Medicare and other coverage options for medical alert systems

Medicare and other coverage options for medical alert systems

Mario Grimes

Medical alert systems benefit seniors staying alone. They ensure security and safety in case of a fall or sudden illness. Users only have to push a button on a wearable device to connect with emergency services. While necessary, these systems can be expensive. Medicare provides coverage for a range of medical services and supplies. Find out below if Medicare covers medical alert systems, how much they cost under Medicare, and the coverage options beyond Medicare.

Does Medicare pay for medical alert systems?
In general, Part A and Part B of Original Medicare pay for most durable medical equipment. These include blood sugar meters, walkers, hospital beds, and canes. It is easy to assume that these parts also cover medical alert systems and related equipment. However, none of the Original Medicare plans provide insurance for alert systems. That said, there are other ways through which one can obtain coverage.

Coverage of medical alert system costs with Medicare Advantage
Medicare Advantage, also called Medicare Part C, offers healthcare coverage through private insurance providers. These plans provide the same basic coverage as Original Medicare Part A and Part B plans but with a few extra benefits. However, these extra benefits depend on the individual provider, so Part C coverage varies. Some providers may pay for medical alert systems, while others may not.

How much does a medical alert system cost with Medicare Advantage?
As mentioned, under Medicare Advantage or Part C plans, the coverage for alert systems differs across providers. Some may offer plans that include medical alert systems with no monthly costs. Those looking for medical alert systems for seniors at no monthly fee can consider these plans. In addition, some providers may provide discounted medical alert systems, helping one save 30% to 40% off the original prices. Individuals can expect the cost of medical alert systems with Medicare to range from $0 to $300 for the first year. However, this cost varies depending on the brand and the level of service. The prices may change after the first year of coverage.

Coverage of medical alert systems through Medicaid
Medicaid is a health insurance plan offered by individual states. Depending on which state one resides in, they will be eligible for different types of coverage. Generally, medical alert systems fall under personal emergency response services (PERS) in a Medicaid plan. They are typically covered by programs like the home and community-based services (HCBS). However, the conditions vary across different states. For example, in some states, Medicaid offers coverage for PERS only when these are included in an approved home care plan. The rules may change in other states.

To know whether a state provides Medicaid coverage for PERS, one can look at the state’s profile on the HCBS’s official page. Detailed information can also be found by contacting a local Medicaid office and inquiring about the availability of HCBS.

Coverage options beyond Medicare
One can look into several other options beyond Medicare and Medicaid to cover medical alert systems’ costs. Some popular programs include the following:

Medigap
Private insurance companies offer Medigap policies to cover the “gaps” in Original Medicare plans. These policies help meet a few medical expenses that Medicare does not cover. However, unlike Medicare Advantage, it is not an alternative to Medicare. Medigap adds extra benefits to Medicare coverage. Therefore, the coverage of a medical alert system depends on the insurance plan and provider.

AARP and other senior discounts
The American Association of Retired Persons (AARP) offers several benefits to its members, including medical benefits. For instance, some medical alert system providers offer discounts to AARP members. Members may get discounts of approximately 15% with free shipping and free activation included on medical alert systems from certain brands. Alternatively, one may save around $60 a year on specific alert system packages after buying the device. One can contact a medical alert provider to determine if they offer an AARP discount.

Long-term care insurance
Private insurance providers offer these. Most long-term care insurance plans cover the costs related to permanent disability or medical conditions related to aging. The coverage can include the cost of a medical alert system as well. One may call their insurer to learn more about long-term care insurance packages.

VA discounts
All veterans are eligible for discounts on medical equipment, which includes medical alert systems. Some medical alert companies offer price cuts on the device. Others may give discounts on monthly service. In addition, some may offer low prices on the device as well as monthly services.

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