Medical alert systems help protect seniors by providing on-call help any time an emergency occurs. Whether it’s a household accident or a simple fall, seniors can press a button to summon assistance, but this help comes at a price. Medical alert systems generally cost between $25 and $45 per month, which can be a significant amount for seniors on a limited budget.
Many seniors are on Medicare, which covers medical expenses and some medical supplies. Some forms of Medicare may cover a medical alert system, depending on the specific plan. This guide explains how Medicare coverage for medical alert systems works, so seniors can figure out whether they can get a system for in-home use without paying out of pocket.
Medicare Parts A and B offer coverage for necessary medical expenses, but medical alert systems aren’t included because they are considered optional. In general, Part A covers hospital inpatient care, home health care, nursing facility care and hospice care. Part B covers preventative health care, medically necessary services, ambulance services, mental health care and some prescription drugs. Things that aren’t covered at all under Parts A and B include dental care, hearing aids and eye exams.
One category of coverage in Medicare Part B that seniors often wonder about is coverage for durable medical equipment. Unfortunately, Medicare doesn’t consider medical alert systems to be part of this category. Things that do fit into this category include wheelchairs, walkers, oxygen equipment, blood sugar monitors and infusion pumps.
Seniors with Medicare Part A and Medicare Part B who need more coverage can opt for a Medicare Advantage plan, which may cover some of the things not covered by the other plans.
Seniors who use Medicare Advantage, also known as Medicare Part C, choose a plan from a listing of private insurance plans. Whether medical alert systems are included depends entirely upon the plan. Medicare Advantage plans are required to cover all of the same things that Part A and Part B cover, so there is no risk of losing coverage if you switch to a Medicare Advantage plan.
Medicare Advantage involves private insurance companies, so specific coverage options vary widely. Most plans accessible through Medicare Advantage require a monthly premium. Plans that offer more coverage for medical supplies and accessories, such as medical alert systems, may have higher premiums than plans that only offer basic medical coverage.
Health savings accounts sometimes reimburse for medical alert systems, but these types of accounts are typically linked with an employer-sponsored insurance plan, not Medicare. If a working spouse still has insurance through an employer, this might be an option.
Medicaid, a program for low-income seniors, might cover the costs of a medical alert system, depending on the state and the specific options available in a community. Check into whether home and community-based services (HCBS) or consumer-directed services are available through Medicaid in your state. With these programs, the goal is to help seniors stay in their own homes instead of entering assisted living, and medical alert systems help achieve this goal.
Long-term care insurance is another potential way to cover the expenses of a medical alert system. These plans are available as individual insurance plans, as part of an employee benefit package or through professional trade organizations. Not all long-term care insurance plans cover medical alert devices, so seniors should check with the insurance provider to determine what is covered and what is not.