Original Medicare, made up of Part A and Part B, does not cover medical alert systems. However, some Medicare Advantage (Part C) plans may cover the devices.
A medical alert system is a personal emergency response device.
A person wears a small radio transmitter on a wristband or around their neck on a pendant. If the person falls, feels unwell, or experiences other trouble, they can call for help by pressing a button. This connects to a response center that monitors calls 24 hours per day, 7 days per week.
The cost for a medical alert system device varies depending on the system. It may include a one-time activation fee and a monthly charge. If a person wants additional features beyond the basic service, the monthly fee may increase.
This article discusses Medicare coverage of medical alert systems. Then, it examines their costs and how a person can get help paying for them.
Medicare is a federal government health insurance that covers medically necessary services and supplies. Generally referred to as original Medicare, it includes Part A (hospitalization insurance) and Part B (medical insurance).
Because individuals do not need a medical alert system to diagnose or treat an injury or health condition, original Medicare generally does not cover them.
However, Medicare Advantage (Part C) plans may cover the device.
Private insurance companies administer these plans as an alternative to original Medicare, and they generally provide some benefits beyond original Medicare. A person can use this tool to find a Medicare Advantage plan in their area.
If someone receives Medicaid, they can check if the program could help with coverage or costs for a medical alert system For example, Medicaid’s Home and Community Based Services (HBCBS) program may help people who receive long-term care services in their own home rather than in a facility.
This assistance could extend to a medical alert system device.
Costs for a medical alert system vary and may depend on the features a person chooses.
Safe Home reports that the average monthly cost for a medical alert system package ranges from $10.00 to $29.99. A person would need to pay additional equipment costs.
Consumer Reports shows some common costs per item may be:
- Fall detection: The company’s package deal may include this, or it could cost up to $15 per month.
- Mobile GPS tracking: This could cost an extra $19-$50 per month, plus a device fee in some cases.
- In-home landline service: This may have monthly costs ranging $20-$49.
- In-home cellular service: Monthly costs may range from $20-$59.
- Activation fees: These can range from no cost to $95.
Some companies may require a person to sign a contract to use the service for a certain number of months. If someone cancels their contract early, they may have to pay a fee. For this reason, an individual may want to look for a plan without a long-term contract or one with a free trial period.
Because Medicare does not consider medical alert system devices “medically necessary,” it does not cover them. However, a person may look into other options to help with costs:
- If a person has Medicaid, they can check if the program can help with coverage or costs.
- They can check if the medical alert system company offers discounts or rebates.
- If an individual belongs to a membership organization, it may be worth checking to see if that organization offers any discounts.
- A medical alert system may potentially fall into the “tax-deductible” category. A person can check their status with a tax professional.
- An individual might prefer to avoid long-term contracts because of potential early cancellation fees or penalties.
Original Medicare does not cover medical alert systems because it does not typically consider them medically necessary.
Some Medicare Advantage plans may cover the devices, however, so a person may wish to check their plan’s coverage. Medicaid may also help cover costs.
Medical alert systems may increase a person’s safety and independence at home, but the devices may not be suitable for everyone.
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