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POINTS
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Original Medicare won't consider Life Alert medical necessary, so it won't cover the cost of Life Alert or other personal emergency response systems.
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Some Medicare Advantage plans will cover these systems as an additional benefit.
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Some Medicare Advantage or Medigap plans have discount programs that may help beneficiaries get a PERS for a reduced price.
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Compare medical alert systems to find the ones that offer better value and conform to the user's preferences.
Personal emergency response systems (PERS) can help seniors retain their independence without sacrificing safety and peace of mind. Unfortunately, PERS are not considered medically necessary by Original Medicare, so access to such systems might be difficult or impossible for some. Medicaid and Medicare Advantage plans may be able to help where Original Medicare cannot; read on to understand what PERS are, Medicare’s coverage of PERS, and how you might protect yourself or a loved one with the aid of insurance.
What Are the Benefits of a Personal Emergency Response System?
These emergency alert systems first appeared in the 1970s and have spread widely throughout the United States and other countries. Today, the devices might consist of wristbands or pendants worn around the neck.
Some more advanced systems can automatically detect changes in blood pressure or falls, so users don’t need to have the capacity to push the button to get help. Some systems work through phones or have a base unit that lets the user speak with responders. More advanced features could include GPS, fall detection, and more.
According to The National Library of Medicine the alert systems help support independent living and safe aging in place. They offer a way to contact somebody for help in an emergency. Life Alert stands out as a recognizable brand name for personal emergency response systems, but other manufacturers also offer them.
Does Medicare Cover Life Alert or Other PERS?
Even though these systems can benefit older adults who live alone, Original Medicare does not consider PERS medically necessary. Thus, Medicare Part A and B don’t cover the cost, but other Medicare insurance plans may help with coverage and discounts.
It’s possible to argue that PERS are medically necessary for some. The technology can help seniors enjoy more independence and safety, reducing the cost of caregiving. Efficiently and quickly helping seniors in crisis may also reduce the amount of expensive healthcare services that Medicare often ends up paying for.
Right now, the reality is that Medicare disagrees. Medicare supplements are not a good place to look for PERS coverage either. Medicare supplements focus on reducing out-of-pocket expenses for services already covered by Original Medicare and won’t include PERS coverage as part of their core benefits.
Will Medicare Insurance Plans cover Life Alert or Other PERS?
Original Medicare won’t cover PERS. At the same time, some Medicare insurance plans may help pay for some or all the cost of using Life Alert and other systems.
Medicare Advantage plans can offer benefits that Original Medicare doesn’t provide. Thus, some of these plans will help pay for PERS systems. For instance, Medicare beneficiaries can enroll in a Medicare Advantage plan as an alternative to Original Medicare. If so, they may pay for Life Alert or another system they include in their network.
Medicare Advantage plans and Medigap policies often come with discount plans for members, offered as an additional perk. These discount plans don’t count as insurance, but they may still help reduce the out-of-pocket expense of using one of these systems.
In some states, Medicaid programs may also offer coverage for PERS as part of their benefits. Thus, dual-eligible beneficiaries of both Medicare and Medicaid in these states may access one of these systems for little or even no cost.
Tips to Compare Alert Systems
Before investing in one alert system or another, prudent seniors or family members should compare essential features. These include:
- Check speaker volumes: Hearing tends to decline the older you get. Thus, individuals may need to turn the volume up very high, and not all base units have this capacity.
- Ask for discounts: Some purchasers have found that their sales representatives have the authority to offer deals, and it never hurts to ask.
- Respect the user’s wishes: Before purchasing an alert system for a loved one, find out about the various features. Then consult with the user to determine which type of system they’ll find satisfying. After all, these systems only work effectively if the individual uses and understands them.
- Consider connectivity options: Most of these systems offer landline or cell options. Weigh these alternatives in reference to the user’s current capabilities.
- Explore return, upgrade, and exchange policies: Things can change, and the best system for an individual today might not satisfy them in the future. Find out how easy and affordable the company will make it to change plans, add and reduce features, or opt out.
How Much Will a Medical Alert System Cost?
These systems vary in technology and complexity. For instance, some offer 24-7 monitoring by a call center, but others let users call a family member or friend for help. Some only work at home, but others have a GPS feature, so they can track the user’s location. Some offer a call button, but others may include various features, like two-way communication. As the systems vary, so can the price.
Consumer Reports claims you may pay from $20 to $50 a month for a monitored system. The systems often have a base price and extra charges for such features as GPS or fall detection. The price of these medical alert systems can represent a substantial additional expense. Still, many people find the cost modest because of the extra protection and the ability to let seniors remain at home and live independently.
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