Are Medical Alert Systems Covered By Medicare

Would A Medical Loan Charity Lend Me An Emergency Medical Device

Many communities have independent charities that collect gently used durable medical equipment and lend it to members of the community who have a demonstrated need and are unable to purchase their own. However, these loan closets often rely on donations, so theres no guarantee that your area will have a medical alert pendant available when you need it.

What Are Medical Alert Devices And How Do They Work

A medical alert device is a wearable technology that alerts emergency responders or a caretaker if the user is in trouble. For example, if someone has fallen and cant get up, has dangerously low blood sugar or is feeling symptoms of a heart attack or stroke, the medical alert device can signal for help if the wearer isnt near a phone.

Some devices have GPS tracking or WanderGuard technology that can track those with dementia or Alzheimers disease and ensure they havent wandered into an unsafe area or gotten lost. Also, some assisted living communities and memory care facilities issue medical alert and emergency response pendants to residents to protect them and monitor those prone to wandering.

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Without Prompt Treatment A Fall Heart Attack Or Stroke Could Cause Permanent Disability

Life alert systems are a popular type of personal medical alert device used by many seniors throughout the world. The basic idea behind these devices is that they function as a help button to be worn on your person at all times and, when pressed, will trigger a call to emergency services. This offers a great extra level of security for seniors who live alone and want to be able to stay in their own homes but are worried about being able to contact emergency services.

But are they covered by Medicare? The short answer is no, but there are options available if youre a Medicare beneficiary. Lets take a look at all of the options available to you.

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Does Medicaid Cover Pers Devices

Medicaid is a complicated web of supporting programs. Some will pay for medical alert devices or monthly fees. In fact, there are four programs in place that are funded by Medicaid that will pay for a PERS device. If you qualify for Medicaid, you’ll likely be eligible for one of these programs. However, each program operates a little differently state by state, so be sure to get information first.

1. Consumer Directed Services: In these situations, Medicaid covers funding for the elderly and allows them to use the stipend for whatever they like, as long as the expenses related to health. Funding from this program can be used for PERS devices as well as additional services, like monitoring, fall-detection, and medication management. Check the National Conference of State Legislature site for more detailed information on your state’s policy.

3. Medicaid State Plan Personal Care Attendant Programs: Attendant programs cover the costs of caregiving. If you’re caring for your loved one in any way, Medicare may reimburse some of the costs. Much like the HCBS programs, they vary from state to state and pay around the same. Learn more about Personal Care attendant programs in your state by .

Supplemental Medicare Plans And Medical Alert Devices

Supplemental Medicare plans are optional plans available to individuals enrolled in traditional Medicare . These plans are purchased separately from private insurance companies, and often the only requirement for acceptance is current Medicaid coverage.

Medicare Advantage plans cover a wide variety of health and wellness services not paid for by the regular Medicare insurance plan. Services provided can include dental and vision, hearing aids, gym memberships and, sometimes, medical alert devices.

Supplemental Medicare plans vary from region to region and state to state. Sometimes, the coverage available in one city isnt available in another. This is something that senior snowbirds may need to take into account when paying for their medical alert devices. If they have coverage in their winter home but not their summer home, they may have to consider budgeting for the out-of-pocket expense of the device in the area not covered.

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Medicare Part C Coverage

Seniors who need a medical alert system for medical reasons might be able to get it covered by a Medicare Advantage Plan.2 Some Medicare Part C plans cover 100 percent of the cost, while others only cover a portion. You’ll need to talk with your insurance provider to find out how much they cover and for what medical reasons, and for how long.

The types of medical alert systems a plan might cover include:

• Alert bracelets or necklaces
• Cellular medical alert systems with GPS technology
• Activity tracker systems

Alternative Ways To Pay For A Medical Alert System

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 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.

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Does Part A Cover Medical Alert Systems

Medicare Part A is the standard part of Medicare that you will be automatically enrolled in when you become eligible for Medicare. Part A offers coverage for hospital treatments and other forms of inpatient care, including long-term care. It also notably covers in-home care some of the time.

Although life alert systems may seem like they fall under in-home care, they arent covered by Medicare Part A. Medicare Part A will only cover in-home care under certain very specific circumstances, and unfortunately, life alert systems do not qualify.

Life Alert Systems: An Overview

Before getting into the coverage details, lets take a look at how life alert systems work and exactly what type of service they offer. The functionality can vary widely, with some systems using more advanced functions like automatic fall detection, while others focusing purely on allowing you to call medical emergency services with a click of a button. Even if you can’t find coverage, it’s worth looking into personal emergency response systems to provide peace of mind for you or your loved one.

Many of these services will function as subscriptions, where you pay a monthly fee to use their functionality. In the past, these systems would connect to your landline, but these days its more common for them to connect to a mobile network. The cost of a medical alert system can vary depending on the details of that specific service. There are several medical alert companies out there, so make sure to compare.

Although life alert systems seem like they would fall into the category of durable medical equipment or DME, the situation is a bit more complicated. Well get into the details below.

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Can Private Insurance Cover My Medical Alert System

In some cases, yes, private insurance may cover medical alarms for seniors and other at-risk individuals. 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 service out of necessity. But youll need at least a doctors 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:2

• Visual impairments
• Dementia
• Parkinsons disease

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

Traditional Medical Alert Pendants Or Bracelets

Worn on the neck or wrist, these lanyard-carried alert systems can be worn comfortably and allow you to push a button in the event of a fall or health emergency. You can then speak directly to a central monitoring system from the base unit in your home. If youre unresponsive, rescue services are triggered.

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What Is A Medical Alert System

A medical alert system is a device or set of devices that aid a person typically older adults or people with disabilities in case of a medical emergency. Its main purpose is to contact a monitoring service, a close relative, guardian or the local authorities in case of an emergency.

These systems usually include a base station as well as small, wearable necklaces or wristbands with a button. Users can then communicate with the companys monitoring service with a single click of a button.

More advanced options also include automatic fall detection, GPS tracking, two-way communication and more.

Many systems provide additional services or accessories such as medication reminders, wall buttons, optional fall detection, a free lockbox to give a designated person access to your home, customized touchscreen tablets, motion sensors and more.

What Is The Monthly Cost Of A Medical Alert System

Medical alert systems typically cost between $19 and $30. There is a range of $95 to $49 for this item. The cost of equipment is included in the monthly fee of $95. Thankfully, Medical Alert offers plans at a lower price. activation is free, there are no hidden fees, and long-term contracts are not required.

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How Could A Senior Receive Help With The Cost Of Medical Alert Systems

Seniors who arent enrolled on a Medicare Advantage plan may be able to find other ways of reducing the cost of a medical alert system. Some options include:

• Health Savings Accounts : If a close family member has an HSA-approved, high-deductible health insurance plan then they can open a health savings account. Once the account is opened, any member of the family can make use of it.
• Flexible Spending Accounts: Older adults who are employed can use a Flexible Spending Account to save for medical expenses. Some plans include medical alert systems as an allowable expense.
• Senior discounts: Members of popular senior organizations may qualify for discounts on the cost of a medical alert system. Bay Alarm Medical, for example, offers discounts to USAA and AARP members.
• Veteran discounts: Many manufacturers offer discounts to veterans. In addition, Live Life Alarms offers free mobile medical alert systems with automatic fall detection to eligible veterans.

Seniors may need to shop around to find the best deal on medical alert systems. There are many choices on the market, so whatever a households needs and budget it should be possible to find a system that offers peace of mind.

How Much Do Medical Alert Systems Cost Without Medicare Coverage

Regardless of whether your insurance covers the cost of a medical alert system, we believe the monthly cost, is well worth the investment. To put it in perspective, most medical alert systems are cheaper than a cup of Starbucks coffee a day.

Here’s a list of the range of prices you can expect to pay for different types of systems:

• At-Home Landline: $19.99 – $39.99 / month
• At-Home Cellular: $19.99-$39.99 / month
• Mobile with GPS: $38.99-$49.95 / month
• Adding Automatic Fall Detection: $10-$15
• Smartwatch: $44.95 / month

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Does Medicare Cover Medical Alert Systems

Part B of Original Medicare covers durable medical equipment, such as hospital beds, canes, walkers, and blood sugar meters.1 By that definition, you might expect Medicare to cover medical alert systems. Unfortunately, though, Medicare does not cover medical alert systems. Still, that shouldn’t stop you from getting a system. There are other ways to pay for a medical alert system, which we’ll cover below.

Do Some Medicare Advantage Plans Cover Life Alert

Some Medicare Advantage plans such as some Anthem Blue Cross and Blue Shield plans may cover personal emergency response systems such as Life Alert.1

Some insurance providers may offer coverage for Life Alert or other medical alert systems at no added cost, and other providers may charge a fee for the system. Plan availability, benefits and cost can vary based on your plan provider.

Depending on your plan, you may have a monthly plan premium in addition to your Part B premium, an annual deductible and coinsurance or copayment requirements. Some Medicare Advantage plans, however, may feature $0 monthly premiums.

Medicare Advantage plans provide Medicare Part A and Part B benefits combined into one plan sold by a private insurance company. Some Medicare Advantage plans may also include coverage for prescription drugs, dental, vision and wellness programs, which are not typically covered by Original Medicare.

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Original Medicare Vs Medicare Advantage Plans

Original Medicare is made of Part A and Part B coverage, while Medicare Advantage Plans are Part C.1

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

Medicare Advantage Plans usually dont 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

B: Does It Cover Life Alert

Medicare Part B functions as the second half of Original Medicare, along with Part A. Part B will cover most of your outpatient care when you receive Medicare. These will be things like doctor visits and diagnostic tests. Part B is also notable in that it covers durable medical equipment .

DME refers to things like wheelchairs, oxygen tanks, and so on, that are required for use outside of a care facility. Part of the qualification for DME is that it is medically necessary. This designation can be a bit complex, but it means that it directly contributes to the medical care that you are receiving.

Unfortunately, life alert systems arent considered medical equipment. The reason for this is that although they are medical in nature and can help people in medical situations, they dont directly contribute to your physical health in the way that something like a wheelchair or hospital bed does. For this reason, Part B wont cover life alert systems, even though they may seem like durable medical equipment at first glance.

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It’s Complicated But Medicare Part C And Medicaid Can Cover The Cost Of Pers Devices

It may be difficult to get cost assistance for medical alert devices, but don’t give up. Through some parts of Medicare and Medicaid, you can get support covering the costs and fees of a PERS device. While it may be a hassle, these devices save lives in medical emergencies.

If these options don’t work for you, you can always ask the medical alert companies directly what discounts are available for free or low cost. Most are happy to offer discounts for AARP members, veterans, and advance payers. Think of a medical alert device like insurance, and the price will mean nothing in comparison to all of the benefits of having a medical alert device handy brings. If you have any questions about our PERS devices, please get in touch with us today.

RELATED:

Best Medical Alert Systems Of 2021

Industry leading offer. Fast response times, mobile device can be used as an additional hub with 500ft of range

Lowest high end price but higher “basic” monthly plan

Uses both AT& T and Verizon networks for added range and reliability, only $5 for fall detection

Extra charge for the mobile app

One of the lowest upfront costs, free equipment with the basic plan

Not the fastest response time

Very advanced kit with motion sensors and a comprehensive mobile app that allows 24/7 monitoring

Relatively high cost compared to other services

$29.99-49.99

While cell phones are essential tools in ensuring a loved one’s safety, medical alert services offer features that take remote care a step further and that step can certainly be life-saving.

Read on for more on the best medical alert systems, and see if one of these options could help keep you or your family safe.

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So Medicare Is Out What Next

Many private insurance companies see medical alert devices as nonessential peripherals, therefore refusing to pay for them. If paying for Medicare parts A and B isn’t affordable enough, there are many options available in your community. There are hundreds of senior assistance programs in place that help seniors with a variety of different expenses, including PERS devices. To find out which services are in place in your area, be sure to contact your local Department of Human Resources. You can also touch base with the Department of Aging Services and similar departments that are tasked with serving the elderly.