Is Your Medical Alert Covered by Medicare?

Medical alert systems can be life-saving if you are a senior and find yourself facing an accident or an illness. You might also be the loved one of an older person and want them to have a medical alert system for your peace of mind so that you know assistance is on the way if needed.

Medical alert systems do come at a cost, however. This leaves many wondering if this is something covered by Medicare. What about private insurance and VA health care? Do they cover medical alerts?

Will Medicare Cover Medical Alert Systems?

There are many Medicare benefits to be aware of, but is Medicare coverage for a medical alert system one of those benefits?

Around 64 million seniors in America have their insurance coverage fully or partially through Medicare. Medicare is a federal insurance program for people who are elderly or disabled. Medicare coverage includes essential expenses such as hospitalization and medication.

Understanding Medicare

There are different types of Medicare coverage. Medicare Part A covers hospitalization costs that qualify and assisted living expenses. Additionally, Medicare Part A may also cover surgeries and hospice care, and there’s reimbursement for in-home health services.

Medicare Part B covers medically necessary expenses such as the cost of CT scans, prescription medicines, and visits to doctors, including both primary care and specialists.

Medicare Part C is known as Medicare Advantage. It’s a supplemental plan, and it is something you get as an existing policyholder. Medicare Advantage Plans tend to provide coverage for things not covered by Original Medicare, such as hearing, dental, vision, and fitness programs.

Medicare Part D is for prescription drug reimbursement.

Medicare Coverage for Medical Alert Systems

• Original Medicare will usually not cover medical alert systems.
• Part A and part B also don’t typically cover medical alert systems. It’s possible under Medicare Part B you could receive a reimbursement for the cost of a medical alert system, but it’s not common.
• Medicare Part D will not cover medical alert systems.
• With a Medicare Advantage plan, you might have coverage for a medical alert system, but coverage varies.

A Medicare Advantage Plan means that you have original Medicare benefits, but you receive them through private insurance. As such, your insurance may offer coverage for a medical alert system.

Every insurance plan is different, so you need to verify with your company as to the specifics of your plan.

Interestingly, Medicaid may pay for emergency alert systems. Medicaid is different from Medicare because it’s for low-income adults, elderly adults, children, pregnant women, and people with disabilities. Four Medicaid programs might cover the cost of an emergency alert system. These include:

HCBS Programs:

Home and Community Based Services programs may offer waivers for the cost of emergency response services, but the specifics of this varies depending on the state where you live. The waivers may only be available for the startup fees and not the monthly payment.

Consumer Directed Services:

Medicaid sometimes provides funding to elderly people without restrictions regarding the health-related costs they can use them for. It’s possible that under this Medicaid program, a senior could pay for an emergency alert system.

Money Follows the Person:

This Medicaid program is geared toward people in assisted living facilities or nursing homes. The program aims to make it possible for these residents to move in with a family member or live independently, so the program will cover the cost of services with that goal in mind. These services can include a medical alert device.

Medicaid State Plan Personal Care Attendant Program:

Some states have coverage for the cost of caregivers, and this could include financial help with an alert device.

Does Private Insurance Cover Medical Alert Systems?

Similarly to Medicare, most private insurance is unlikely to cover the cost of an alert system, but it’s possible. However, you should always personally check with your insurance company as to what they cover and don’t cover.

Some people have health care through the Department of Veterans Affairs (VA). The VA does have a program where they may provide free alert systems, but you would likely have to use the product and brand they select rather than being able to choose your own.

How Much Do These Systems Cost?

Since most insurance options, including Medicare, are unlikely to cover the costs of an alert system, you will probably have to pay out of pocket. Things that factor into the cost of an alert system include:

• Fees: You always want to make sure you carefully compare the fees of pricing plans as well as activation fees before you make a decision. Some companies will include the device cost in your monthly service fee, but others may charge more for the equipment in addition to your service and activation fees.
• Contracts: it’s best to avoid a long-term contract if you can. You can usually find services where you pay month-to-month, so you aren’t locked in or committed to anything. Don’t pay in advance for any service either, because you may end up not needing it for some time.
• Trial periods: It can be good to choose a medical alert system and service that offers a money-back guarantee or a trial period within which you can cancel your service and return your device.
• Discounts and deals: There are often discounts and deals available when you purchase an alert system. For example, if multiple people in your household need devices, you may get a discount. You may find discounts for being a member of certain groups, or you could be eligible for lower prices if you are lower income.

MobileHelp is a top-rated company that offers two months free when you sign up, and they have great customer reviews.

OneCallAlert features a long 60-day trial, and LifeFone features one month free plus free activation.

Summing Up

Medicare benefits typically do not include coverage for a medical alert system. If there were any coverage, it would be under Medicare Advantage, which isn’t a universal or guaranteed benefit. Most private insurance, as well as VA health care, don’t cover emergency alert systems either.

With that being said, these systems can be life-saving. If you’re a senior who wants to retain your sense of independence or you want peace of mind for your loved one, you might consider learning more about these systems.

Although Medicare and private insurance coverage are rare, there are often special prices and discounts available and programs that can help cover the costs.