Does Medicare Cover Life Alert? 

The ability to have emergency services on-call can be very comforting, especially if you have a medical condition and live alone. The emergency phone number 911 is the first step in getting help in an emergency, but if you’ve fallen and are unable to get to a phone to call for help, or you are not at home and have no access to a phone, 911 may not be of much use in that moment.

Although cell phones are everywhere these days, some seniors still feel more comfortable using services like Life Alert. This service offers the ability to summon emergency services by pressing a button on a wearable pendant. These devices feature two-way communication, and Life Alert also offers emergency response buttons for use in the shower, around the home and on the go.

How does Medicare cover Life Alert?

Because seniors are the largest demographic likely to take advantage of Life Alert and similar services, it would be good to know whether Medicare covers Life Alert and its related equipment. Medicare typically covers durable medical equipment (DME) through Medicare Part B. These Medicare benefits are designed to cover outpatient services, but most DME that is purchased from Medicare-approved providers is also covered at 80% once you’ve reached your deductible for the benefit period.

Unfortunately, Original Medicare does not cover Life Alert or similar services and products. This likely has to do with the medical necessity of emergency alert systems. Much like cosmetic surgery and treatment for conditions that arise from lifestyle factors, Original Medicare does not cover healthcare costs that are not proven to be medically necessary.

Is filing an exception waiver possible?

If, however, a service, treatment or item is medically necessary and your doctor is willing to document this fact, it may be possible to file an exception waiver with Medicare to seek coverage for things that are not listed under your Medicare benefits. Doing this with Life Alert is not likely to be successful as other options exist to contact emergency services.

Medicare’s coverage of supportive DME

Original Medicare coverage may apply toward the cost of wheelchairs, walkers and other mobility equipment that is designed to provide support around the home and on the go. If falling or being unable to get up after a fall is a concern, you’re encouraged to work with your doctor to seek covered options that can keep you from needing emergency alert systems in the first place. These items would once again be covered by the DME portion of your Medicare benefits under Part B.

Does Medicare Advantage cover Life Alert?

One possible way to get coverage for Life Alert would be to work with an independent insurance broker who can shop around to find Medicare Advantage plans for you. Medicare Advantage plans contain all of the same benefits as Original Medicare, but they have more freedom and flexibility to offer additional benefits that are not included in Original Medicare and may include coverage for devices like Life Alert. This coverage may be extended in the form of a discount on the subscription cost of Life Alert, or it may be provided in the form of reimbursement after you purchase Life Alert.

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