Does Medicaid Cover Medical Alert Devices

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What Is A Medical Alert System

What Is Medicaid? | Medicaid Made Clear

A medical alert system is a device or collection of devices that provide an added level of protection for older adults or those with health conditions and/or physical and sensory disabilities that can impact mobility while theyre at home or away. Medical alert services can help reduce the risk of living aloneincreasing independence for older adults and providing peace of mind for their caregivers, said Liron Sinvani, MD, director of the geriatric hospitalist service at Northwell Health in the New York City area. In the event of a fall or medical situation, an alert system makes help available at the push of an emergency button.

At-home systems typically have a base unit that communicates with trained staff at a monitoring center and a help button that connects to the base unit. You plug the base unit into an outlet, somewhere near the middle of your home. With the help button, you can move around the house or yard and still be able to call for help by pressing the button. Most systems let you choose between a landline or cellular connection.

An on-the-go system uses a mobile device with a cellular connection, enabling you to call for help when youre away from home. Some systems also use a lightweight help button that communicates with the mobile device. You can carry the device in your purse or on your belt while wearing the help button around your neck or wrist.

For more information, check out our how do medical alert systems work article.

$30 Per Month $179 For Equipment

Tech-savvy users might think you can simply use any smartwatch as a medical alert. After all, youre always wearing it anyway, and you can use it to make emergency calls. But a dedicated medical alert smartwatch is different it allows you to simply press an SOS button and get quick access to a 24/7 emergency dispatch center or call your caregivers.

Some medical alert smartwatches require a smartphone, but the Bay Alarm SOS Smartwatch is functional all on its own. It has two-way calling, so if you press the help button, you can talk directly to the dispatcher through the smartwatch . It also features location tracking and a built-in step tracker. The battery life ranges from six to 18 hours, depending on usage, and the device is water resistant with a rating of IP67. Note that it does not come with fall detection, as Bay Alarm says that technology is simply not accurate enough for its wrist devices.

In addition to the monthly fee, the SOS Smartwatch costs $179 to own the device outright.

Pros Of Having A Medical Alert System

  • Minimized anxiety associated with the fear of dropping inside the house when alone
  • Improved comfort knowing that the system is easy to access
  • Much-needed security and protection knowing that with a single press of a button, immediate help will arrive
  • Improved self-assurance in performing normal activities
  • Overall improved quality of life

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Does Medicaid Cover Medical Alert Systems

Low-income seniors may qualify for Medicaid and Medicare coverage. Medicaid plans generally do not cover medical alert systems, but you can request assistance from a Medicaid waiver through the Home and Community Based Services program or the Personal Care Attendant program. Participation varies by state, so you may have different waivers available in your area.

Medicaid recipients can also contact their insurance program or local social services agency for information about Money Follows the Person. This program is offered in most states, and it provides coverage for medically necessary devices. The program strives to help seniors transition from nursing home facilities back into their own homes so they can age in place. It goes by different names, including the Kentucky Transition Program, Colorado Access to Community-Based Transitions & Services and My Place Louisiana.

Before qualifying for a Money Follows the Person program, a senior must reside in a nursing home for at least 90 days and maintain active Medicaid enrollment. Once these qualifications are met, potentially eligible seniors must undergo an assessment to determine which services or home modifications they need to age safely at home. The agency may determine an elderly adult needs a wheelchair ramp, adaptive lighting or other essential safety modifications. Seniors may also receive reimbursement for a service animal.

Starting At $40 Per Month $200 For Equipment

medicare medical alert coverage

Aloe Care Health claims to have the worlds most advanced medical alert system. Thats a pretty bold claim, but its system is definitely a more innovative version of the traditional medical alert, while still remaining accessible and easy to use. The Smart Hub allows you to access a 24/7 call center through voice activation, and it automatically monitors the air quality, motion and room temperature.

Like other home-based systems, Aloe Care has a base unit and a wearable help button, and it uses 4G cellular coverage only . But unlike other brands, you dont have to switch to another device if you want on-the-go coverage as well. You can just opt for the Essentials Plus or Total Care packages, which come with a mobile device that can go anywhere, yet is still compatible with your regular home unit.

Aloe Cares caregiver app is one of the best around, according to reviewers. It allows your loved ones to check in directly with you and collaborate on your care. Add in other small, but important perks like a free lockbox for your home valuables, and the ability to amplify sound for the hearing impaired and this is a great all-in-one medical alert for those that can afford it.

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Does Aetna Cover Life Alert

Like most health insurance companies, Aetna does not usually cover the cost of Life Alert systems, as it deems it a safety item. However, Aetna plans vary, so you should confirm with the company about whether Life Alert is covered by your plan.

While Aetna Medicare plans typically don’t cover Life Alert, Aetna Medicare plan members may be able to take advantage of special Aetna discounts from LifeStation, the #1-rated medical alert system. Aetna members can shop special offers starting at $19.95 per month.

It’s possible that you may be able to have a doctor write a note supporting that a personal alert system like Life Alert would be beneficial for you due to being a high fall risk or living with a chronic condition. This note can sometimes be used to make a direct appeal to the insurance company.

Do I Need A Medical Alert System

Whether you need a medical alert system depends on your individual circumstances. The U.S. Center for Disease Control and Prevention reports that 1 in 4 Americans over the age of 65 experience a fall every year, and falling is the leading cause of injury in people over 65.

If you live alone, you may benefit from a medical alert system.People fall for different reasons, such as physical weakness, medication sideeffects, poor vision, or other health problems or illnesses. Knowing you canget the help you need, when you need it can give you a sense of protection andhelp you maintain your independence.

Nothing on this website should ever be used as a substitute forprofessional medical advice. You should always consult with your medicalprovider regarding diagnosis or treatment for a health condition, includingdecisions about the correct medication for your condition, as well as prior toundertaking any specific exercise or dietary routine.

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Cost Of Life Alert Vs Other Medical Alarms

Even if you don’t have coverage for a medical alert system through your Medicare plan, choosing a low-cost provider like Bay Alarm Medical can save you about 65% off the cost of Life Alert.

Life Alert costs $695 for the first year, making it one of the most expensive medical alert systems. Because of these high prices, Medicare plans will rarely partner with this medical alarm provider. Instead, it’s more common for insurance companies to offer coverage for providers like Philips Lifeline or LifeStation, which have mid-range base prices.

If you’re shopping for a system, you can save money by choosing a lower-cost option.

Full-price cost without Medicare coverage

System
$240

How Much Does Life Alert Cost Out Of Pocket

Medicare & Medicaid 101

In the absence of an Aetna plan that covers medical alert systems, paying for Life Alert out of pocket is quite expensive. An estimated breakdown of Life Alert shows what you can expect to pay:

  • $95 for the activation fee
  • $49.95 per month for the base unit and the pendant
  • $19.95 per month to add another help button or a GPS device, with an additional activation fee

So, if you opt for Life Alert, you can expect to pay in the neighborhood of $50 to $70 a month for the service, with an activation fee of as much as $198.

In addition to the relatively high cost, one potential drawback of Life Alert is that the user has to sign a 3-year contract that can’t be broken unless the user dies or enters into a nursing home or other care facility.

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How Much Does A United Healthcare Plan That Covers Life Alert Cost

The average cost of a United Healthcare Medicare Advantage plan covering a medical alert system ranges from $15 per month for a plan with a local PPO provider network to $74 per month for a private-fee-for-service plan. Keep in mind that these monthly premiums are on top of your Medicare Part B premium. A financial advisor can discuss your needs with you and guide you toward the best plan for your budget.The table below shows the average premium costs for different types of United Healthcare Medicare Advantage plans.

Type of plan

Choosing The Best Medical Alert System To Protect Yourself Or Your Loved One

There are many reasons people buy medical alert systems and not all of those reasons are because of age. A medical alert device could be used to monitor an aging loved one, but it could also be used for people of any age who are living with a disability, or perhaps a person who has some other type of medical issue such as diabetes or asthma that could cause them at some point to need immediate medical assistance.

Medical alert systems are also purchased by people who dont have any immediate medical need at all or are at an age where a medical device is needed. They are sometimes purchased for people of any age who are healthy but have some type of medical issue in their family history that could potentially affect them at any given moment such as a family history of heart disease or stroke, etc.

FYI: Did you know that Bluetooth is a common technology used in medical alert devices? Learn more in our guide to the best mobile medical alert devices that use Bluetooth.

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Does Medicare Cover Wearable Alert Devices

Home / FAQs / Medicare Coverage / Does Medicare Cover Wearable Alert Devices

Medical alert systems are a key factor in allowing many seniors the opportunity to live an independent lifestyle. At the touch of a button, these wearable devices alert a call center in the event of a health emergency, fall, or illness.

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Often, medical alert systems can cost upwards of $100 and even require a monthly subscription to remain active. Currently, there are no medical alert systems covered by Original Medicare. However, other options, such as a Medicare Advantage plan might pay for some medical alert system costs.

Medicaid Or Medicare Free Medical Alert System

Does Medicare Pay For Medical Alert Systems?

Medical alert systems or personal emergency response systems are NOT covered by Medicaid or Medicare. However, with a Medicaid Waiver or certain Medicare Advantage plans you may be able to obtain a free medical alert device system.

  • Medicaid Waiver Check with your case worker, or local Area Agency on Aging to obtain a Medicaid Waiver for medical alert systems. Some counties and municipalities may provide Medicare waivers for free medical alert systems, which are generally reimbursed after the fact.
  • Medicare Advantage While Medicare does not provide payment coverage for personal emergency response systems, check with Medicare Advantage plans in your area . Some Medicare Advantage plans may pay for your Medical Care Alert personal emergency response system as an additional benefit. Call your Medicare Advantage plan company’s Member Services department for more information.

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What To Know About Medicaid

Seniors aged 65 and older can qualify for Medicare. This is the federal health insurance program that covers a variety of health care expenses. There are different parts to Medicare that cover different services.

Medicare Part A covers inpatient hospital stays, care in a nursing facility, hospice care, and some home health care. Medicare Part B covers certain doctors services, outpatient care, medical supplies, and preventive services. Medicare Part C is a private health insurance plan that contains services from Part A, Part B, and additional benefits. Medicare Part D is optional prescription drug coverage.

Medical alert systems are not typically covered by Part A or Part B, Medicare. Certain Medicare Part C plans may cover medical alert systems in special circumstances.

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What About Medicaid Coverage Of Medical Alert Systems

Medicaid is a state and federal program that provides health insurance and is eligible depending on your income levels.

Each state has different rules about what types of medical care Medicaid will cover. However, in general, Medicaid will cover the cost of medical alert systems for people who qualify for the program.

If youre not sure whether you qualify for Medicaid, you can contact your states Medicaid office or speak with a qualified Medicare advisor.

They can help you determine if you meet the requirements for coverage. Once you know if you qualify, they can also help you enroll in the program and use your new medical alert system.

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Is A Medical Alert System Tax Deductible

Aahhh, tax time. Everyones favorite time of year. For some, this includes adding up all the medical expenses incurred during the previous year. The silver lining to medical expenses is a potential tax deduction. However, expenses need to be considerable in order to receive the deduction. You can only use the expenses as a deduction on Schedule A if your total medical and dental expenses exceed 7.5% of your adjusted gross income.

First, lets go to IRS Publication 502. If you are like us and dont have one lying around your house, it can be easily accessed online. In this publication, the IRS uses the following definition for medical expenses:

Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body. These expenses include. the costs of equipment, supplies, and diagnostic devices needed for these purposes. Medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness.

So far it sounds like medical alert systems would fit within this description after all, they do help prevent injury or disability.

The publication goes on to list those things that are medical expenses. It does not explicitly state that medical alert systems are considered a medical expense and therefore tax deductible. However, it does include a few items that could possibly encompass medical alert devices.

Which Medicare Advantage Plans Cover Medical Alert Systems

CalPERS Quick Tip | Medicare

While Medicare wont cover an alert system, there are Medicare Advantage plans that offer benefits beyond the scope of Medicare. Some Part C plans do cover a medical alert system.

Youll want to check with your plan to find out about possible coverage. There will be Part C plans that dont cover an alert device, each policy is different.

If youre new to Medicare, looking for a plan during the Annual Enrollment Period, or looking for a policy during the Open Enrollment Period, talk to your agent about finding a policy that covers a medical alert system.

Keep in mind, Part C plans change by zip code and there is no guarantee that a policy in your area includes coverage for a medical alert device. Also, if you dont find a policy in your area this year, check back again during the Annual Enrollment Period.

If your Medicare Advantage plan does cover a medical alert device, you may need to pay a portion of the cost. Consult with your plan to better understand the terms and conditions of coverage.

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Are Medical Alert Systems Covered By Insurance

It depends on the type of insurance you have. Most private insurance or Affordable Care Act plans will not cover the cost, and those that do require a doctors signature. Your best chance for insurance coverage is if you have long-term care insurance5 or use Medicaid. In both cases, plans vary according to state. Call your provider to learn more.

Best Medicare Advantage Plans For Medical Alert Systems

With an AARP/UnitedHealthcare Medicare Advantage plan, most enrollees can get a free medical alert system through Philips Lifeline.

AARP/UnitedHealthcare offers the best coverage available because the free alert systems are available to most policyholders, without restrictions. However, coverage can still vary by plan. You can confirm that you’re eligible by checking your Medicare plan’s schedule of benefits or by entering your member number into the Phillips online portal.

Medicare Advantage plan

Find Cheap Medicare Plans in Your Area

Humana and Blue Cross Blue Shield plans both provide medical alert systems for as low as $0, but coverage has more limitations or restrictions.

Humana Medicare Advantage plans will only cover medical alert systems when the enrollee has congestive heart failure. And BCBS coverage varies because each of its divisions is independently operated and offers a different set of benefits.

Kaiser Permanente offers the most straightforward communication about their medical alert system coverage. This transparency about policy benefits is one of the reasons that Kaiser Permanente is the best-rated Medicare Advantage company and has so many satisfied customers. However, policyholders only get a 32% discount on the Lively Mobile Plus system, which is not as good as what other companies offer.

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