Which Insurance Is Best for Medical Alert Sy...
While aging in place may be ideal for many older adults, home modifications or specific devices like medical alert systems may be needed to help you live a safer day-to-day life. Medical alert systems are in-home units or on-the-go wearable devices that allow you to call for help in the event of an emergency. While used primarily by older adults, medical alert systems are beneficial for people of all ages with decreased mobility as well as for those who may need to get in touch with emergency support quickly for any reason.
Medical alert systems usually have an up-front cost plus a monthly monitoring fee. There can be many factors that play a role in the cost of a medical alert system, but on average, you can expect to pay somewhere between $20–$60 a month. While certain medical alert systems allow you to rent the equipment on a monthly or yearly basis, others require that you purchase all of the equipment initially, which can cost upwards of $200. This can be a substantial sum for older adults who may be on a fixed income. In fact, in an AgingInPlace.org Survey of 1,000 respondents, improving the price of medical alert systems ranked just behind improving battery life as a matter of importance to our respondents.
While most health insurance policies don’t provide coverage for medical alert systems, there are other options for payment assistance. Below, we’ve provided a breakdown of which type of insurance is most likely to provide such coverage.
Long-term care insurance is designed to meet the needs of people, especially older adults, who need ongoing or long-term medical or daily life skill services and support, potentially including medical alert systems. Long-term care policies reimburse policy holders a pre-set daily amount for care services. You choose the type of care covered and your level of benefits when you select your policy. The cost of your long-term care policy is determined by:
Not everyone is eligible for long-term care insurance. Eligibility is determined on a case-by-case basis by the insurer. Those in good health are generally offered policies, but those who have a chronic illness or disability, or are already receiving care for daily living skills, may not qualify for certain policies. While the terms of policies vary greatly, long-term care insurance is the most likely of all types of insurance to cover medical alert systems.
Medicare Advantage (Part C) is insurance you buy from private insurers. As Mary Marshall, a medicare insurance specialist, explained, “It covers everything that Original Medicare does, plus some extras. You choose those extras based on your needs.” Many Medicare Part C plans will cover some or all of the cost of medical alert systems. You may have to use certain pre-approved systems or buy them from specific providers, which would be detailed in your policy.
For example, Aetna’s Medicare Advantage members have access to the LifeStation discount program, which provides a medical alert system with 24/7 monitoring for about $20–30 per month. Also, Cigna-Health Spring plans provide discounts on several medical alert systems. Which systems are covered depends on your location and specific plan. Eligible Humana Medicare Advantage customers can receive the Philips Lifeline medical alert system and monthly monitoring for free. The Program of All-Inclusive Care for the Elderly is another option for people who are eligible for Medicare (and Medicaid), with the cost of a medical alert system typically included in this benefit. Contact your Medicare Advantage provider to find out if medical alert system options are included with your plan
Unlike Medicare, which is funded solely by the federal government, Medicaid is funded by the federal government and the state in which you reside. There are some mandatory coverage groups including low-income families, pregnant women, children, and people receiving Supplemental Security Income (SSI). Some states choose to cover additional groups, and every state has their own list of covered benefits. Most states, such as New York, will cover the cost of medical alert systems if your doctor prescribes one for your use. California offers a Medi-Cal Waiver which can be used to pay for home modifications, including medical alert systems. You may search Medicaid’s website in order to get information about eligibility and benefits in your particular state. Medicaid refers to medical alert systems as Personal Emergency Response Services (PERS). Check with your local Medicaid office to find out if you have coverage for a medical alert system and, if so, which ones. Also, check to see if the system will be rented, requiring you to return it, or if you will own it outright.
Private health insurance coverage for medical alert systems varies from plan to plan. While rarely covered, you can still ask your specific insurance company about this type of coverage. Most private health insurance companies provide this type of coverage through Medicare Advantage plans rather than through standard health insurance plans. In some instances, your state of residence may play a role. David Singer, a health insurance agent in Denver, reported that he’s not aware of any private health insurance companies that cover medical alert systems. “Medicare Advantage would be your best bet when trying to get this type of coverage.”
Original Medicare is a federally funded program. It consists of Part A and Part B. Part A covers inpatient services, such as those you get in a hospital or skilled nursing care facility. Part B covers outpatient services, including durable medical equipment (DME) for home use. Medical alert systems are not considered DME, so Original Medicare won’t cover them. Part D is Medicare prescription drug coverage, which also does not cover the cost of medical alert systems.
If you have Original Medicare, Medigap covers the “gaps” in your out-of-pocket costs for copays and coinsurance. Medigap works in conjunction with Original Medicare but doesn’t pay for equipment or services that Original Medicare won’t cover (with a few exceptions, based on your plan). Since they’re not covered under Original Medicare, Medigap won’t cover any of the cost of a medical alert system.
Military veterans can get free medical alert systems through their local VA branch. The VA partners with two companies that provide this service: MedEquip Alert and LiveLife Personal Mobile Alarms. The MedEquip Alert system connects to a 24-hour monitoring center with a two-way speaker so that you can speak to an operator in order to ask for help. The LiveLife system, on the other hand, is not monitored but will contact a list of loved ones and/or 911 when you press the ‘help’ button or if it detects that you have fallen. So if you have a condition that may cause falls or loss of consciousness, the LiveLife with automatic fall detection may be your best choice.
“When considering this option in light of these medical issues, be sure that your type of fall is likely to be detected by the alert,” said Christopher Norman, a board-certified geriatric nurse practitioner and holistic nurse. “A fall from a standing height—say you’re walking, get dizzy, and your legs ‘give out,’—is likely to be detected automatically because there is sufficient velocity for the accelerometer in the alert to be detected.” Norman added that if someone is sitting and loses consciousness, it may not be detected because it’s a lower velocity fall. “So when considering an alert for medical condition reasons, talk to your health care provider about these concerns and make this decision together,” he said.
If talking to an emergency operator is important to you, MedEquip Alert may be a better option. Either way, in order to get a VA-funded medical alert system, you’ll have to work with a VA-approved physician, social worker, or occupational therapist who will certify your need for the system.
If you’re a veteran interested in more features than the above-mentioned systems offer, you may be able to find a discount from other medical alert companies. These discounts are often not mentioned on their websites but will be quoted over the phone if you call them directly to inquire.
Some medical alert companies will provide discounts to AARP members. Just like with veteran discounts, it generally takes a phone call to ask. Finally, the Administration on Aging is tasked with promoting the Older Americans Act, which promotes the well-being of older individuals by providing services and programs designed to help them live independently in their homes and communities. Services vary by location, but it’s worth checking on as a final potential resource for assistance with paying for a medical alert system.
Medical alert systems can provide peace of mind to older adults and their loved ones, especially for those living alone. Unfortunately, insurance coverage for medical alert systems is not guaranteed. Some insurers provide coverage for these devices, but others do not. Always check with your plan to be sure. Original Medicare doesn’t cover medical alert system costs, but many Medicare Advantage plans do. Long-term care insurance is most likely to offer this type of coverage. “As talking with insurance companies can sometimes be cumbersome, another option is contacting your local Area Agency on Aging,” said Norman. “Some, but not all, of these agencies might have a person or two (often a social worker, sometimes a nurse) that is knowledgeable in what plans might cover what benefits.”
Corey Whelan contributed to this report.
AARP is not an insurance provider so it does not “cover” anything, but many medical alert companies will offer discounts to AARP members. A phone call to the provider is the best way to inquire about this discount.
WRITTEN BY
Lauren Sherman, M.S., is a health content writer with a master's degree in human genetics from the University of Colorado Anschutz Medical Center, laboratory experience at National Jewish Health, and clinical experience at Children’s Hospital Colorado. She has extensively researched products to help those wanting to age in place such as medical alert systems, walk-in tubs, adjustable beds, and oxygen concentrators.
View AuthorMEDICALLY REVIEWED BY
Christopher is a Board-Certified Geriatric Nurse Practitioner and Holistic Nurse. As a Nurse’s Aide, Registered Nurse and now Nurse Practitioner, he has loved working with older people since 2004. He earned his Master’s Degree with Honors at Yale University, completed an Advanced Practice Nurse Fellowship in Geriatrics at New York University, and gained comprehensive experience working with people with dementia (and their families) at Upstate Medical University in Syracuse, NY.
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