Understanding 'You' In Life Insurance Alerts

Medical alert systems are devices that can be lifesaving for older adults. They are personal emergency response systems that can alert emergency services when the user presses a help button or, if the device has automatic fall detection, when the user falls. Medical alert systems are not cheap, with starting monthly costs ranging from $20 to $45, and often have additional upfront or added service fees. Therefore, having insurance coverage can make a significant difference for many people. However, most insurance plans do not cover the cost of medical alert systems. Original Medicare, comprising Part A and Part B, does not consider these systems medically necessary and does not cover them. On the other hand, some Medicare Advantage plans, also known as Medicare Part C, may offer free or discounted medical alert systems as part of preventive health services. Additionally, long-term care insurance and Medicaid waivers in certain states may provide coverage for these systems.

Medicare Advantage plans may cover Life Alert

Life Alert is a popular emergency response system that is also sometimes called a Personal Emergency Response System (PERS). This device can be worn around a user's neck or placed on their wrist, allowing for convenient access in case of an emergency. A button located on the device instantly connects the wearer to an emergency call centre.

Original Medicare plans do not provide coverage for medical alert systems like Life Alert. However, Medicare Advantage (Part C) plans may cover Life Alert as an added benefit. These plans are sold by private insurance companies and can offer more benefits than Original Medicare.

Medicare Advantage plans are required to provide at least the same benefits as Original Medicare, but many offer additional coverage. If you have a Medicare Advantage plan, the benefits included may cover the cost of an emergency response system or PERS. It is important to note that Medicare coverage varies on a case-by-case basis, so individuals should contact their Medicare Advantage plan provider directly to confirm whether their specific plan covers Life Alert.

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

While Original Medicare does not consider Life Alert and similar PERS medically necessary, Medicare Advantage plans may cover them as part of preventive health services. Individuals with Medicare Advantage plans can speak with their plan providers to confirm whether they have coverage for these devices.

In addition to Medicare Advantage plans, there are other options to help with the cost of Life Alert and similar devices. Some agencies run by state or local entities may provide discounts, and the price of these services typically ranges from $20 to $40 per month, with potential setup or activation fees.

Original Medicare does not cover Life Alert

Life Alert is a personal emergency response system (PERS) that enables a person to call for help in various emergencies. These scenarios include falling in the bathtub or another part of the home, a sudden onset of a serious medical problem, or an intruder breaking into the home. The service offers 24/7 access to a monitoring center that can contact an ambulance, the police, the fire department, or other authorities and dispatch them to a person’s home.

Original Medicare, which comprises Part A and Part B, does not cover Life Alert and other PERS as they are not considered medically necessary. Medicare Part A covers inpatient care, including hospital care, nursing facility, hospice, lab tests, surgery, and home care. Medicare Part B covers clinical research, ambulance services, and mental health services, as well as durable medical equipment such as wheelchairs.

However, some Medicare Advantage plans (also known as Medicare Part C) may cover PERS as part of preventive health services. Medicare Advantage plans are sold and run by private companies and can include additional coverage such as dental, vision, prescription drug, and fitness plans. These plans are required to offer at least the same level of coverage as Original Medicare but often provide more benefits. While Medicare Advantage plans typically won't pay for Life Alert due to its high prices, they may offer cheaper alternatives.

It is important to note that insurance coverage for medical alert systems varies, and it is recommended to contact your insurance provider to confirm if you are covered for the cost of a medical alert system.

Long-term care insurance may cover Life Alert

Life Alert is a personal emergency response system (PERS) that enables a person to call for help in various emergencies. These include falling, a sudden onset of a serious medical problem, or an intruder breaking into the home. The system offers 24/7 access to a monitoring centre that can contact an ambulance, the police, the fire department, or other authorities.

Long-term care insurance helps to pay for things like caregivers or long-term care facilities. It is designed to bridge the gap and cover costs that health insurance won't. It can be used to pay for routine daily assistance, such as bathing, dressing, or getting in and out of bed, when an individual has a chronic medical condition, disability, or disorder such as Alzheimer's disease.

To find out if a long-term care insurance plan covers Life Alert, individuals can visit the plan's website or call the number on their insurance card to speak to a representative.

Medicaid waivers may cover Life Alert

Life Alert and other personal emergency response systems (PERS) are essential for older adults, especially those at a high risk of falling or managing a chronic illness. These systems can be costly, so it's natural to wonder if insurance can help cover the expense. While most insurance plans do not cover the cost of medical alert systems, there may be some options for those on Medicaid.

Medicaid is a federal program administered by individual states, and eligibility depends on income and assets. There are different programs within Medicaid that serve distinct populations and offer waivers to ensure individuals get the support they need. Here's how Medicaid waivers may cover Life Alert:

• Money Follows the Person (MFP) Program: This program helps older adults transition from nursing homes or assisted living facilities back to their own homes or relative's homes. It covers services that align with this goal, including medical alert devices. While this program is not available in all states, it can be a valuable resource for those looking to regain their independence.
• Consumer-Directed Services or Self-Directed Services: In some states, Medicaid distributes funds to enrollees and allows them to decide how to spend the money, as long as it is used for health-related costs. This gives individuals the flexibility to purchase a Life Alert system and pay for ongoing monitoring services.
• Waiver Programs: Many states have waiver programs to help Medicaid enrollees access necessary services to remain in their communities. These programs allow states to waive certain eligibility requirements, ensuring individuals receive support even if they don't typically qualify for Medicaid. While the benefits covered vary by state, many waiver programs include personal alert services.
• Personal Care Attendant (PCA) Programs: PCA programs aim to help Medicaid beneficiaries stay in their communities and pay for services that promote safety at home. These programs often cover emergency monitoring and other services, such as personal alert devices and their associated fees.

To determine if your Medicaid coverage includes Life Alert, it's essential to understand the specific programs and waivers available in your state. Contact your state's Medicaid office or refer to the list of state-specific programs below to explore your options:

• Alabama: State of Alabama Independent Living (SAIL) Waiver or Alabama Community Transition (ACT) Waiver
• Alaska: Alaskans Living Independently
• Arizona: Agency With Choice Program or Arizona Long-Term Care System
• Arkansas: ARChoices Program or Independent Choices
• California: Multipurpose Senior Services Program or Home and Community-Based Alternatives Waiver
• Colorado: Elderly, Blind and Disabled Waiver
• Connecticut: Personal Care Assistance Program
• Delaware: Diamond State Health Plan Plus
• District of Columbia: Elderly and Persons with Disabilities Waiver
• Florida: State Medicaid Managed Long-Term Care
• Georgia: Community Care Services Program or SOURCE
• Idaho: Aged & Disabled Waiver
• Illinois: Medicaid-Medicare Alignment Initiative, HealthChoice Illinois, Community Care, HCBS Waiver for Supported Living, or HCBS Services for Persons Who Are Elderly
• Indiana: Aged and Disabled Waiver
• Iowa: HCBS Elderly Waiver
• Kansas: HCBS Waiver for the Frail Elderly
• Kentucky: Home and Community-Based Waiver or Supports for Community Living Waiver
• Louisiana: Community Choices Waiver
• Maine: Elderly and Adults with Disabilities
• Maryland: Increased Community Services Program, Community First Choice Program, or Community Options Waiver
• Massachusetts: Frail Elder Waiver
• Michigan: Health Link Program or MI Choice Waiver
• Minnesota: Community Access for Disability Inclusion Waiver or Elderly Waiver
• Mississippi: Assisted Living Waiver
• Montana: Self-Direction Waiver or HCBS Waiver
• Nebraska: Aged and Disabled Waiver
• Nevada: Waiver for Persons with Physical Disabilities or HCBS Waiver for the Frail Elderly
• New Hampshire: Choices for Independence
• New Jersey: Personal Preference Program or Managed Long-Term Services and Supports
• New Mexico: Centennial Care Community Benefit
• New York: Community First Choice Option, Assisted Living Program, or Long-Term Home Health Care Program
• North Carolina: Community Alternatives Program for Disabled Adults
• North Dakota: HCBS Medicaid Waiver
• Ohio: MyCare Ohio or PASSPORT Waiver
• Oklahoma: ADvantage Program
• Pennsylvania: HealthChoices Program, Services My Way, or HCBW for Individuals Aged 60 and Over
• Rhode Island: Global Consumer Choice Compact
• South Carolina: Community Choices Waiver
• South Dakota: HOPE Waiver
• Texas: Community First Choice Program or STAR+PLUS Waiver
• Utah: Aging Waiver or UT New Choices Waiver
• Vermont: Choices for Care Moderate Needs Group or Global Commitment to Health Waiver
• Virginia: Commonwealth Coordinated Care Plus Waiver
• Washington: Medicaid Alternative Care Program, COPES, New Freedom Program, or Community First Choice Option
• Wisconsin: Family Care or IRIS
• Wyoming: Community Choices Waiver

Remember that the availability and specifics of each program may vary by state, so it's essential to contact your local Medicaid office or refer to your state's Medicaid website for the most accurate and up-to-date information.

Veterans Affairs may provide free Life Alert

Life Alert and other personal emergency response systems (PERS) are not covered by Original Medicare (Part A and Part B) as they are not considered medically necessary. However, some Medicare Advantage plans (Part C) may cover PERS as part of preventive health services.

Veterans Affairs (VA) may provide free Life Alert or other medical alert systems to eligible veterans. As of 2022, there are two VA-approved medical alert systems: Latitude Mobile Alert (formerly LiveLife Mobile) and MedEquip Alert. These devices are free for eligible veterans when prescribed by a VA physician and authorized by the VA. To qualify, the VA physician must document the need for a PERS, such as fall risk, cognitive impairment, or other medical conditions that require immediate attention in emergencies.

Latitude Mobile Alert works both indoors and outdoors and offers features like fall detection, GPS, and 4G mobile connection. It has its own mobile number and can be programmed to automatically answer trusted callers. On the other hand, MedEquip Alert devices are monitored, allowing users to quickly connect to a 24/7 monitoring center for help. Operators at the monitoring center are automatically provided with the user's name, address, and GPS location in an emergency, potentially reducing response times.

To obtain a free medical alert system from the VA, veterans should:

• Contact their VA primary care doctor or VA hospital clinician.
• Discuss the reasons for requesting a medical alert system, such as living alone or a risk of falls.
• The physician may then send a prescription to the VA for authorization.
• If approved, the device will be provided directly through Latitude USA or MedEquip at no cost.

In addition to the two VA-approved devices, the VA may also help veterans pay for other medical alert systems through the VA Prosthetic and Sensory Aids Service. Veterans can discuss their needs with their VA doctor or contact their local VA office to inquire about coverage for their preferred device.

Frequently asked questions