Does Medicare Pay for Medical Alert Systems?

Every year, more than 30 percent of seniors will fall, according to the National Institute on Aging. As we age, our risk of falling increases often due to vision problems, health issues, medications, alcohol use or other factors. Falling can lead to minor injuries, such as bruises or scrapes, but as many as one out of five results in a serious injury, such as a broken hip or concussion, according to the CDC. Medical alert systems can help save lives by getting you or your loved one help faster.

What Are Medical Alert Systems?

These devices, which are also called Personal Emergency Response Systems or Mobile Personal Emergency Response Systems, are kept on your person and used to connect you with emergency services whenever necessary. These devices are especially useful for those with chronic health problems, elderly people or people who live alone. With a touch of a button, these systems will immediately alert a dispatcher in the event of an emergency, such as a fall, a health issue, a fire or another serious problem.

Medical alert systems can call for help when you cannot, but they can also monitor different aspects of your day-to-day life to help you stay safer and healthier. Some feature fall sensors, smoke or carbon monoxide detectors, monitor vital signs, send out medication reminders and track your daily movements. Some services even provide daily check-ins with a live person, which can give you and your loved ones greater peace of mind.

Medical Alert Options

Systems can vary quite a bit depending on the type of device and the user’s needs. The simplest ones consist of a base unit and a portable alert button, and they work with a landline. These simple systems are great for people who are home most of the time. More complex systems connect with a cellular phone and feature embedded GPS technology, allowing you to move about and travel freely.

Some things to consider when choosing a medical alert system include:

  • Is it wearable? Is it comfortable to wear and discreet?
  • Is it waterproof enough to wear while bathing? Is it fully immersible?
  • How far away from the base unit will it continue to operate?
  • Does it feature a GPS that allows you to travel freely?
  • Does it feature battery backup in case of power outages? How long is the battery life?
  • Does it use the most advanced technology? Is it regularly updated automatically, or will it require manual updates?
  • How are calls routed? How long is the average response time?
  • Can calls be routed to family members or non-emergency services if appropriate?
  • Is the system secure?
  • Do you have to sign a contract? Is pricing transparent? Does the system offer guarantees?

Not all medical alert systems are available in all areas, so you will also want to ensure that your preferred system is available where you live.

Does Medicare Pay for Medical Alert Systems?

Because medical alert systems are not typically considered medically necessary, they are not typically covered by either Medicare Part A or Part B. Medicare Part C plans, which are also known as Medicare Advantage Plans, may cover medical alert systems depending on the type of plan and where you live. Medicare Advantage Plans are most likely to cover an alert system if you have pre-existing health issues that could predispose you to a fall. To find out if your plan covers them, contact your plan’s provider.

While Medicare may not pay for these devices, they may be eligible for reimbursement through a healthcare reimbursement account (HRA). This can be a good option for those who are still working and have access to HRAs. Depending on your tax situation, they might also be tax-deductible.

With the right system, you or your loved one can maintain a level of independence. Medical alert systems will not prevent falls, but it can help reduce the risk. You can further reduce the risk of falling by identifying potentially hazardous situations and eliminating them, talking to your doctor about medications that could lead to falls, and creating a comprehensive fall prevention strategy, including a medical alert system.