Medical alert systems are emergency response devices that ensure seniors, patients, and disabled people get immediate help. A person wears a radio transmitter embedded in a pendant or a bracelet. If they sense a fall or feel unwell, they press a button, connecting them to a 24×7 call center immediately. Medical alert systems include the cost of the device, one-time activation fee, monthly subscription, and optional costs for additional features.

The cost of the device, installation, and activation is around $250, and a monthly subscription is between $25 and $60 based on the type of device and service. Considering the expenses, it is better to get insurance coverage for these systems. Read on to know more about medical coverage for medical alert systems.

Medicare coverage for medical alert systems
Medicare insurance covers specific medical expenses like the cost of medication and certain medical equipment for seniors over the age of 65 as per the plan they choose. Understanding the different parts of Medicare can help you know the coverage better.

Medicare has four parts A, B, C, and D.:

Part A covers hospital inpatient care, medical services, ambulance services, mental health care, and specific prescription drugs. It does not cover private room charges, private nursing, the cost of long-term stay in assisted living or skilled nursing facilities, and perks like television. Hence, Part A does not cover medical alert systems.

Part B covers medically-necessary services, including physician’s services, home health services, durable medical equipment, outpatient care, transplants, smoking cessation, and other services. Since medical alert systems are emergency response devices and do not qualify for durable medical equipment, it is not eligible for Medicare coverage under Part B.

Part C or Medicare Advantage Plans are sold by private insurance companies that include Medicare Part A and Part B coverage along with additional coverage and benefits. You can choose from four types of Medical Advantage plans:

• Health Maintenance Organization (HMO) Plans where you can choose facilities and services from only the providers’ in-network doctors.
• Preferred Provider Organization (PPO) rates where the plans charge different rates for doctors, healthcare services, and hospitals differ between in-network and out-of-network.
• Private Fee-for-Service plans permit you to choose any service or provider if they accept the terms and conditions specified in your insurance plan.
• Special Need Plans (SNP) plans provide coverage for diseases that may need long-term medical care.

You can buy a Medical Advantage Plan if you already have Medicare Part A and Part B. Apart from the coverage provided by Part A and Part B, you can get additional coverage for hearing, vision, dental, health, and wellness programs.

When you buy a Medicare plan, you can choose a private company that offers coverage for medical supplies and accessories like medical alert systems. Since Medicare Advantage Plans vary from one state to another, research to verify if the insurance companies in your state offer coverage for medical alert systems.

Part D covers only prescription medication.

To summarize – if you are looking for Medicare insurance coverage for medical alert systems, the only option is to enroll for a Part C – Medicare Advantage Plan from a company that covers medical alert systems. Not every insurance company offers such coverage as a default option. Alternatively, you can talk to medical alert system companies to verify if they have a provision for coverage. Since it is a rare service, the premium for such plans is higher.

Does Medicaid cover medical alert systems?
Medicaid offered by states as per Federal requirements is a health coverage program for seniors, adults, pregnant women, children, and disabled patients. The eligibility and waivers for Medicaid vary from one state to another but are broadly based on household income. Medicaid also considers other factors like family size, age, disabilities, and other factors. You can contact the Medicaid offices in your city to verify if they offer coverage for medical alert systems.