Are Medical Alert Watches Covered by Medicare?

Medical alert watches are generally not covered by Original Medicare (Parts A and B), as they are not considered medically necessary durable medical equipment (DME). However, there are some options that might help cover or offset the cost.

Some of the Medicare Advantage plans (Part C) available may offer additional benefits, such as coverage for medical alert systems or other personal safety devices. You’ll need to check with your specific plan to see if this benefit is included.

While Medigap (Medicare Supplement Insurance) typically doesn’t cover medical alert systems, certain long-term care insurance policies might provide assistance for these devices.

State Medicaid or other state-based assistance programs may cover medical alert systems if they are deemed necessary for the individual’s health and safety. Eligibility and coverage vary by state – see below for steps to find out if your state covers these devices.

Veterans may qualify for medical alert devices through the VA if they are deemed essential for health monitoring or safety.

Many medical alert companies offer discounts or payment plans, especially for seniors or those with limited income.

To explore your options, contact your Medicare Advantage provider or consult local resources such as Area Agencies on Aging (AAA) to see if there are programs in your area that might assist with costs. To check directly with your state’s Medicaid coverage:

• Look up your state’s Medicaid agency contact information online. Call and ask specifically about coverage for personal emergency response systems (PERS) or medical alert devices.
• Check your state’s Medicaid website and look for information on Home and Community-Based Services (HCBS) waivers. Search for details on covered durable medical equipment or assistive technology.
• Consult with a Medicaid caseworker, who can provide detailed information on eligibility criteria and coverage options in your state.
• Speak with your healthcare provider, and ask if they can provide documentation of medical necessity, which may be required for coverage.
• Review your state’s Medicaid handbook or manual. Look for sections on durable medical equipment or home health services.

In considering a medical alert watch, be aware that they come in two different forms: the smartwatch that has added medical alert features, and the dedicated medical alert watch designed exclusively for this purpose. Here are the essential differences.

Smartwatch with Medical Alert Features

Smartwatches such as Apple Watch or Samsung Galaxy Watch include medical alert features alongside a suite of other functionalities. Beyond alarm features, these watches can offer health services such as fitness tracking, heart rate monitoring, step counting, and even ECG or blood oxygen monitoring.

“person clicking Apple Watch smartwatch” by Luke Chesser, licensed under Unsplash

The smartwatch can pair with your smartphone for calls, messages and notifications, and is generally a little sleeker and more fashionable, appealing to those who prioritize aesthetics.

Besides the optional fall detection, services such as GPS tracking and voice assistance (e.g., Siri or Google Assistant) are built in. The smartwatch is used for both everyday use and emergencies.

Drawbacks to the smartwatch include that it must be paired with its smartphone, and that it doesn’t offer a monitoring center connection, instead reaching directly to first responder services. Costs will also be higher, both in equipment purchase and monthly connectivity.

Dedicated Medical Alert Smartwatch

The dedicated medical alert smartwatch is purpose-built for medical alert services, focusing on simplicity and reliability. Avoiding the complexity of the smartwatch, the alert watch offers enormously simple ease of use, helpful for those with failing eyesight or diminished faculties.

Built around its core functionality of emergency detection and response, the medical alert watch will include direct links to 24/7 monitoring centers. Typically this device is more rugged and less fragile than a smartwatch, and certainly costs less.

Who Should Choose What?

Tech-savvy users and active seniors may prefer to bundle the medical alert features into their everyday smartwatch usage, while seniors who want simplicity and reliability for the core functionality may prefer the dedicated watch.

Budget-conscious individuals will prefer the dedicated watch with lower upfront costs, although power users of their smartwatch may find a savings in not purchasing an additional device. In the case of the dedicated watch, caregivers concerned about safety should look for devices with 24/7 monitoring and GPS.