Falls are the leading cause of injury for adults over the age of 65 — and even if falls aren’t an issue, some health conditions, like a stroke, could keep you from being able to use the phone. Or you may want a wearable medical alert device that tracks you outside of the home so family members can locate you if you fall or need help. For these reasons and more, you may feel more comfortable and independent with a medical alert system.
Also known as personal emergency response systems (PERS), these products provide 24/7 help in case of an emergency. They’re typically wearable devices like bracelets or necklaces that connect you to emergency services with the push of a button.
But this peace of mind isn’t free. Most of these systems have various activation, equipment, programming, and shipping fees that can add up to well over $100. The monthly charges typically range from about $25 to $50, depending on whether the system links you to a call center or to 911.
If you’re wondering if the costs of a Life Alert are covered by Medicare, it depends on your plan type. Here’s what you should know about medical alert system out-of-pocket costs, the Medicare Advantage PERS benefit, and other ways you can save.
Traditional Medicare coverage
Medicare Part A and Part B do not cover any of the costs associated with medical alert systems. These products aren’t covered because Medicare doesn’t consider them medically necessary to diagnose or treat any health conditions.
Medicare does cover other products known as durable medical equipment (DME). This equipment is meant for repeated use to help someone who is sick or has an injury that limits their ability to perform daily activities. DME includes things like:
- canes, crutches, and wheelchairs,
- diabetes supplies, including monitors and test strips,
- oxygen equipment, nebulizers, and CPAP (continuous positive airway pressure) machines,
- patient lifts,
- and hospital beds and pressure-reducing support surfaces.
Medicare Advantage PERS benefits
Though Original Medicare doesn’t cover medical alert systems, Medicare Advantage may cover some or all of the costs for a device. Some Medicare Advantage carriers offer supplemental benefit plans that provide discounts on PERS. Other insurance carriers offer plans that provide total coverage for alert devices.
For a Medicare Advantage or Supplement plan to cover a medical alert device, your doctor may have to say it’s medically necessary. Whether or not your plan will pay toward a device also depends on your insurance carrier and medical necessity.
Other ways to save
If insurance doesn’t cover your medical alert system out-of-pocket costs, but you think a device will make you feel more comfortable, there are many other options to consider for assistance.
- Use your HSA or FSA. Medical alert devices are often considered eligible expenditures for health savings accounts and flexible spending accounts. Money coming out of these accounts is pre-tax dollars.
- Pay upfront. Some vendors will offer discounts on your monthly fees if you pay by the quarter or year, instead of monthly.
- Check with Medicaid. If you are eligible for Medicaid (often called dual eligible), that state program may help you pay for your device.
- Ask the VA. For eligible veterans, the Department of Veterans Affairs provides free medical alert devices.
- Check with PACE. The Program of All-Inclusive Care for the Elderly, which helps people live at home instead of in nursing homes, is available in 33 states and Washington, D.C. If a medical alert device is deemed medically necessary, this program should cover the cost.
Original Medicare doesn’t pay toward emergency response systems. But there are options, like using HSA dollars or a Medicare Advantage plan, to make one more affordable. Peace of mind doesn’t have to be out of reach.
