Does Medicare or Medicaid Cover Medical Alert Systems?

Your parent needs a medical alert system. You've priced them at $30 to $89 per month. Now you're wondering whether any of their existing coverage pays for it. The answer depends entirely on which program they're enrolled in.

Original Medicare (Parts A and B): No Coverage

Original Medicare does not cover medical alert systems. Personal emergency response systems (PERS) are classified as non-medical consumer devices under traditional Medicare, so neither Part A (hospital) nor Part B (outpatient) will pay for equipment or monitoring fees.

This catches many families off guard because the devices serve an obvious medical purpose. But Medicare's classification hasn't changed.

Medicare Advantage (Part C): Maybe

Medicare Advantage plans are privately administered and can offer supplemental benefits beyond what Original Medicare covers. Some Part C plans include medical alert systems as a supplemental benefit — but this varies by carrier, plan, and year.

To check:

1. Find your parent's Evidence of Coverage (EOC) document for their current plan year
2. Search for "personal emergency response" or "PERS" in the supplemental benefits section
3. If listed, note whether it requires a letter of medical necessity from the primary care physician

Important: some carriers have reduced or eliminated PERS benefits in recent plan years. The benefit that existed last year may not exist this year. Verify annually.

Medicaid: Often Covered, State by State

Medicaid coverage for medical alert systems is available in many states through Home and Community-Based Services (HCBS) waivers. These waivers fund services that help seniors stay at home rather than entering institutional care — and PERS monitoring fits that category.

The billing code is S5161 (Personal Emergency Response System). Coverage details vary by state:

• Eligibility: Your parent must meet both financial and clinical criteria for the state's Medicaid program
• Clinical requirement: Some states require documentation that the person lives alone and has a medical condition creating a risk of emergency
• Provider restrictions: The monitoring company may need to be an approved Medicaid provider in that state

Contact your parent's local Medicaid agency or Department of Social Services to determine eligibility and approved providers.

VA Benefits: Fully Covered for Veterans

The Department of Veterans Affairs provides medical alert systems at no cost to eligible veterans through national contracts with authorized suppliers. This is one of the most underused benefits available.

To access VA coverage:

1. Schedule an evaluation with a primary care provider or occupational therapist at your parent's local VA medical center
2. Request a prescription for a mobile PERS unit with fall detection
3. The VA contracts directly with authorized suppliers — the veteran pays nothing

In Canada, Veterans Affairs Canada covers 100% of emergency call device rental costs through Program of Choice 13. Your parent needs a prescription from a physician, RN, or nurse practitioner justifying fall risk. Submit a preauthorization request for Benefit Code 361018 — costs are billed through Medavie Blue Cross.

Other Funding Sources

HSA and FSA accounts: Medical alert monitoring fees and equipment costs generally qualify as eligible medical expenses for Health Savings Accounts and Flexible Spending Accounts. This lets your parent pay with pre-tax dollars.

Long-term care insurance: Some long-term care policies reimburse PERS equipment rentals. Submit a clinical justification letter from the primary care physician to the insurer.

State and local programs: Some Area Agencies on Aging (AAAs) offer free or subsidized medical alert systems through local community programs. Call 211 or the Eldercare Locator to check availability.

UK residents: Local councils may provide personal alarm systems through Adult Social Care. Costs are often means-tested — some residents receive them free. The system may also qualify for VAT relief under HMRC Notice 701/7 for disabled persons.

What to Do Next

Check every applicable funding source before paying out of pocket. Many families spend months on monitoring fees without realizing their parent qualifies for full coverage through the VA, Medicaid, or a Medicare Advantage supplemental benefit.

The Medical Alert Systems Buying Guide includes a funding source worksheet that walks through each program's eligibility criteria and application steps for US, Canadian, and UK residents.