Does Medicare Pay for Medical Alert Systems?

Fall-related injuries cost Medicare an estimated $67.7 billion in 2020, and with almost 1 in 4 adults aged 65+ reporting a fall during that same year and an aging population, this figure is set to rise. To help reduce injuries, more than 3 million seniors turned to using medical alert systems in 2020. From wearable pendants and wristbands to wall-mounted alarm buttons, these devices are an important safety measure that can save lives in emergency situations.

With seniors paying initial equipment costs and monthly service fees of $20 to $45, medical alert systems aren’t cheap. Many people assume Medicare or other insurance will cover these expenses. Unfortunately, they rarely do.

So, how do older adults afford medical alert systems to help them maintain independence and allow them to age in place? This article explains why Medicare doesn’t cover these important gadgets and discusses how seniors can find help to cover the cost.

How Much Do Medical Alert Systems Cost?

Medical alert system prices vary depending on the type of system and the provider’s pricing structure. Based on 2023 rates, seniors can expect to spend:

• Installation and Activation Fees: One-time charge of $25-$100
• Equipment: Rented with a monthly fee; on-the-go systems range from $50 to $100
• Service Fees: $20-$30 per month for in-home and $29-$45 for on-the-go systems that include 24/7 monitoring and trained personnel who can assist or call 911

In addition to these costs, many providers offer special add-ons for one-off or monthly charges, such as:

• Automatic Fall Detection: $5-$10 per month
• Wall Buttons: One-time fee of $35-$40 or $3-$5 per month
• Personal Help Buttons: One-off fee of $25-$35 or $3 per month

Are Medical Alert Systems Covered by Medicare?

Figures from March 2023 suggest more than 65.7 million American seniors are enrolled in Medicare, paying monthly premiums for Medicare Parts B and C. Older adults not receiving Social Security or RRB benefits also pay for Part A. Coverage includes:

• Medicare Part A: Inpatient hospital care, nursing home services and home health care
• Medicare Part B: Preventative and medically necessary services, such as X-rays, blood tests, prescription medications, doctors’ visits and some medically essential equipment
• Medicare Part C/Medicare Advantage: Additional services including dental, vision, hearing and wellness programs
• Medicare Part D: Prescription drugs
• Supplemental Insurance/Medigap: Help pay out-of-pocket expenses

With these costs in mind, many seniors wonder if Medicare can help.

 Why Doesn’t Medicare Cover Medical Alert Systems?

Unfortunately, Medicare doesn’t specifically cover medical alert systems, as they’re considered optional devices rather than essential. However, coverage may be available via Medicare Part C, but seniors typically have to prove a medical alert system is necessary for their health.

While Medicare’s stance is clear, what about Medicaid?

Does Medicaid Pay for Medical Alert Systems?

Medicaid plans don’t typically cover medical alert systems. However, low-income seniors may find assistance through Medicaid waivers that cover medical devices, such as Home and Community Based Services or Money Follows the Person programs. The latter is available in most states and provides medically necessary devices that help adults transition back to their homes after a nursing home stay.

Medicaid programs, including waivers, vary by state, so seniors should contact their local Medicaid provider for information.

Does the VA Pay for Medical Alert Systems?

Military veterans and their spouses may qualify for assistance paying for medical alert systems through VA health care benefits and insurance programs, such as TRICARE. Many manufacturers offer discounts to veterans, so seniors should check with providers for current offers.

Beyond governmental support such as the VA, individual insurance policies might offer some help.

How To Find Out If Your Insurance Covers Medical Alert Systems

Although rare, some insurance plans do cover medical alert systems. Policies vary, so seniors should visit the “Covered Benefits” section of their insurance provider’s website or call the company to check for coverage.

Other Ways To Pay For or Save Money on Medical Alert Systems

There are several programs and special offers that can help seniors save money and pay less for medical alert systems. Options to consider include:

• Health Savings Account (HSA): HSAs let seniors save tax-free money and use it for certain medical expenses. Many medical alert systems are covered under “medical information plans,” as they maintain a digitized account of a customer’s important health data.
• Manufacturer Discounts: Many medical alert system suppliers offer deals to new customers when they commit to a contract. Offers may include discounts on advance payments, free installation or a free device.
• Sales and Special Offers: Medical alert system providers typically offer discounted rates and holiday specials throughout the year. Monitor provider websites for special offers around the Fourth of July, Memorial Day, Christmas, Thanksgiving and other holidays.
• Area Agency on Aging (AAA) Resources: Local AAA organizations can help seniors connect with community resources and programs that assist with paying for medical alert systems. They also operate senior centers that often provide grants to help cover the cost of these devices.
• Local Emergency Services Programs: Many states operate programs through their emergency services that support residents and seniors living alone. Grants for safety monitoring systems may also be available, so seniors should inquire with their local sheriff’s office.

Are Medical Alert Systems Worth The Price?

With monthly fees and setup charges, medical alert systems may seem expensive. However, they’re an important safety measure, providing seniors and their families with confidence that help is always nearby. Devices featuring automatic fall detection and built-in GPS tracking allow emergency services to locate a subscriber and provide essential medical care.

Considering the medical costs associated with the consequences of an untreated fall or delayed care, a medical alert system is a small price to pay.