Page Reviewed / Updated – September 08, 2020

Medical alert systems, also known as personal emergency response systems can help seniors remain independent by providing them with a simple way to call for help. Most medical alert systems include a small, wearable panic button that users can press at any time to connect with either a medical alert call monitoring center, a trusted neighbor or family member, or 9-1-1.

While most medical alert systems are supplied by companies that charge a monthly monitoring fee in exchange for 24/7 call answering service, there are a few no monthly fee medical alert systems available. These self-monitored medical alert systems may be a good option for those who have a network of caregivers, family members and friends who are willing and able to respond to an emergency call, or seniors who are comfortable with a help button that only connects to 9-1-1.

LogicMark FreedomAlert

FreedomAlert is a self-monitored, all-in-one medical alert system from LogicMark. This system connects to any standard landline telephone, and users choose one of three contact modes triggered when the help button is activated. These modes include:

  • Call 9-1-1
  • Call up to four user-programmed contacts
  • Call up to four user-programmed contacts, then 9-1-1 if none of the contacts pick up the call

The system includes one base unit that plugs into a landline phone and a standard wall outlet, and one water-resistant pendant equipped with a speaker, help button and microphone. The base unit also has a help button and speakerphone, as well as a pendant battery charger.

The pendant range is up to 600′ from the base unit, and up to four pendants or wireless emergency wall buttons can be synced with each base. There’s also a 24-hour backup battery in the base, and the FreedomAlert pendant can be used to answer incoming calls to a landline phone.

FreedomAlert Pros

  • No monthly monitoring fees
  • Users can set the system to call 9-1-1; call up to 4 contacts; or call up to 4 contacts then 9-1-1
  • Water-resistant pendant is safe to use in damp environments
  • Optional wall buttons and additional pendants can be purchased
  • Multiple users can connect to the same base unit
  • Pendant equipped with a speaker and microphone for clear two-way conversations

FreedomAlert Cons

  • Up-front cost may be prohibitive for some
  • Maximum range of 600′ between base unit and pendant may be insufficient for some users
  • Only works at home with a landline phone connection – no mobile/cellular service
  • Pendant is larger and heavier than many other pendant-style help buttons
  • Emergency contacts must press ‘5’ to continue emergency call
  • No fall detection or GPS location tracking

LogicMark also sells the Guardian Alert, a no monthly fee landline-based medical alert system consisting of a two-way emergency pendant and a charging station. The Guardian Alert is pre-programmed to dial 9-1-1 when the help button is activated. Unlike the FreedomAlert, the Guardian Alert cannot be programmed to call any other phone numbers, and there’s no option to purchase additional pendants or wall buttons.

Apple Watch

While not marketed as a medical alert device, the Apple Watch has a number of built-in features that make it a popular option for those who are looking for a no-fee personal emergency response system. While it’s one of the highest-priced smartwatches on the market today, this device includes a number of advanced features including an integrated SOS app, ECG-quality heart rate monitoring and automatic fall detection.

Emergency SOS App

This high-tech smartwatch comes pre-loaded with Apple’s own emergency alert app called Emergency SOS, which automatically calls local emergency services and shares the caller’s GPS coordinates with first responders. In order to use the Emergency SOS app, Apple Watch owners need to either purchase a cellular Apple Watch and pay for a cellular service plan, or have their synced iPhone nearby with Bluetooth activated.

To trigger a call for help, Apple Watch users simply press and hold the side button on the device until the Emergency SOS slider appears, and either wait for the SOS timer to count down, or swipe the SOS slider on the screen. After the call is placed to emergency services, the device automatically sends a text message to any emergency contacts added by the user unless the caller cancels this function.

Fall Detection

Every Apple Watch Series 4 and later includes an automatic fall detection app that can sense if a wearer suffers from a hard fall using the accelerometer, gyroscope and an advanced algorithm.

If the watch detects user movement following a fall, the device gives users 60 seconds to respond. If the user doesn’t deactivate the fall detection feature within 60 seconds, the watch places a call to 9-1-1 with the users’ exact location.

Voice-Activated Calling and Text Messaging

Apple Watch is equipped with Siri, Apple’s voice-activated assistant. Apple Watch owners can use Siri to place phone calls and send text messages, a feature that could be helpful in an emergency situation.

Apple Watch Pros

  • Full-featured smartwatch with GPS, voice-activated calling and voice-to-text feature
  • All-in-one cellular model available that works on nationwide mobile networks
  • Integrated automatic fall detection
  • ECG-grade heart rate monitor alerts users when an irregular heart rate is detected
  • Emergency SOS app connects users with local emergency services
  • GPS location tracking
  • Watch is water-resistant
  • Access to thousands of apps on the iOS store

Apple Watch Cons

  • Up-front cost may be prohibitive for some
  • Small touchscreen may be hard for those with limited dexterity or low vision
  • Watch needs to be removed and recharged daily
  • Must be either linked with a compatible iOS phone with an active data plan, or activated on a smartwatch cellular plan
  • No option to program Emergency SOS and fall detection app to call emergency contacts rather than 9-1-1
  • Device has a number of features and options that may not be needed by seniors, and can be confusing for those who aren’t tech-savvy


Notifi911+ is a small, lightweight and water-resistant panic button pendant that works anywhere cellular service is available. This innovative device takes advantage of FCC rules that require all wireless service providers to transmit 9-1-1 calls, even calls initiated from devices that are not activated on a wireless network. There are no monthly fees for the Notifi911+, and a cell phone or landline account isn’t needed.

The small black pendant is equipped with a speaker and microphone to enable two-way conversations with 9-1-1 operators, and there’s a large red button on the face of the pendant that’s used to call for help. Notifi911+ is powered with a rechargeable battery rated to last 3 months when the device is powered on 24 hours a day, and there’s an AC adapter included to charge the battery.

Notifi911+ Pros

  • No need for either a landline or cellular phone service
  • Lightweight pendant is fully self-contained with a speakerphone and help button
  • Device is water-resistant
  • Can be worn as a pendant, clipped to a belt or carried in a pocket, purse or bag
  • Long battery life
  • Works nationwide on any cellular network
  • Allows two-way voice communication with the nearest 9-1-1 dispatch center
  • Easy to use by those with limited mobility, low vision and cognitive issues

Notifi911+ Cons

  • No GPS location tracking or automatic fall detection
  • No option to dial any number other than 9-1-1
  • User needs to remember to test the battery and plug the device into the charger every few months

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