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Does Insurance Cover Medical Alert Systems?
Health insurance plans like Medicare Advantage, Medicaid, and some long-term care insurance policies may cover the cost of a medical alert system, including Life Alert or Medical Guardian, but actual coverage depends on the specific company and state.
Updated:
At a glance:
- Original Medicare (Parts A and B) and most private health insurance plans do not cover the cost of a medical alert system, but there are other coverage options available for older adults.
- Medicare Advantage plans, Medicaid, VA Benefits, and some long-term insurance companies may help cover the cost of a medical alert device.
- The average monthly out-of-pocket cost for a medical alert system is $37, with a range of $25 to $50 depending on additional features such as automatic fall detection, GPS tracking, and others.
If you’re a senior or a caregiver assisting a loved one, finding coverage for a wearable or in-home medical alert system can be a challenge. Original Medicare, including both Part A and Part B, doesn’t cover the cost, and private insurances offer no guarantees. However, there are ways you can get the financial assistance you need. From Medicare Advantage plans to state-based Medicaid programs, read on to discover the best funding options.
Why Doesn’t Medicare Cover Medical Alert Systems?
No portion of original Medicare coverage—Medicare Part A, Medicare Part B, or Medigap plans—will pay for medical alert systems because they don’t meet the eligibility requirements. The government-administered program only covers Durable Medical Equipment (DME), but medical alert systems are not included in this category.
Can I Get Coverage Through Medicare Advantage?
Medicare Advantage (Medicare Part C) is a private healthcare plan that might partially cover the cost of your new medical alert device. Plans typically come with deductibles and copays, but often cover medical expenses that original Medicare doesn’t.
However, actual coverage depends on each individual insurance policy. We recommend contacting your Medicare Advantage insurance provider to determine if your plan covers the cost of a medical alert system. You can also find more information on Medicare.gov.
Will Medicaid Cover The Cost of Medical Alert Systems?
Medicaid is a more reliable method for covering the best medical alert systems, also known as Personal Emergency Response Systems (PERS), as referred to by some plans. In fact, there are multiple Medicaid programs that provide full or partial coverage, including:
Home and community-based services (HCBS)
HCBS waivers enable seniors on Medicaid to fund life-saving care in their homes, rather than requiring them to move to a nursing facility. While the level of coverage varies by state, many waivers include medical alert systems, as they help seniors monitor medical conditions. Some plans also offer Consumer-Directed Services (CDS), where you can choose and manage your own medical equipment, including in-home and on-the-go PERS.
Money Follows the Person (MFP)
This Medicaid program specifically supports seniors transitioning back to their homes from assisted living facilities or nursing homes. It provides funding for medically necessary PERS, including in-home and mobile systems.
Medicaid State Plan Personal Care Attendant (PCA) programs
Depending on the state, PCA programs may help cover or allow for the reimbursement of medical alert devices. However, the level of assistance ultimately depends on the state.
The Program of All-Inclusive Care for the Elderly (PACE)
PACE is a joint Medicare and Medicaid program, funded by both, which helps older adults who qualify for nursing homes remain home instead. Having access to two-way communication with a monitoring center makes life easier for seniors living at home, which is why PACE plans often include medical alert systems as part of the safety and monitoring services they provide.
Can I Get My Medical Alert Device Covered Through Veterans’ Benefits?
The Department of Veterans Affairs (VA) often provides additional benefits to senior veterans, including partial or full coverage of the cost of medical alert systems. For example, Veterans Directed Home and Community-Based Services (VD-HCBS) waivers work similarly to Medicaid HCBS waivers, allowing eligible veterans to cover the cost of services they need for in-home care, like access to emergency services through a medical alert device.
Private Insurance Solutions For Medical Alert Devices: Long-Term Care Insurance
While most private insurances don’t cover the cost of a medical alert system, seniors with medical conditions or disabilities may qualify for long-term care plans that do. There are many different types of long-term care insurance with different levels of coverage, including:
- Individual Plans for yourself or a senior family member can be purchased through a licensed agent or broker. Before purchasing, check if the agent you’re working with is certified in your state.
- Employer-Sponsored Plans offer discounted rates to employees, and even if you’re a senior who can’t work, family members may qualify for enrollment. Employer-sponsored programs may also be easier to access because they typically waive medical exams.
- Plans from Membership Organizations, like trade associations or service organizations, might also offer long-term care insurances that cover medical alert devices. For example, the National Association for the Self-Employed helps self-employed people across the United States access funding.
- Joint Policies that cover two people—such as spouses, partners, or relatives—under one plan may also help pay for medical alert systems, as the shared benefits can be used by either insured person.
Are There Other Financing Options For Medical Alert Systems?
Yes, there are other financing options available for various types of medical alert systems, even if you can’t get insurance coverage. We recommend looking into:
- Area Agencies on Aging (AAA) is a local resource that can help you cover the cost of a medical alert system through grants or refer you to beneficial community programs.
- Nonprofits and charities, such as Lions Club or local senior centers, might provide funding or access to donated or discounted medical alert systems.
- Health Savings Accounts (HSA) are tax-advantaged savings accounts that allow you to withdraw pre-tax funds for a medical alert system recommended by your doctor.
- Flexible Spending Accounts (FSA) work similarly to HSAs, with some plans allowing you to cover the cost of a medical alert device.
- Manufacturer Payment Plans are loans with monthly fees provided by medical alert companies, but be sure to choose a low-interest or no-interest plan.
- State Assistive Technology Programs are available in certain states, allowing you to access health and mobility equipment, like PERS.
Medical Guardian
Great variety
Call chain for caregivers
Sleek, stylish wearable devices
ADT Medical Alert
Great plans
Home temperature monitoring
Fixed-rate service
The Bottom Line
Having access to a help button that immediately connects to an emergency call center can be a lifeline for many seniors, but navigating insurance coverage isn’t always easy. To determine whether your insurance covers the cost of a medical alert device, we always recommend contacting your insurance provider directly.
Not able to get coverage? Start researching the programs available in your state, or consider switching to a plan that provides better peace of mind for seniors.
Frequently Asked Questions
Neither original Medicare (Parts A and B) nor most private insurance plans cover the cost of a medical alert system; however, some forms of Medicaid, Veterans Administration programs, and long-term care insurance can help.
No, Medicare does not typically pay for medical alert systems, as they’re not considered Durable Medical Equipment (DME).
Life Alert insurance coverage varies by state and by the individual health insurance program. Medicare Advantage plans and Medicaid are more likely to provide coverage, but this isn’t a guarantee.
Senior veterans can often have their medical alert system partially or fully covered by Veterans Benefits, but qualification ultimately depends on your individual situation.
The best way to cover the cost of a medical alert device without insurance depends on your circumstances. For example, Health Savings Accounts (HSAs) can provide financing, while disabled veterans might qualify for special grants. It’s important to understand your unique situation before you invest.
The out-of-pocket cost of a medical alert device varies depending on whether it’s an in-home landline or a mobile device (such as smartwatches or wristbands). However, the average monthly cost falls between $25 and $50.
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