Original Medicare won't pay for a medical alert system, but some Medicare Advantage plans and some state Medicaid programs can. If you lie awake picturing your mom or dad on the floor at home with no one there, you want that answer before you sign up for anything. If your parent has a Medicare Advantage plan or already gets Medicaid care at home, ask first whether that plan or program covers a medical alert system; if neither pays, a short list of questions will help you compare companies before you spend your own money.

In This Guide

What a Medical Alert System Is

A medical alert system goes by a few names. Ads call it a medical alert or a "fall button." Government programs usually call it a personal emergency response system, or PERS. The idea is the same: your parent presses a button, and the device calls for help.

CMS, the federal agency that runs Medicare, describes it plainly. Its Medicare Managed Care Manual, which governs Medicare Advantage plans, calls a PERS an in-home device "designed to notify appropriate personnel of an emergency (e.g., a fall)." CMS's Medicare equipment list calls the same kind of device an emergency communications system. Those two descriptions matter, because how a program classifies the device decides whether that program will pay for it.

If your parent hasn't fallen yet, an alert button isn't the only step worth taking. Our guide to home safety and fall prevention covers the changes that make a fall less likely in the first place.

Does Medicare Cover Medical Alert Systems?

No. Original Medicare (Parts A and B) doesn't pay for a telephone alert system as medical equipment. It's a hard answer when you were hoping for help, but it's better to know now than after a bill arrives.

The reason is in writing. CMS keeps a national reference list of durable medical equipment, National Coverage Determination 280.1, and Medicare's claims contractors are required to follow it. National Coverage Determination 280.1 gives the equipment category "Telephone Alert Systems" the Original Medicare coverage status "Deny," with this explanation: "these are emergency communications systems and do not serve a diagnostic or therapeutic purpose."

That denial tracks how federal regulation defines durable medical equipment. Under 42 CFR 414.202, equipment Medicare treats as durable medical equipment must meet every listed condition, including that it "is primarily and customarily used to serve a medical purpose" and "generally is not useful to an individual in the absence of an illness or injury."

One caution on wording. CMS's list names "telephone alert systems," and newer devices come in many forms. The reasoning CMS gives, that these are communications devices rather than medical ones, is the part to hold onto when a salesperson suggests Medicare might reimburse you.

Can a Medicare Advantage Plan Cover a Medical Alert System?

Sometimes, yes. If your parent has a Medicare Advantage plan, it's worth a phone call to find out.

A Medicare Advantage plan (Part C) must cover everything Original Medicare covers, and it may also cover things Original Medicare doesn't, like some vision, hearing and dental services. Medicare Advantage extras of this kind are called supplemental benefits, and CMS's Medicare Managed Care Manual lists a personal emergency response system among the examples a plan may offer.

CMS attaches conditions to a Medicare Advantage PERS benefit:

  • A Medicare Advantage PERS has to be primarily health related. CMS's Medicare Managed Care Manual says Medicare Advantage plans may provide in-home personal emergency response devices "provided that they are primarily health related."
  • A cell phone doesn't count. CMS's Medicare Managed Care Manual says a PERS offered as a Medicare Advantage supplemental benefit "may not include cellular telephones because such devices are not primarily health related."
  • No Medicare Advantage plan is required to offer a PERS benefit. CMS calls its list of eligible supplemental benefits "illustrative, not exhaustive," and each plan decides what it includes.
  • A Medicare Advantage PERS benefit isn't necessarily free. Under 42 CFR 422.100, a Medicare Advantage supplemental benefit is paid for through the plan's premiums or cost sharing, and an optional supplemental benefit is one your parent chooses to buy and pays for in full.

So if your parent is in a Medicare Advantage plan, call the member services number on their plan card and ask, in these words, whether the plan covers a personal emergency response system this year, what it costs, and which company provides it. If your parent has a serious chronic condition, their plan may also offer special supplemental benefits for the chronically ill, which have their own rules. For how these plans work more broadly, see our guide to how Medicare Advantage works.

Can Medicaid Pay for a Medical Alert System?

In some states, for people who qualify, yes. Some state Medicaid programs that help older adults get care at home instead of in a nursing home list a personal emergency response system by name among their covered services.

Three examples show what that looks like. They're examples, not a full list, so check your own state's program even if it isn't named here.

  • District of Columbia. DC Medicaid's EPD Waiver (Elderly and Persons with Physical Disabilities) covers personal emergency response services (PERS), along with case management and personal care aide services. The DC EPD Waiver serves DC residents who are 65 or older, or 18 to 64 with a physical disability, who would otherwise need nursing-home care, and it has its own financial rules. Our guide to the DC EPD Waiver walks through them.
  • Arkansas. Arkansas Medicaid's ARChoices in Homecare program lists a personal emergency response system among its services. An Arkansas ARChoices applicant must meet all three of its requirements: be 65 or older, or 21 through 64 with a physical disability; meet the program's financial criteria; and meet the nursing-home level of care. See our Arkansas HCBS waiver guide for details.
  • Delaware. Delaware Medicaid's Diamond State Health Plan-Plus (DSHP-Plus) covers long-term care services for Delaware residents who are elderly or physically disabled, and Delaware's Medicaid agency says DSHP-Plus home and community-based services "might include" personal emergency response systems. The DSHP-Plus page doesn't publish an eligibility test, so a Delaware family needs to confirm the qualifying criteria with the state. Our Delaware HCBS guide has more.

If your parent already gets care at home through Medicaid, the simplest step is to ask their case manager whether a personal emergency response system can be added to the care plan.

Who Pays: A Side-by-Side Look

Payer Will it pay for a medical alert system? What decides it
Original Medicare (Parts A and B) No, not as medical equipment CMS's national equipment list marks "Telephone Alert Systems" as "Deny"
Medicare Advantage (Part C) Maybe, if the plan offers PERS as a supplemental benefit The plan's own benefits; a cell phone doesn't qualify
Medicaid home and community-based programs In some states, for people who qualify The state program's covered services and eligibility rules, as in DC, Arkansas and Delaware,,
Your family Yes, you choose and pay the company directly The company's own terms, so read the contract

What to Ask Before You Buy

If no program will pay, you'll be choosing on your own, and the ads all sound alike. You don't need to become an expert. You need a short list of questions, asked the same way of every company, so you can compare the answers side by side.

About what happens when the button is pressed:

  • Who answers the call, and are they available 24 hours a day?
  • What does the person on the line do next: call 911, call you, or both, and in what order?
  • Can your parent talk to them through the device from anywhere in the home, including the bathroom?
  • Does it work outside the home, like in the yard, at the store, or on a walk?

About the device itself:

  • Does your parent have to press the button, or can it detect a fall on its own? If it detects falls, what happens when it's wrong?
  • Is it waterproof enough to wear in the shower?
  • How is it charged, and how will you know if the battery is low?
  • What does your parent need at home for it to work: a landline, a cellular signal, or Wi-Fi?

About money and commitment:

  • What's the monthly cost, and is there a separate charge for the equipment, setup or shipping?
  • Is there a contract? What does it cost to cancel, and is there a trial period?
  • If your parent moves into assisted living or a hospital stay runs long, can you pause service?
  • If a Medicare Advantage plan or Medicaid program covers PERS, is this company one it works with?

One more question to ask yourself: did you contact this company, or did it contact you? Be cautious with any unexpected call offering a "free" device. Our guide to scams targeting older adults explains the common patterns.

And if your parent pushes back on wearing one, our guide on what to do when a parent refuses help has ways to talk it through.

Where to Get Local Help

The fastest way to find out what's available where your parent lives is the Eldercare Locator, a free national service of the Administration for Community Living. Call 1-800-677-1116 or search online at eldercare.acl.gov. The Eldercare Locator links families with state and local Area Agencies on Aging and community organizations that serve older adults and their caregivers, and its operators refer callers to a local agency that can help.

When you call, ask whether any local program helps pay for a personal emergency response system, and whether your parent might qualify for your state's Medicaid home and community-based services. If you're not sure which door to knock on first, our guide to the AAA, the ADRC and the Eldercare Locator sorts them out. And if you live far from your parent, our long-distance caregiving guide covers how to coordinate help from a distance.

Frequently Asked Questions

Does Medicare cover Life Alert or other brand-name alert systems?

No. Original Medicare's denial applies to the whole category of telephone alert systems, so a brand name doesn't change the answer (see Does Medicare Cover Medical Alert Systems? above). A Medicare Advantage plan is a separate question, because each Medicare Advantage plan decides whether to offer a PERS.

Is there a free medical alert system for seniors?

"Free" usually means a program is paying for the device. Even a Medicare Advantage PERS benefit can carry a cost: an optional Medicare Advantage supplemental benefit is one the enrollee chooses and pays for in full through premiums or cost sharing. Ask the plan which kind its PERS benefit is before you assume it costs nothing.

Can a cell phone or smartwatch count as a medical alert system?

A cellular telephone can't be a Medicare Advantage PERS benefit, under CMS's Medicare Managed Care Manual. That CMS rule names cellular telephones only, so for a smartwatch or other wearable, ask your parent's Medicare Advantage plan which devices its PERS benefit supplies. A phone your parent already carries can still help the family stay in touch, even though no Medicare Advantage plan will cover it as a PERS.

Should my parent switch to Medicare Advantage to get a medical alert benefit?

Weigh the whole plan, not one extra. A person who joins a Medicare Advantage plan still has Medicare and keeps the same rights and protections, but gets most Part A and Part B coverage from the plan instead of from Original Medicare. Because no Medicare Advantage plan has to offer a PERS and the cost depends on the plan, confirm that a specific plan includes a PERS benefit, and what it charges, before choosing that plan for it. For help comparing plans, see our guide to Medicare counseling through SHIP.

Learn More

CaregiverHome Safety and Fall Prevention for Aging Parents: A Caregiver's GuideFalls are the leading cause of injury death for adults 65+, but most are preventable. The four CDC steps, a room-by-room checklist, and who to call for help. MedicareHow Medicare Advantage Works: Costs, Networks, and CoverageMedicare Advantage (Part C) is a Medicare-approved private plan that gives you most of your Part A and B coverage. What you pay, networks, and when to switch. CaregiverAAA vs. ADRC vs. Eldercare Locator: Which Door Do I Use?Eldercare Locator, Area Agency on Aging, or ADRC? Learn what each federal front door to elder care does and which one to call first for your aging parent. CaregiverLong-Distance Caregiving: How to Help an Aging Parent From Far AwayHow to care for an aging parent from a distance: what you can do from afar, the family meeting to have first, staying connected, and finding local help. CaregiverSigns Your Aging Parent Needs Help: What to Watch ForHow to tell when an aging parent needs help: warning signs in daily tasks, personal care, safety, medications, and memory, plus what to do and where to start.

Find personalized help figuring out who can pay for a medical alert system for your parent at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.