How To Choose a Medical Alert System

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Senior woman looking at family photo album with her grandchildren while wearing a medical alert system button over her neck.

Rather than calling 911, the medical alert system directs you to a monitoring center with care professionals available around-the-clock who assess your situation and alert your loved ones, and dispatch emergency medical services to your home if necessary.

“Systems have evolved so they are not just, ‘I’ve fallen and I can’t get up,’” says Beth Weeks, a registered nurse and co-founder of Senior Living Consultants of New York, serving the New York City metropolitan area. “If someone falls, a sensor can detect that they are on the floor and notify a care provider or emergency services.”

Ultimately, the purpose of a medical alert system is to act as a “backup to a backup,” Weeks says, noting that these devices do not replace the role of a caregiver, but they are an extra layer of protection and oversight for older adults, and offer peace of mind to loved ones.

“The technology of medical alert systems has been around for quite some time, and it definitely has evolved with the size, shape, sensors and features, and technology has made them cheaper than they were years ago,” says Saket Saxena, M.D., a physician at the Center for Geriatric Medicine at the Cleveland Clinic in Cleveland, Ohio. “It’s fair to say, we have seen an increase in the use of medical alert systems and devices as years have passed by.”

Medical Alert Systems vs. Medical ID Bracelets

Medical alert systems are not the same as medical ID bracelets, which are exactly that: a bracelet that contains identifying information and pertinent healthcare details such as allergies. A medical ID bracelet can also include the name of an emergency contact. Medical alert systems are devices that alert a monitoring center when you need help so the service can contact a loved one and/or emergency services.

A medical alert system and medical ID bracelet can work hand-in-hand. “The bracelet is a nice backup in case a caregiver turns their back for a minute to go to the bathroom and Mr. Smith goes out the door,” Weeks says. “There’s a nice synergy there, but one does not replace the other.”

A medical ID bracelet by itself is “a limited way of communication,” Dr. Saxena says.

Monitored vs. Unmonitored Medical Alert Systems

Monitored medical alert systems connect you to a call center that is open 24/7 and staffed with operators who field calls for help, dispatch emergency medical services, and contact loved ones. With monitored medical alert systems, you get the peace of mind that when you press the help button or when a fall detection device is triggered, you’ll be automatically directed to a monitoring center that will address the situation. The drawback is you’ll pay a monthly subscription fee for the monitored system.

On the other hand, unmonitored medical alert systems do not charge monthly fees but have limited capabilities. While the unmonitored system will connect directly to 911 or the contacts you provide, it usually lacks features like fall detection, activity tracking, medication reminders, and wellness checks like what’s offered by the Best Medical Alert Systems of 2021.

You may need a medical alert system if you live at home alone and want the assurance of a direct call for help in case of an accident, medical emergency, or healthcare need. These devices are ideal for “patients who are older, who are at risk for falls, who have fallen in the past and who have medical conditions that elevate the risk of falling, such as Parkinson’s, or who are on multiple medications that could also increase the risk of falling,” Dr. Saxena says.

Weeks also recommends medical alert systems in cases where an older adult lives far away from loved ones or those who could help. “I spoke with a sister of a client who is 79 and lives at home alone, and she is her responsible party who oversees care,” she says. “She is concerned because her sister has Alzheimer’s. She said, ‘I don’t know what will happen if she gets lost.’ I told her one thing to consider is a medical alert system that is GPS-tracked."

Another advantage of a medical alert system is that "it works as a virtual person in the room who sees mom fall on the floor and notifies emergency services rather than a doorman finding her three days later,” Weeks adds.

Other reasons to use a medical alert system include:

  • If you take medications with side effects
  • If you feel anxious about living alone or worry about getting help when you need it
  • If you do not live close to family or caregivers who can help
  • If you have a health condition that can result in confusion or wandering
  • If you want the assurance of being able to contact help when you are out of the house

Choosing a Medical Alert System

Today’s medical alert systems include a variety of features, such as being able to automatically detect falls and call for help, track your location, and remind you to take your medications. You can go for a simple system or opt for a high-tech wearable smartwatch. Of course, with features comes added cost. When buying a medical alert system, you’ll want to consider which features you’ll actually use and how much each costs. Also carefully review the alert company's policies so you understand how the monitoring center works, your contract obligations, and out-of-pocket fees like activation and equipment charges.

How Much Does a Medical Alert System Cost?

In our Best Medical Alert Systems of 2021 rankings, monthly subscription prices start at $19.95 for a basic in-home system from One Call Alert that's cellular-based (no landline required) and comes with a wearable help button that is not GPS-enabled. At the top of the price range is the MobileHelp Touch. This advanced system replaces the basic base station with a tabletlike touch screen that connects with your wearable pendant. Prices start at $59.95 a month with its semiannual payment plan.

Depending on the medical alert company, you can often choose whether to pay monthly, quarterly, semiannually, or annually. Your costs are often lower if you choose a yearly payment plan over a month-to-month plan.

“The competition is pretty big out there, so pretty much everyone charges around the same prices,” says Alex Guitelman, owner of ResponseLink of Manhattan, a national distributor of personal emergency response devices. “Most devices you rent, so you’ll pay a monthly subscription. Some make you pay for the device ahead of time.”

Shipping ranges from free to $19.95. Most companies we rated do not charge an upfront equipment fee. The exception is if you choose a GPS-enabled smartwatch or cell phone, as with the GreatCall JitterBug Smart2 smartphone or Bay Alarm Medical On-The-Go SOS Smartwatch.

You’ll also want to find out if the company charges an activation fee. While the majority of companies in our Best Medical Alert Systems of 2021 rankings do not, this fee can cost up to $198 (Life Alert).

Here are fees to be aware of when picking a medical alert system:

Monthly Fees: Medical alert companies charge a monthly subscription fee for the monitoring service, equipment, and features.

Annual Fees: Depending on the company, you can pay annually for your subscription to a medical alert system, or select monthly payments.

Shipping Fees: Shipping for the medical alert system you order is free in many cases, though several companies we ranked charge an average of $10 and as much as $19.95 for shipping.

Activation Fees: Activation fees cover the cost of “turning on” your medical alert system’s connectivity to the monitoring center. In most cases, activation is free.

Upfront Device Fees: All of the in-home systems in our ratings that are landline-based and cellular-based systems come with free equipment. If you choose a medical alert system that is a smartwatch or phone, or a GPS-enabled wearable, you might pay an upfront device fee of $49.99 (GreatCall Lively Mobile Plus) to $299.95 (Medical Guardian Freedom Guardian Smartwatch and charging units).

Does My Medicare Policy Cover Medical Alert Systems?

Traditional Medicare (Parts A and B) does not cover medical alert systems, but Medicare Advantage (Part C) provides some extra benefits that could include reimbursement or some coverage for these devices.

Do Other Insurance Policies Cover Medical Alert Systems?

Other insurance policies could cover a medical alert system subscription or equipment, or provide some reimbursement for these expenses. The coverage depends on your carrier and policy.

Do Medical Alert Systems Have a Money Back Guarantee?

Some medical alert systems come with a money-back guarantee, but be sure to read the fine print in the contract so you understand the terms and whether a trial period with refund is available. Of the Best Medical Device Systems of 2021 that we ranked, those that offer money-back guarantees like LifeFone, Philips Lifeline, and MobileHelp provide a 30-day trial period. Some companies will require you to activate the device and try it before you return it. Check the fine print because you might not get reimbursed for activation fees or shipping charges.

Do Medical Alert Systems Have a Warranty?

The Best Medical Alert Systems of 2021 that offer a warranty generally cover equipment wear and tear, but be sure to read the fine print so you understand the exclusions. Some companies like Bay Alarm Medical offer an additional protection plan for a fee (Bay Alarm's is $5 per month). These protection plans typically cover a one-time replacement of the base station or a device and a discount on lost and damaged accessories.

Do Medical Alert Systems Require a Contract?

No, most alert companies don't ask you to sign a long-term contract. The only company we reviewed in our Best Medical Alert Systems of 2021 that requires a contract is Life Alert with a three-year term. Some plans, such as those from LifeFone, have a price-lock guarantee that your monthly rates will never increase.

Most medical alert systems are either in-home base units that operate from a landline or cellular service and include a help button that you wear. Some are mobile systems that work anywhere a cellphone network reaches. (Check to see if the specific cellular network is available in your area.) Beyond these basic features, today’s medical alert systems may also allow you to set medication reminders, see the current location of the person wearing the alert device, and automatically call for help if a fall is detected.

Before adding features, consider what you (or your loved one) can reasonably use. “We have to take into account the individual’s capabilities and their functions – what they can and cannot do – and that way it will help us make a decision about what type of technology would be helpful for that patient,” Dr. Saxena says.

An important feature is automatic fall detection that alerts the monitoring center when it picks up a sudden change in elevation (a fall) so you do not have to press a button if you fall. That said, medical alert companies still recommend that you press your help button if you fall to ensure that the monitoring center is notified. Fall detection is a common add-on feature, with most companies in our Best Medical Alert Systems of 2021 rankings offering the service for an extra $10 per month. Spouse monitoring is also nice to have because you can add another adult in the household to your plan, and many of the companies we rated offer this at no extra cost. However, the least expensive medical alert systems do not offer any of these extras.

Devices: Medical alert devices can include in-home base units that plug into a wall electrical socket and connect via your landline or the provider’s cellular service. With this unit, you’ll usually also get a wearable help button that is about the size of a silver dollar and weighs a couple of ounces. These are sometimes completely waterproof, and all are at least water-resistant and can be worn in the shower. Some companies offer mountable help buttons you can post on walls or in the shower. There are GPS mobile units that you can wear on a lanyard or as a wristwatch. Some larger GPS units clip to a belt. You can also opt for a smartphone or smartwatch that has medical alert capabilities.

In-Home Range: The in-home range is how far your wearable help button will work from the base unit. In-home ranges from the companies we ranked vary from 350 to 1,400 feet.

Base Unit: Base units for in-home medical alert systems plug into a typical electrical outlet. You’ll want to avoid using a plug that is connected to a switch so it doesn’t accidentally get turned off. You can get a base unit that connects to the monitoring center using your landline or a cellular connection (provided by the medical alert company). These devices include two-way communication so you can speak to the operator at the monitoring center and the care professional can hear you. Some companies, like Alert1, offer a voice extender that acts like an intercom system and is ideal for large homes. The base unit has a help button on it as well. Battery backup for base units is important in case your power goes out, and battery life ranges from 24 to 72 hours.

Emergency Call Button: Emergency call buttons are on base units, GPS mobile devices, and smartwatches. Systems also come with wearable help buttons that connect to an in-home base unit or GPS unit. You can also find wall-mount emergency call buttons, such as the shower button offered by Life Alert and wall buttons offered by Medical Alert.

Two-Way Communications: Base units, GPS devices, and wearable help buttons are typically equipped with a speaker and microphone for two-way communication. Basically, two-way communication is like using a speakerphone. This allows you to speak to the monitoring center or caregiver when you call for help. Two-way communication is a feature that all the Best Medical Alert Systems of 2021 offer, and we consider it a standard feature.

Automatic Fall Detection: Every second of the day, an adult 65 years or older falls, according to the Centers for Disease Control and Prevention (CDC). The CDC also reported that one out of four adults in this age group will fall each year. Fall detection is designed to immediately and automatically call for help. The wearable (neck or wrist) fall button senses sudden changes in elevation and triggers a call to the medical alert system’s monitoring center. Fall detection is available with most of the Best Medical Alert Systems of 2021 we ranked, at an average cost of $10 per month.

GPS Tracking: GPS tracking on medical alert systems allows the monitoring center to find out the location of the person wearing the device. With some GPS-enabled devices, the user and their emergency contacts can access an online dashboard to see the user's current location, location history, and activity levels.

Type of Connection: Mobile alert systems can connect with a landline in the home or through the company’s cellular provider, which is generally Verizon Wireless or AT&T. GPS units and GPS wearables, including smartwatches, also connect using cellular service. You do not have to subscribe or pay extra for cellular. For example, you can still use a medical alert system that connects through AT&T if you have a cell phone from Verizon Wireless or no cell phone at all. However, be sure that the medical alert company’s cellular provider gets a signal in your area.

Monitoring: Monitoring centers are open 24/7, and all of the Best Medical Systems of 2021 we ranked have U.S.-based centers with multilingual support through a translation service or in-house care professionals who speak languages other than English. Look for industry certifications like the Five Diamond designation from The Monitoring Association (TMA, previously Central Station Alarm Association) for response time, customer service, and meeting best practices. Some monitoring centers are also certified by the Underwriters Laboratory (UL) for safety.

“It’s important to make sure your medical device is part of a reliable monitoring center,” Guitelman says, emphasizing that a real person should answer calls. “A lot of competitors use the same monitoring center and they get a busy signal instead of an operator. Make sure the monitoring center has the latest technology and resources so you can rely on them.”

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