Health Insurance And Life Alert: What's Covered?

Medical alert systems are devices that can be used in emergencies to call for help. They are often marketed to seniors, who may need them if they fall or experience a health issue. However, they are not limited to seniors and can be useful for anyone who wants the peace of mind that comes with having a safety net. The cost of these systems can be a barrier for some, especially those on a fixed income. So, does health insurance cover medical alert systems?

Medicare Part C may cover Life Alert

Medicare Part C, also known as Medicare Advantage, is a supplemental health plan that may cover Life Alert. It is an addition to an existing policy, so you can only get it if you’re an existing policyholder. While Original Medicare plans do not provide coverage for medical alert systems, Medicare Advantage plans may include it as an added benefit.

Medicare Advantage plans tend to cover various health concerns and may include coverage for medical alert systems. However, medical alert systems and other personal emergency response systems (PERS) are not typically an added benefit.

If your Medicare plan doesn’t cover your medical alert system, you may still be eligible for discounts and/or tax-advantaged payment methods like health savings accounts or flexible spending accounts.

To find out if your Medicare Advantage plan covers Life Alert, you should contact your provider directly.

Medicaid may cover Life Alert

Medicaid may provide coverage for "Personal Emergency Response Services", which can include medical alert devices or similar monitors and sensors. There are four programs under Medicaid that can provide funding for a medical alert system:

Home Community Based Services (HCBS) Waivers

These waivers are the most common source of funding for medical alert systems. While each state sets its own policies for waivers, they typically cover the monthly service fees of medical alert systems. The waivers can also come in the form of a one-time reimbursement for start-up costs such as setup fees or equipment costs.

Money Follows the Person (MFP)

This is a grant intended for consumers receiving care from nursing homes or assisted living facilities. The grant provides assistance for patients who want to move back to their homes or to a relative's home. Medical alert systems are covered under this grant as they support the goal of aging in place without healthcare facilities.

Consumer Directed Services

Medicaid provides funding for daily assistive care but does not specify further requirements for that care. Thus, a consumer can decide which assistive healthcare services the funding is used for, including medical alert systems.

State Plan Personal Care Attendant (PCA) Programs

These are entitlement programs that pay amounts comparable to the HCBS waivers.

While Medicaid may cover Life Alert, it is important to note that each state oversees its own Medicaid program, so it is best to contact your state insurance provider to find out if you can get full or partial coverage.

Long-term care insurance may cover Life Alert

Long-term care insurance is designed to bridge the gap and cover costs that health insurance won't. It helps cover the costs of care when you have a chronic medical condition, disability, or disorder and can reimburse you for care given in a variety of places, such as an assisted living facility, an adult day care center, or a skilled nursing facility.

Long-term care insurance and medical alert systems: Long-term care insurance may cover medical alert systems, but this depends on the provider and plan. These plans often cover all or a portion of the cost of a medical alert system because they aim to help seniors as they age. To find out if your long-term care insurance provider offers coverage for medical alert systems, you can review the covered services on the plan's website or call the number on your insurance card to speak to a representative directly.

It's important to note that long-term care insurance policies usually have specific requirements for an individual to be eligible for benefits. For example, you may need to be unable to perform a set number of activities of daily living or have a cognitive impairment. Additionally, there may be a waiting period before benefits kick in, typically ranging from 30 to 90 days.

When considering long-term care insurance, it's essential to review the specific terms, conditions, and exclusions of the policy to understand what is and isn't covered. Contacting the insurance provider directly is the best way to get accurate and detailed information about your coverage.

Private health insurance may cover Life Alert

If you have private insurance, it is worth checking with your provider to see if you are covered for the cost of a medical alert system. You can do this by calling the number on the back of your health insurance card or by visiting your insurance plan's website.

Even if your private insurance does not cover the cost of a medical alert system, you may still be eligible for discounts or be able to use pre-tax money to pay for the system. For example, you may be able to use a health savings account (HSA) or flexible spending account (FSA) to help cover the costs. Additionally, some companies offer discounts and deals on medical alert systems throughout the year.

Discounts and rebates may be available

Some insurance companies may reimburse the cost of a life alert system if the individual's circumstances merit it. This usually requires a doctor's recommendation. Long-Term Care Insurance may also cover the cost of a life alert system as it includes durable medical equipment.

If your insurance does not cover the cost of a life alert system, there are other options to consider. Some providers offer discounts and deals, and flexible payment plans are also available. Additionally, AARP members may be eligible for discounts on life alert systems. Senior Safety, for example, offers a $25 Visa gift card to new customers who sign up for a quarterly or annual medical alert plan. Life Alert is a reputable company that offers top-notch customer service and prompt medical attention, but it does require a 3-year commitment, which may be a financial burden for some seniors. It is important to consider your budget and choose a plan that fits your needs and lifestyle.

Frequently asked questions