Does Medicare Cover Costs for Medical Alert Systems?

Medical alert systems allow you to get help if you’re alone and have an emergency or injury. Typically, a button on the device sends a signal to the alert company to let them know you need assistance.

Although these devices can provide peace of mind and help in emergency situations, Medicare doesn’t consider them necessary medical devices. So, Medicare does not usually cover the costs of purchasing or maintaining an alert system.

In this article, we’ll explore parts of Medicare that may offer some coverage for a medical alert system and how to choose one if you’re purchasing it on your own.

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Medical alert systems aren’t listed under Medicare’s covered services or devices. This is likely because medical alert systems are not considered “medically necessary” and do not directly improve a person’s health (like a blood glucose monitor helps you monitor and treat diabetes).

Here’s a review of coverage under different parts of Medicare:

• Medicare Part B covers durable medical equipment, like walkers, wheelchairs, or crutches. Medical alert systems do not qualify as durable medical equipment and so they aren’t covered.
• Medicare Part C, or Medicare Advantage, is a plan provided by private insurance companies. Some plans offer additional benefits and services that traditional Medicare doesn’t. In some plans, this may include medical alert systems. Check with your plan provider to find out if they provide coverage for medical alert systems.
• Medigap, or Medicare supplement insurance, helps offset some of the out-of-pocket costs that come with original Medicare, such as deductibles and copayments. However, because original Medicare doesn’t cover medical alert systems, Medigap doesn’t cover them either.

If you have a Medicare Advantage plan, you may have all or a portion of the costs covered. However, if you have only original Medicare coverage (parts A and B), you will likely need to pay all costs out of pocket. We’ll look at a few other ways to save on medical alert systems next.

Medical alert systems can have several fees, including costs for purchasing the system, an initiation fee, and a monthly fee. Some ways you can get financial help with a medic alert system include:

• Checking if Medicaid will cover costs: If you qualify for Medicaid in your state, some programs may help cover some or all of the costs for a medical alert system.
• Contacting the company for potential discounts: Some medical alert companies will offer discounts based on income or membership in various organizations, or even through a local hospital.
• Checking for tax deductions: Sometimes, you can deduct all or a portion of the expenses related to medical alert systems. Check with a tax preparation professional to see if this applies to your situation.

More cost-saving tips

Medical alert systems can be an extra cost, and healthcare costs are already expensive. Here are some other ways you can save on a medical alert plan or system:

• Avoid long-term contracts: If a situation comes up where you won’t be using the system for a while, such as a long hospital stay, it would be helpful to be able to cancel the plan without penalty. Long-term plans may continue billing you throughout the contract period or charge costly early cancellation fees.
• Look for return plans: Several medical alert plans offer a 30-day trial program. This can help ensure you are able to use the device and that it works well for you before committing to a longer-term contract.
• Call the company directly: Many companies allow customer service representatives to offer discounts or other rebates for additional cost savings.

In most cases, medical alert systems are not covered by health insurance. You can find out if your insurance provider covers medical alert systems under your policy by checking your documents or the company website or calling them to request information.

Long-term care insurance is one option that may cover medical alert systems, at least partially. This type of private insurance is designed to cover ongoing care for older adults or individuals with disabilities. Although the details vary by plan, long-term care insurance typically covers costs associated with in-home care, residential or nursing home care, and medical alert systems.

Since long-term care insurance is designed to cover medical and personal needs, it’s more likely than health insurance to provide medical alert system coverage. But because there may be different coverage levels, it’s important to compare policies and read the fine print to determine whether medical alert systems are included and what you need to pay out of pocket.

Contact your long-term care insurer directly to determine whether your policy covers medical alert systems. It’s helpful to ask them the following questions:

• Do you cover the monthly monitoring fee or just the device?
• Do I need to provide documentation from my doctor to be eligible for coverage?
• Is there a lifetime reimbursement value for a medical alert system?

Medical alert systems may provide peace of mind to you and your family. According to a study from 2017, research indicates that medical alert systems may provide some benefits.

However, there can also be downsides to consider.

Medical alert systems typically consist of three components:

1. a help push button
2. a communication system that is often in the home
3. an emergency response center

Some systems may also offer additional features, including fall detection.

Here is an overview of some of the popular types of systems available today:

In-home assistants

These may include Amazon’s Alexa or Google Home, where you can give a voice command to call a family member. However, many of these or similar devices may not be able to call 911. That said, if you have a Google Nest Aware subscription and have the device’s cameras and sound detection enabled, the 911 feature can connect you with the call center closest to your home. But depending on where in your home you fall, the device may not be able to detect your voice.

Nest Aware subscriptions start at $6 per month, single cameras are listed at $100, and displays at $100.

Mobile or smartphone systems

Smartphones are a portable way for you to contact help in an emergency. The GPS function might also help others locate you. However, for this to serve as an emergency contact system, you would need to have your mobile phone with you at all times. The Jitterbug Smart3 is a special, simplified smartphone with a large screen, minimalistic menu, and voice typing.

There’s also an Urgent Response button that connects you to an agent, or you can speak with a doctor or nurse. The phone itself costs $150, plus a monthly plan that costs $15 or $20.

Smart watches

A “smart” watch has a wireless communication system that allows you to make calls through your cell phone or wireless system. Some smart watches will let you call emergency services directly from your watch. They may also offer GPS tracking and heart rate monitoring.

For example, the MGMove smart watch from Medical Guardian shares real-time location data with your chosen contacts or call center when you press the SOS button. You can also message and chat with your loved ones from the watch. It costs $199, with plans around $40 each month.

Two-way communication systems

Two-way communication systems include a bracelet or necklace with a button you can press to communicate with a call center. The call center will assess what kind of help you need and send help to your home. Some of these systems can be used only in the home because they don’t have GPS tracking.

However, others, like Helpbutton, have both in-home and on-the-go capabilities, thanks to built-in location tracking. The monthly plans for this award-winning monitoring device start at $35.

How do I choose the right system for me?

The amount and types of medical alert systems available can be overwhelming. You can start by considering your actual needs, finances, and any conditions you may have. Other things to consider include:

• Do you want GPS technology? If so, you will need a device that operates on a cellular network. If you don’t leave your home often, you probably won’t need GPS technology.
• How tech-savvy are you? If you aren’t good with gadgets, a push-button medical alert system may be easier and more useful in an emergency.
• Do you want a monitored system? A monitored system requires a monthly fee, but it offers the ability to speak with a live operator if you have a medical concern.
• How much can you afford to spend? If you’re keeping to a strict budget, a medical alert bracelet might be more affordable than more costly devices and systems.

Narrowing these factors down can help you find the right medical alert system for you.

Though medical alert systems can provide assistance, they are not covered under Medicare or any other insurance plans.

However, Medicare Advantage and some long-term care insurance may cover these devices. They’re designed to cover ongoing care for older adults.

Contacting a device company directly to ask about discounts can provide cost savings as well.

Think about your needs and those of your loved ones in order to assess whether a medical alert device is right for you and which one might work best for your situation.