for Disease Control and Prevention (CDC). About one out of five falls result in head injuries, hip fractures or even death. Recent research estimates that up to 50% of those over the age of 65 who fracture their hip will die within six months.

As you would expect, the risk of falls and other traumatic events is higher among older adults who live alone. Imagine suffering a stroke and having no one around to call 911. While you may not be able to prevent such events, you can protect yourself by using a medical alert system to call for help.

These devices can be a good choice for those with mobility issues, chronic diseases, poor vision and other physical limitations. With the press of a button, you’ll be connected with a trusted caregiver, monitoring center or emergency responders, ensuring you’ll get the help you need when you need it. A medical alert system could save your life in the event of a fall, stroke or other emergency.

The problem is that such devices often come with a high price tag. Depending on the brand, you may have to pay an equipment fee, an activation fee and monthly subscription fees. The costs can add up quickly and are often out of reach for many of the people who would most benefit from them.

On the positive side, it’s possible to cut these costs, or at least bring them down. Medicaid, Medicare Part C and other insurance policies may cover your medical alert system in part or in full, depending on the state you live in and the level of coverage you have.

Are medical alert systems covered by insurance? The answer depends on a number of factors, such as your state of residence and the plan you’re enrolled in. The level of coverage will also vary from one insurer to another, even within the same state.

“Most [private] insurance providers don’t cover medical alert systems, and for those that do, the coverage varies,” explained Anthony Martin, founder and CEO of Choice Mutual Insurance. “Some may cover 100% of the cost, but others will only cover a portion. You can check with your insurance provider to see if they offer a discount or have certain criteria you have to meet to qualify for full coverage.”

A medical alert system, or personal emergency response system (PERS), can cost as little as $20 per month to purchase, but you may have to pay extra fees such as activation or equipment fees.

With a monitored medical alert system, you’ll be connected to a call center in the event of an emergency. So, if you fall or suffer a heart attack and press the help button, you’ll be connected with a live agent who will address the situation and get help to you as quickly as possible.

Some devices have fall detection sensors that automatically send alarm messages to a monitoring center if you lose your balance and fall, whether you push the button or not. For example, Lifeline uses AutoAlert, a technology that claims to detect 95% of falls and differentiate between true and false alarms.

Monitored medical alert systems require a monthly fee. The device itself isn’t expensive, but you’ll pay anywhere between $10–$30 for a monthly subscription.

Alternatively, you can opt for an unmonitored system, which isn’t tied to a call center and hence doesn’t require a subscription. With this option, you’ll be automatically connected to 911 or to a caregiver of your choice when you press the help button.

Unmonitored medical alert systems start at around $20 for a basic device and can go up to $300 or higher, depending on the features. The most basic devices will sound an alarm or send a message to a caregiver when the button is pressed, while the more advanced systems can include daily tracking and two-way communication with caregivers and 911. But our Health Products Review Team recommends monitored medical alert systems over unmonitored ones, since you may not always need 911 assistance, or your emergency contacts may miss the alert.

According to the Administration for Community Living, long-term care insurance offers more coverage options than traditional health insurance plans. These policies usually pay for assistance with daily activities, nursing home care, in-home care and other services designed to meet the needs of older adults and those with chronic health conditions. But again, the level of coverage may vary from one insurance provider to the next.

As the name suggests, this type of insurance covers long-term care. However, there may be limitations in terms of how much it’ll pay for specific services and for how long. For example, it may cover in-home care, but only up to a certain amount of time.

Insurers may also limit what services or health conditions they will cover; they may or may not pay for a medical alert system. But since these devices are considered medical equipment, there’s a good chance that your long-term care insurance provider will cover some or all of the costs.

If you are not yet covered by a long-term care policy and are looking for coverage, the best thing you can do is to call several insurance companies that offer long-term care insurance and inquire about the level of coverage they offer.

Whether you have a current policy or are looking for one, consider asking the following questions when talking to an insurance agent:

• Are they going to cover the monthly fees, the equipment costs, or both? What about the installation or activation fees?
• Will they cover any brand or type of medical alert system, or do they partner with specific companies?
• Do you need a medical alert system prescription or other documents from your doctor to qualify for reimbursement?
• Are there any other requirements you should be aware of?

If your policy doesn’t cover these devices, there are other options available.

Medicare, generally speaking, does not cover medical alert systems.

Medicare, the national health insurance program in the United States, is aimed at elderly adults over the age of 65 and people who become disabled before 65. It also covers individuals with permanent kidney failure, regardless of their age, according to the Centers for Medicare and Medicaid Services.

Unlike traditional health insurance, Medicare doesn’t provide coverage for families, only individuals. It has four parts, each covering different services: Medicare Part A, Medicare Part B, Medicare Part C and Medicare Part D.

U.S. citizens who apply for retirement or disability benefits are automatically enrolled in Medicare Part A, also referred to as Original Medicare. Others have to sign up for it, such as people who are over the age of 65 but have not yet retired.

Part B is an optional coverage plan that provides more services than Part A but requires a monthly premium. Medicare Advantage, or Part C, as well as Medicare Supplement Insurance, or Medigap, are available through private insurers. The same goes for Medicare Part D, which covers the cost of prescription drugs. Medicare Part C may pay for medical alert systems, but only under certain conditions.

So, if you’re wondering, “Does Medicare pay for medical alert systems?” the answer, generally speaking, is no.

“Medicare, unfortunately, does not cover these devices, though some parts of Medicare partner with private insurance providers to cover the cost of medical alert systems with a doctor’s recommendation,” said David Lewis, a life insurance agent and founder of Monegenix.

With that in mind, let’s take a closer look at Medicare coverage for medical alert systems.

Medicare Part A

Medicare provides coverage for almost 64 million elderly adults in the United States. But even so, navigating the system can be tricky, especially if you’re new to it.

Let’s start with Medicare Part A, or hospital insurance. This type of health insurance policy covers inpatient care in most hospitals, hospices and skilled nursing facilities.

The policy may also pay for certain home care services, such as physical therapy and part-time skilled nursing care. What’s more, you can get reimbursement for essential medical supplies and durable medical equipment, including but not limited to:

• Oxygen machine or cylinders
• Crutches, canes and walkers
• Blood sugar monitors
• Nebulizers
• Wheelchairs and mobility scooters
• Hospital beds

This category does not include medical alert systems, unfortunately.

Medicare Part B

Medicare Part B, or medical insurance, covers preventive services, such as colorectal cancer screenings and flu shots, as well as medically necessary products and services. With this option, you’ll also get coverage for walkers, mobility scooters and other durable medical equipment.

Neither Medicare Part A nor Part B will pay for medical alert systems. These devices are not considered necessary from a medical standpoint, despite the fact that they save lives and reduce the health burden associated with falls and fractures.

Medicare Part D only pays for prescription drugs, so it won’t cover the cost of a medical alert system or other alert devices.

Medicare Part C 

Medicare Advantage, or Part C, covers all of the services and medical supplies covered by Part A and Part B. Depending on the insurance plan you’re enrolled in, you may also get coverage for:

• Reading glasses
• Hearing aids
• Prescription and over-the-counter drugs
• Dental checkups
• Mental health services
• Gym memberships
• Emergency medical assistance when traveling abroad

The types and levels of coverage can vary from one insurer to another, and some will pay for medical alert systems while others won’t. The number of plans covering these devices increased from 1.2% to 14.5% between 2017 and 2019, and these figures are expected to rise over the next few years.

Cigna, Anthem, Humana, Blue Cross Blue Shield and other insurance companies offer Medicare Advantage plans. Reach out to them and ask what services are covered and under what conditions. With some research, you may find an insurance provider that is willing to pay for a medical alert system.

The answer is: It depends on where you live, among other factors.

Pregnant women, children, older adults and other individuals with low income may qualify for Medicaid, a public health insurance program that covers almost 25% of Americans. With this option, you may be eligible to get reimbursed for medical services and supplies that are not covered by Medicare Part A and Part B.

Each state oversees its own Medicaid eligibility requirements and benefits. Let’s see a few examples of services that are generally covered by Medicaid:

• Vision and dental
• Home health services
• Podiatry
• Prescription drugs
• Nursing home care
• Family planning
• Physical therapy
• Dentures

The services covered by Medicaid vary from state to state. All states are required to offer specific benefits, such as inpatient hospital care, but other services — including coverage for prescription drugs, physical therapy and prosthetics — are optional and may or may not be available in your area.

Each state has specific Home- and Community-Based Services programs that may offer waivers for medical alert systems. Some programs will cover equipment fees but not the monthly subscription fees, whereas others may give an allowance each month to cover the fees.

For example, Kansas residents can apply for the Frail Elderly Waiver, which covers personal emergency response systems. To qualify, it’s necessary to prove that you are alone most of the time and have no regular caregiver. Applicants must also demonstrate that they would require “extensive routine supervision” in the absence of a medical alert system.

Note that you must rent, not buy, the unit in order to get reimbursed. What’s more, you’ll have to pay out-of-pocket for equipment maintenance and repairs. If you decide to buy a medical alert system instead of renting, the program won’t cover its cost.

Other states may cover the cost of purchasing a medical alert system, but you’ll also need to check with the medical alert company to confirm that it accepts Medicaid payments. Alert1, for instance, does not accept Medicaid.

While Medicaid and Medicare Part C may cover PERS devices, older adults with long-term care insurance have the highest chances of getting reimbursed. However, there are several other options you may want to consider.

For example, the Department of Veterans Affairs (VA) provides certain types and brands of medical alert systems from approved sellers, such as MedEquip and Latitude USA.

To qualify, you must be a veteran and have a VA-approved physician, occupational therapist or social worker certify that you need the device. The VA may not pay for wall-mounted call buttons and other extra features, or cover your monthly subscription fees, but you’ll still save a good chunk of money.

That said, let’s see other programs that may cover medical alert systems.

AARP

When you are a member of AARP, you may apply for discounts on various products and services, including PERS devices. Currently, AARP offers a 15% discount on Lifeline medical alert systems.

This deal applies to the monthly subscription fees charged by Lifeline, and you won’t pay anything upfront. If you already use a Lifeline device, you can still apply for the 15% discount. Simply log in to your customer account and update your billing information. You may also call 855-681-5351 to discuss your options with a Lifeline sales agent.

Note that AARP updates its offers every few months. For example, it recently offered a $60 discount on the annual fee for Lively medical alert systems. This campaign isn’t available anymore, but you might find new deals in the future.

Area Agencies on Aging

Area Agencies on Aging are public or private nonprofit agencies that serve local or regional areas across the United States. Made up of loose local networks and overseen at the federal level by USAging, Area Agencies on Aging are committed to helping elderly adults and other groups enjoy better health and maintain their independence. Members have access to special discounts, educational resources, counseling services and other perks.

Area Agencies on Aging exist across the country, and their services vary from one location to another. Some Area Agencies on Aging may have the resources to fully cover the cost of a medical alert system or offer substantial discounts. Visit the Eldercare Locator to find your local Area Agencies on Aging office and reach out to see if they can help.

Government Employees Health Association (GEHA)

GEHA is a nonprofit organization that supports federal employees. Its members receive medical and dental benefits, gym membership discounts, vision coverage, rewards for healthy living and more.

As a GEHA member, you can get a 10% discount on your monthly subscription fees for Life Alert emergency response systems. Plus, your device will be activated for free. To find out more, contact a GEHA representative at 800-640-0518.

If none of these options are available to you, contact the companies you’re interested in and ask about their current offers. Some deals and promotions are not advertised online, but you can call the company and talk to a sales agent to discuss your options.

While there are few medical alert systems covered by insurance, Medicare or Medicaid, you can still keep the costs down. But first, take some time to research your options in terms of pricing.

The average price of a medical alert system is around $20–$45 per month, according to the National Council on Aging (NCOA). However, these figures don’t include additional fees, such as activation or equipment fees. Also, some devices have add-on features that are available for an extra fee.

For example, One Call Alert offers six types of PERS devices with monthly rates starting at $22.95. The most affordable one is pretty basic and doesn’t include things like a mobile GPS unit, medication reminders or fall detection buttons. A more expensive device will have these features — and others — but you’ll pay at least $36.95 per month.

Generally, the device itself will cost anywhere between $50–$350, depending on the brand, as reported by NCOA. If you choose to rent a medical alert device instead of buying it, you’ll only pay the monthly subscription fee and generally won’t be charged an equipment fee.

As far as the subscription fees go, some companies offer discounts on annual membership plans. If you rent a medical alert system, you might end up paying higher monthly fees than if you had purchased it.

Other factors that may influence the price include:

• Connectivity options (e.g., landline vs. cellular connection)
• The type of device (e.g., monitored vs. unmonitored medical alert systems, at-home vs. on-the-go systems)
• Add-ons (e.g., wall-mounted home buttons, wrist buttons, medical alert necklaces)
• Automatic fall detection
• Access to mobile apps
• Extended warranty
• Additional services included in the subscription plan (e.g., telehealth, medication reminders)
• Replacement equipment fees (for rental devices)
• Shipping fees
• Cancellation fees (if applicable)

Some companies also charge additional setup fees to install and activate your medical alert system. If you install and activate it yourself, you won’t have to pay any setup fees.

When it comes to medical alert system pricing, there’s quite a range. This depends on the type of device (base station, on-the-go necklace or smartwatch), if the device offers technologically advanced features (for example, GPS tracking, which is mostly offered in the more expensive smartwatch and pendant style systems) and whether fall detection is included (if it is, it might be at an additional monthly cost to you).

There are three affordable medical alert system options we recommend that have a starting monthly cost under $30. First, we like MobileHelp as the cheapest option at $19.95 per month. Next, we recommend Bay Alarm Medical, which costs $24.95 per month, has a quick response time and a 24-hour call center based in the U.S. Finally, Medical Guardian is one of our top picks thanks to its quick response time and around-the-clock call center, the long battery life on its mobile devices, and a monthly cost of $29.95.

Depending on your particular situation, you may be able to get a free or discounted medical alert system.

First, look into manufacturer’s discounts. A lot of companies offer free shipping or other discounts throughout the year. You can also call them directly to see if they’re willing to give any discounts for bundled systems or waive certain fees for new customers, veterans and other groups.

Another option is to sign up for a yearly plan rather than a monthly payment plan. As discussed earlier, many medical alert providers will offer discounts on annual subscriptions.

Older adults may also reach out to local senior centers and ask for guidance or recommendations. If you’re affiliated with any organizations or industry groups, let them know about your needs. With some luck, you may be able to get a better rate through them.

Anthony Martin, founder and CEO of Choice Mutual, recommends checking nonprofit organizations in your area. “You may find one that provides assistance to seniors, so you can get a free medical alert system or buy one for a significantly discounted price,” said Martin.

Some state sponsored agencies also have programs and partnerships that may allow you to get a medical alert system for free or at discounted rates.

For example, Alabama residents may apply for the Elderly and Disabled Waiver, which covers medical supplies, meal delivery services, companion services and more.

If you live in Georgia, consider applying for the Community Care Services Program Waiver. Those who qualify may benefit from medical management services, skilled nursing care, home care and other community-based services designed to help them live independently. The program may cover PERS devices if they are considered a medical necessity.

Similar programs are available to older adults based in Kansas, Illinois, Florida, Maine and other states.

Also, note that Michigan residents with auto no-fault insurance may qualify for a free medical alert system as part of their home care in the event of a car accident. To confirm coverage, Medical Care Alert and other companies that participate will require your claim number, a copy of your insurance policy and other documents, such as authorization from your primary care provider, before sending you the device.

It’s not easy to find medical alert systems that are covered by insurance. Original Medicare, which includes Part A and Part B, won’t pay for these devices despite their potential to save lives. However, you may be able to get coverage through Medicare Advantage, Medicaid, long-term care insurance or private health insurance. Plus, there are a number of other programs that may help to cover the cost of a medical alert system.

Depending on your financial circumstances and state of residency, you may be able to get a medical alert system for less. For example, you or your loved one may qualify for discounts through the VA, AAA, AARP or other organizations. Alternatively, you can purchase a basic system from discount retailers and upgrade later on.

Take the time to research the different types of medical alert systems available. While it’s nice to have add-ons like a medical alert necklace and wall-mounted buttons, you may not need these features, in which case it wouldn’t make sense to pay for them. A basic PERS device or tabletop medical alert system is still better than none at all, and it would give you some peace of mind.

Sources:

• Centers for Disease Control and Prevention, Facts About Falls
• Acta Ortopédica Mexicana (2014), Hip fracture as risk factor for mortality in patients over 65 years of age. Case-control study
• Administration for Community Living, What Is Long-term Care Insurance?
• Centers for Medicare and Medicaid Services, Medicare Program — General Information
• Medicare.gov, How do I sign up for Medicare?
• Centers for Medicare and Medicaid Services, Statement by HHS Secretary Xavier Becerra, CMS Administrator Chiquita Brooks-LaSure on the 57th Anniversary of Medicare and Medicaid
• Medicare.gov, What Part A covers
• Medicare.gov, Home health services
• Medicare.gov, What Part B covers
• Medicare.gov, Medicare Advantage Plans cover all Medicare services
• Medicaid.gov, August 2022 Medicaid and CHIP Enrollment Data Highlights
• National Council on Aging, How Much Do Medical Alert Systems Cost?