Life Line Alert For The Elderly: Insurance Coverage Explained

Medical alert systems are devices that can be life-saving for older adults, especially those at high risk of falling or managing a chronic illness. While these systems can be costly, there are several ways to get financial support. Original Medicare (Parts A and B) does not cover medical alert systems because they are not considered durable medical equipment. However, Medicare Advantage (Part C) plans offered by private insurance companies may provide full or partial coverage for these devices. Additionally, long-term care insurance, Medicaid waivers, Veteran Affairs benefits, and local area agencies on aging can provide coverage or discounts. It is important to contact your insurance provider and review your specific plan to determine if medical alert systems are included in your coverage.

Medicare Advantage plans

Some of the types of medical alert systems that may be covered by Medicare Advantage plans include:

• Alert bracelets or necklaces
• At-home speakerphone systems
• Cellular medical alert systems with GPS technology
• Activity tracker systems

If you are enrolled in Medicare and want to obtain Life Alert or another PERS, you may have to pay for it yourself if your Medicare Advantage plan does not cover it. The cost of a medical alert system can vary, but it typically involves a monthly subscription fee ranging from $20 to $55, plus additional costs for features like automatic fall detection.

In summary, while Medicare Advantage plans may offer coverage for medical alert systems, it is important to review your specific plan details to determine if this benefit is included and what percentage of the cost is covered.

Long-term care insurance

Seniors with long-term care insurance are most likely to be covered for a medical alert system. Although plans vary, most will cover all or a portion of the cost. This is because long-term care insurance exists to support you as you age.

To find out if your long-term care insurance covers medical alert systems, you can:

• Check directly with your provider for specifics about reimbursement.
• Visit the plan's website to review covered services.
• Call the number on your insurance card to speak to a representative.

When checking with your provider, you can ask the following questions:

• Is a device and the monthly monitoring fee covered, or just the device?
• Do I need any documentation from my doctor to receive coverage?
• What's the lifetime reimbursement for a medical alert system?

If you don't have long-term care insurance, there are other ways to get help paying for a medical alert system. For example, Medicare Advantage plans may cover all or a portion of the cost, and there are also discounts for veterans and AARP members.

Medicaid waivers

A Medicaid waiver allows eligible individuals to receive financial assistance from their state, even if they don't meet the traditional requirements for Medicaid enrollment. Many states offer home- and community-based services (HCBS) waivers, also known as 1915(c) waivers, to help people aged 65 and older access the equipment and services they need to live in their homes, including medical alert systems.

How to Apply for a Medicaid Waiver

To apply for a Medicaid waiver, you can use the NCOA's BenefitsCheckUp tool to find Medicaid waivers for home- and community-based services in your area. Here are the steps to follow:

• Enter your ZIP code and click the arrow to be taken to the categories page.
• Select "Aging in Place" and click "Next."
• Click again on "Aging in Place" and look for the "Home and Community-Based Waiver."
• If it's available in your community, it will appear in the list of programs. (The program may have a different name, such as the Assisted Living for the Elderly (ALE) Waiver.)
• Click "View More Info" to see if Personal Emergency Response System (or similar) is listed as one of the services.
• If you don't see personal emergency response system listed, scroll down and click "Who should I contact?" to find the program's contact information. Call to verify medical alert system coverage, as it may be available under a different name, like environmental modifications or home adaptations.
• Once you've found the right Medicaid waiver, you can click the "Apply Online" button and fill out an application through your state's Medicaid website.

Medicaid Waiver Availability

It's important to note that not all states offer home and community-based Medicaid waivers. As of October 2023, Arizona, New Jersey, Rhode Island, and Vermont do not offer these waivers.

Other Options for Financial Assistance

In addition to Medicaid waivers, there are other options for financial assistance to obtain a medical alert system:

• Long-term care insurance: Medical alert systems may be covered under your long-term care policy. Check your policy's summary of benefits and coverage (SBC) or evidence of coverage documents to see if it includes medical alert systems.
• Medicare Advantage (Part C): Medicare Advantage plans may cover medical alert systems, but coverage varies by plan and state. Check your plan's SBC to see if it includes medical alerts or personal emergency response systems.
• Veterans Affairs (VA): The VA provides free medical alert devices to eligible veterans. You can visit your local VA office, contact your VA health care provider, or talk to your primary care doctor or occupational therapist to request a medical alert system.
• Area Agency on Aging (AAA): AAA provides support services to older adults, and some offer financial assistance or discounted rates for medical alert systems. They can also help you navigate the Medicaid waiver application process.

Veteran Affairs

The Department of Veterans Affairs (VA) provides free medical alert devices to eligible veterans. To find out if you are eligible, you must visit your local VA and request a medical alert system. A healthcare provider will then determine your eligibility, and if applicable, the VA will order the system for you.

Veterans in nursing homes or assisted living care programs are usually not eligible for these free devices. Additionally, Tricare for Life, a free supplemental program for veterans enrolled in Medicare Parts A and B, does not typically cover living space alterations, safety medical supplies, or long-term care, so it is unlikely to cover medical alert systems.

Veterans Affairs Life Insurance (VALife) is a guaranteed acceptance whole life insurance program for service-connected veterans aged 80 and under. VALife provides up to $40,000 in whole life insurance coverage in $10,000 increments. The program began on January 1, 2023, and there is no time limit to apply after receiving a disability rating. The full coverage amount takes effect two years after enrollment, during which time premiums must be paid. If the insured dies within the two-year waiting period, the beneficiary will receive all premiums paid plus interest.

Veterans' Group Life Insurance (VGLI) allows veterans to convert their Servicemembers' Group Life Insurance (SGLI)—a low-cost group term life insurance program for Servicemembers—to a civilian program of lifetime renewable term coverage after separation from service. Family Servicemembers' Group Life Insurance (FSGLI) insures spouses and dependent children of Servicemembers with SGLI coverage. Spousal coverage may not exceed the Servicemember's coverage, while dependent children are automatically covered at no charge. Servicemembers' Group Life Insurance Traumatic Injury Protection (TSGLI) is an automatic feature of SGLI that provides payments to Servicemembers who suffer losses such as amputations, blindness, or paraplegia due to traumatic injuries incurred during service.

Local area agencies on aging

To find your local area agency on aging, you can search online for "local area agencies on aging near me" or "local area agency on aging [your county/city/state]." You can also visit the Benefits CheckUp website to see additional information on services you might be eligible for.

These agencies can provide information on a range of services and resources, including medical alert systems, which can be life-saving devices for older adults, especially those at high risk of falling or managing a chronic illness. While most insurance plans do not cover the cost of medical alert systems, local area agencies on aging may be able to direct you to other options to help cover the costs, such as Medicare Advantage plans, Medicaid, veteran's benefits, or health savings accounts.

Additionally, some medical alert system companies offer discounts for seniors, such as an AARP discount, so be sure to inquire about any potential discounts when speaking with a local area agency on aging or a medical alert system company.

Frequently asked questions