Are Medical Alert Systems Covered by Medicare?

Between doctor visits, adjustments to your home, and a medical alert service to that list, aging at home comes with a lot of costs.

If you have a condition that makes a medical alert system necessary, your device may be covered by a private insurer or Medicare Part C.

But in most cases, Medicare, unfortunately does not cover medical alert systems.

Does Medicare cover medical alert systems? 

No, not usually.

Original Medicare (Part A and B) won’t cover your medical alert device, but Part C (also called the Medicare Advantage Plan) might through the right private company.

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What is Medicare?

Medicare is a federal program designed to help aging Americans over 65, those under 65 who have received Social Security Disability Insurance (SSDI), or have End-Stage Renal Disease (ESRD).

This complex system is divided into several parts that cover hospital costs, doctor visits, prescription drugs, and medical devices like wheelchairs.

Parts of Medicare coverage

Medicare is a four-part system divided into Part A, Part B, Part C, and Part D.

Medical alert systems covered by Medicare generally fall under Part C rather than Part A or Part B. Here’s a quick overview to help you get a better understanding of each:

  • Part A covers hospital, hospice, and some nursing facility costs. 
  • Part B is medical insurance. 
  • Part C combines Part A and Part B but is available through private insurance. 
  • Part D covers prescription drugs. 
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Original Medicare vs. Medical Advantage Plans

Original Medicare is made of Part A and Part B coverage, while Medicare Advantage Plans are Part C.

You can add Part D to Original Medicare or a Medicare Advantage Plan if you need to cover prescription drug costs.

How the Medicare Advantage Plan works

Medicare Advantage Plans (also known as Part C) is coverage provided by Medicare-approved private companies.

That means you can get Medicare coverage (Parts A, B, and sometimes D) through a private insurance provider. The big differences boil down to network size, cost, and coverage.

You’ll generally get more coverage for things like vision and dental through Medicare Advantage than you would through Original Medicare.

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Organization determination

Medicare Advantage Plans usually don’t cover medical alert systems, but you can request an “organization determination.” An organization determination can amend your policy if your need for a medical alert system is great enough.1

Can Medicaid cover my medical alert system costs? 

Like Medicare, Medicaid doesn’t cover medical alert systems or personal emergency devices.

Medicaid helps low-income Americans cover medical costs with funding from state and federal governments. It’s different from Medicare and can vary from state to state.

Simply put, the federal government provides a budget for each state to use as they wish. So coverage, eligibility, and laws will depend on where you live.

Medicaid programs in your state for seniors 

Again, the Medicaid coverage available depends on the state you live in. But the Programs of All-Inclusive Care for the Elderly (or PACE) include a wide range of care options. Check to see if PACE is available in your state.2

So even if you can’t get your medical alert system covered by Medicaid, you’ll be able to access care programs like these for yourself or your loved ones:

  • Adult day care 
  • Home care
  • Nursing home care
  • Physical therapy
  • Transportation 

The following states have active PACE programs:

Arkansas

Missouri

California

Nebraska

Colorado

New York

Connecticut

Ohio

Delaware

Oregon

Florida

Pennsylvania

Illinois

Rhode Island

Kentucky

Texas

Maryland

Utah

Michigan

Virginia

Minnesota

Wisconsin

Can private insurance cover my medical alert system?

In some cases, yes. But it depends on your insurance provider.

If you have a Medicare Advantage Plan, your private insurance company might cover your medical alert device or personal emergency response system out of necessity. But you’ll need at least a doctor’s note to prove your need for one.

For older adults prone to falling injuries, a medical alert device with automatic fall detection can be a lifesaver. Ask your doctor if this is a risk for you.

These conditions increase your risk for falling injuries:4

  • Visual impairments
  • Neuropathy
  • Cardiac arrhythmia 
  • Congenital heart disease
  • Dementia 
  • Parkinson’s disease

Learn about how to prevent falls in your home and avoid injuries as you or your loved one ages.

Are there discounts for medical alert systems? 

Yes, members of organizations like AARP and USAA or veterans may be eligible for discounts off their systems.

When you find a medical alert system that works for you or your loved one, call to order and ask the medical alert provider about any discounts. They will vary from company to company, but it doesn’t hurt to ask.

Why medical alarms are important

Basically, having a medical alarm or medical alert system makes it easier to call first responders when you need help. 

Whether you live alone or with others, having a wearable device like a personal emergency response system can reduce the damage falls, injuries, or other medical emergencies have by getting you assistance more quickly.

Final word 

Unfortunately, Medicare, Medicaid, and private insurers don’t usually cover medical alert systems. But there are exceptions. If you have a medical condition that makes these devices a necessity, you may get partial coverage.

Thankfully, there are affordable medical alert companies out there, and many medical alert companies offer discounts and free devices.

For many aging Americans, a medical alert system isn’t a necessity. But these devices can send help quickly in a scary situation. If you or your loved one is prone to falling, getting lost, or other medical emergencies, a medical alert device is worth purchasing.

Related pages


Sources

  1. Medicare.gov, “Understanding Medicare Advantage Plans,” September 2019. Accessed August 25, 2020. 
  2. Medicaid.gov, “Programs Of All-Inclusive Care For Elderly Benefits,” Accessed August 25, 2020. 
  3. Pace Nation, “PACE Programs,” Accessed August 25, 2020. 
  4. Philips Lifeline, “5 Diseases That Increase Your Risk Of Falling,” April 2014. Accessed August 28, 2020.

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Data effective 09/24/2020. Offers and availability subject to change.

Katie McEntire
Written by
Katie McEntire
As a renter, pet-owner, and woman living alone, Katie McEntire takes safety seriously. She’s tested devices like pet cameras, home security systems, and GPS trackers in her own home and devices in the name of safety. In addition to testing, writing, and reviewing for SafeWise, she also makes videos for the site’s YouTube channel. She’s been featured on publications like TechGuySmartBuy, Forbes, Healthy Moms, and Digital Care. Katie has a Bachelor’s degree in Technical Writing from Austin Peay State University in Clarksville, Tennessee. She’s held previous writing positions at Overstock.com and Top Ten Reviews.