Is Medical Alert Covered by Medicare
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fall alert necklace Unfortunately, medical alert systems are not considered durable medical equipment and thus do not qualify for Medicare coverage. However, many seniors can get assistance with the initial device cost and monthly monitoring fees by checking their local Area Agencies on Aging.
Medicare Part A
Medicare Part A, also known as original Medicare, does not cover medical alert systems. A person who wants this type of coverage must opt for a Medicare Advantage plan, which is administered by private insurance companies and typically requires a monthly premium. Medicare Advantage plans vary in what they cover from state to state, but some do include medical alert systems.
panic alarm button for elderly Other sources of financial coverage for medical alert systems may be available, such as a health savings account (HSA), flexible spending accounts (FSA) or a long-term care policy. Some medical alert system providers offer AARP or other senior discounts, and a person should check with his or her preferred provider to find out whether such options are available.
Individuals can also try to get coverage for medical alert systems through Medicaid, which is run by individual states. Some states, for instance, offer programs such as Home and Community-Based Services or Money Follows the Individual that can cover medical alert devices as part of a package to help seniors stay in their homes instead of moving into assisted living.
Medicare Part B
Most Medicare beneficiaries are familiar with Part B, which covers durable medical equipment like wheelchairs and walkers. But what most seniors don’t realize is that medical alert systems aren’t considered durable equipment, so they don’t qualify for coverage under this part of the program.
medical alert systems However, some seniors with Medicaid insurance may find that their medical alert systems are covered under a program called Home and Community Based Services or Consumer Directed Service, which is run by each state. This type of waiver can cover the cost of equipment and monthly monitoring fees.
Seniors can also find coverage for medical alarm devices by enrolling in Medicare Advantage, which offers private insurance coverage through a variety of companies. This type of coverage includes all of the benefits offered by premium Part A and Part B, but varies by plan. To find out if a specific Medicare Advantage plan covers a medical alert system, contact the plan directly and ask.
Medicare Advantage
Medicare Part C (Medicare Advantage) is private insurance that provides the same coverage as Original Medicare with extra benefits. These benefits can include medical alert systems.
The type and amount of coverage varies by plan and insurer, however. Some plans may offer a bundled option where the device and monthly subscription fee are included in one monthly payment. Some companies may also offer discounts for AARP members or seniors who purchase through a specific provider.
As the cost of these devices has grown, many seniors are looking for ways to cover the expense. While the most obvious options are Medicaid or long-term care insurance, those plans differ from state to state and can vary widely in the level of coverage provided. For instance, some states have specific waiver programs, such as the Home and Community-Based Services Waiver or Consumer Directed Service, that cover medical alert systems. Other states may only offer reimbursement for the device itself, but not the monthly fee.
Medicaid
Medicare, the national health insurance program for seniors in the United States, doesn’t cover medical alert systems. That’s because these systems don’t fit into the category of durable medical equipment, as defined by the Centers for Medicare and Medicaid Services.
Some Medicare Advantage plans offer coverage for medical alert systems, but that varies by plan. If you have Medicare Advantage, call your plan provider to ask about what benefits they offer.
Some private health insurance programs also cover the cost of medical alert systems, as do some health savings accounts, which are often linked to employer-sponsored insurance. Seniors who are on Medicaid, a joint federal and state program for low-income seniors, should check to see if they can get help with the purchase and monthly monitoring costs of a medical alert system through a 1915(c) waiver or home and community-based services (HCBS) or consumer directed service funding programs. These options can vary by state.
