Is Medical Alert Covered by Medicare

If you're a veteran, your local Veterans Affairs office may pay for part or all of the cost of a medical alert system. You should also check with your health insurance plan (Medicare Advantage, or Medigap) to see if they cover them.

Medicare Advantage plans, which are provided by private insurance companies and are governed by the states, vary by state in terms of whether they cover medical alert systems.

Medicare Part A and Part B

A medical alert system is a device worn around the neck or wrist that allows individuals to call for help in an emergency. Individuals can activate the device by pressing a button, which connects to a monitoring center where help is dispatched. These systems can help prevent falls and other dangerous situations, such as choking or being stuck in a bathtub. Many companies offer a trial plan so that seniors can try out the device before they commit to a contract.

Original Medicare, including Part A and Part B, generally doesn’t cover these devices. The exception is if the equipment is needed to improve someone’s health and they can’t safely use it without assistance from a caregiver. In this case, Medicare might reimburse the cost of the equipment. This is called durable medical equipment coverage and is a type of Part B coverage.





Other insurance plans may pay for medical alert systems, such as health savings accounts linked to employer-sponsored insurance or long-term care insurance policies. However, these plans often require that seniors meet certain eligibility requirements. Medicaid, a program for low-income seniors, might also reimburse medical alert systems. The specifics of what is covered varies by state, but some programs like home and community-based services (HCBS) or consumer-directed services might include these systems.

Medicare Advantage, which is administered by private insurance companies, might also cover these devices. These plans offer alternatives to original Medicare and typically have a monthly premium. medical alarm Since Medicare Advantage is run by private companies, it’s important to check the specifics of each plan to determine if these devices are covered.

Individuals can also deduct the cost of medical alert systems from their taxes. To qualify, items must be purchased for medical purposes and exceed 7.5% of an individual’s adjusted gross income. The IRS offers an online calculator to determine if you’re eligible.

Besides assisting in preventing dangerous situations, these devices can provide peace of mind to loved ones. There are many resources available to assist seniors with securing financial help for these devices, such as Medicare Advantage plans, local Area Agency on Aging groups and AARP.

Medicare Advantage

If you have Medicare Advantage, the private insurance that replaces Original Medicare Part A and B, you may be able to get coverage for a medical alert system. Some Medicare Advantage plans offer these devices as an add-on benefit for a monthly premium. Typically, these systems require the wearer to press a button or wear a pendant when they feel unwell or need help. This device connects to a monitoring center that responds to the call and dispatches emergency services.

The reason medical alert systems aren't covered by Medicare is that they fall outside of the definition of "durable medical equipment." Basically, they don't serve a critical medical purpose and aren't necessary for an individual's health, says Casey Schwarz, an attorney at the non-profit group Medicare Rights. She compares them to items like home wheelchair ramps that aid mobility, but aren't considered essential for the average person.

In addition to Medicare Advantage, some Medicare Supplement (Medigap) plans also offer medical alert devices. These private policies cover deductibles and copayments that aren't covered by original Medicare. However, the availability of these add-ons varies by plan. You'll need to contact your Medicare Advantage or Medigap insurer for details on what's offered in your plan.

Medicaid's Home and Community Based Services waiver programs may also offer assistance for medical alert systems. These are specialized programs designed to enable individuals who receive care in nursing homes and assisted living facilities to move back into their own home or the home of a family member. The waiver programs are available in most states, though the name of the program can vary by state.

Seniors with low incomes can also look into their local community assistive technology programs, which often loan out or rent medical alert devices. They can also ask their medical alert provider if they accept AARP or other senior discounts. Finally, those who itemize their taxes can consider claiming the cost of their medical alert device as an eligible expense on their tax return. This is a complex calculation, and it's best to consult with a tax professional before making this claim.

Medicaid

Depending on your state, the type of Medicare plan you have and your insurance provider, it may be possible to cover some or all the costs of a medical alert system. Some private insurers offer coverage for these devices, while others only cover the device itself or a portion of the monthly subscription fee. There are also other ways to pay less for a medical alert system, including through discounts offered by some companies.

Original Medicare (Medicare Part A and Medicare Part B) typically does not cover medical alarm systems because it doesn’t consider them necessary medical equipment. However, some Medicare Advantage plans do offer coverage for these devices. It’s important to note that the device and service fees don’t count towards a person’s annual out-of-pocket maximum.

Other resources to help people cover the cost of a medical alert system include Medicaid programs such as Home and Community Based Services waivers, Money Follows the Person and similar grants. These programs are designed to allow seniors who live in nursing homes or assisted living facilities to return to their own homes or move in with a relative, and they often cover services that go hand-in-hand with that goal, including medical alert systems. Each program is different, though, so it’s important to check with your local Area Agency on Aging group for specific information about what is available in your state.

Another type of private insurance that may cover medical alert devices is long-term care insurance. While details vary by policy, this type of insurance is often more likely to cover these devices than health or Medicare Advantage plans.

The best way to save on a medical alert system is by shopping around for the best price. By comparing options from several different companies, it’s possible to find a lower-cost solution without sacrificing quality. Some companies even offer free trials and flexible contract terms to make it easier for people to try before they commit to a plan. In addition, some membership organizations such as AARP have discounts for their members.

Medicare Part C

A medical alert system is a device that a senior wears, such as a necklace or bracelet, that has a button they can press to summon help. The button connects to a monitoring center, which can call an ambulance or communicate with the person over the phone to find out what happened. Medicare does not cover these systems, but people can get help paying for them in other ways.

Medical alert systems can be expensive, especially the initial device cost and monthly fees. Seniors can find discounts and rebates by checking with their insurer and membership organizations like AARP, AAA, USAA or a similar association. Many community, veteran or state agencies also offer financial support for these devices.

Medicare Part C, sometimes called Medicare Advantage, might cover medical alert systems, depending on the plan. Medicare Advantage plans are run by private insurance companies, and they might offer benefits that original Medicare does not.

For example, some Medicare Advantage plans from Humana and Blue Cross Blue Shield (BCBS) include medical alert systems as part of their plan benefits. These plans may require a doctor’s recommendation or have more limitations than the original Medicare program, but they can still be an affordable option for seniors who need assistance.

In addition to Medicare Advantage, seniors can look for other sources of funding to pay for their medical alert systems. Long-term care insurance, for example, often covers these costs and is available as an individual policy or through employers. People can also check if they have health savings accounts linked to employer-sponsored insurance or through professional trade organizations.

Medicaid, a public health insurance program for low-income seniors, might also help pay for these devices. Check with your state’s home and community-based services (HCBS) or consumer-directed service programs to see if they cover medical alert systems.

panic alarm for elderly Seniors who don’t have any other options for paying for their medical alert systems can also seek tax deductions on these expenses. The amount that is deductible will vary, but it’s worth checking with a tax preparation professional to see if your individual situation qualifies.