Expenses for the best medical alert systems can add up quickly, especially if you’re locked in a long-term contract or want numerous special features for your device. Because of this, budget-minded seniors often turn to Medicare for assistance, but unfortunately, this national health insurance program rarely helps with the cost of medical alert systems. There are ways to get some Medicare plans to pay for a monitoring device, but it depends on several factors, including whether your insurance company deems the device medically necessary.

It’s also tricky to get Medicare to cover the cost of home modifications for elderly adults, though some subscribers have success getting coverage for assistive technology devices. Medicaid is generally better about helping with these types of expenses than Medicare, especially if you qualify for an assessment-based waiver. Some Medicare recipients also qualify for Medicaid coverage, which we discuss below in our detailed guide.

If you’re unsure whether you can afford a medical alert system without help from Medicare, you’re in the right place. We explain which expenses Medicare generally covers, so you have a better understanding of your plan, and we also discuss what to do if you need more coverage than your plan offers. Scroll down to get the facts about the role your insurance company plays when seniors need a medical alert system.

What Are the Different Types of Medicare?

Approximately 15% of Americans rely on Medicare for their health insurance coverage. This federal insurance program covers millions of elderly adults aged 65 and older, but disabled citizens may also qualify for a plan. Unfortunately, Medicare only covers about half of the total health costs for the majority of subscribers, and many members still spend a whopping $3,138 per month on out-of-pocket medical expenses.

As we mentioned earlier, it can be difficult to get Medicare to cover the cost of medical alert systems for seniors. The insurance program generally focuses on necessary medical expenses, including surgical procedures and prescription medication, rather than preventative services. Medicare Part B, C and D require a monthly premium, but Medicare Part A is free for some subscribers.

Medicare Part A

Medicare Part A provides reimbursement for qualifying assisted living expenses. These expenses may include nursing home services and hospice care, but seniors can also receive coverage for surgical procedures and inpatient hospital care. Some short-term coverage is provided for in-home health services, but you typically cannot use Medicare Part A for adaptive technology or medical alert systems.

Medicare Part B

Medicare Part B covers services deemed medically necessary; basically, it’s the closest thing to a general health insurance plan outside of the federal insurance program. Medicare Part B recipients receive assistance with the costs of primary care providers and specialists, plus help paying for medically necessary lab work, imaging tests or prescription medications. You may also receive medical device reimbursement with Medicare Part B, but that typically doesn’t include medical alert systems.

Medicare Part C

Medicare Advantage, also known as Medicare Part C, is a supplemental health plan for current Medicare subscribers. Because Medicare Part C supplements your existing Medicare coverage and requires a monthly premium, you may have success getting the plan to cover a medical alert system. To do this, you must show that the device is medically necessary, and you may need a written recommendation from one of your health care providers.

Medicare Part D

Medicare Part D only covers the cost of prescription drugs, so you can’t use it for medical alert systems.

Do Other Insurance Companies Cover Medical Alert Systems?

Some low-income elderly adults receive medical coverage from Medicare and Medicaid at the same time. If this describes your situation, reach out to your Medicaid plan’s customer help line and request information about waivers. You can generally find this phone number on the back of your insurance card.

When you speak with a customer service representative, explain that you need a waiver through one of the following programs:

• Personal Care Attendant program

• Home and Community Based Services program

• Money Follows the Person program.

These programs sometimes provide coverage for medical alert systems for seniors with a verified need for one of these devices. This may include patients with complications from head trauma, Alzheimer’s disease and various other disabling conditions.

Things to Remember Before Receiving Insurance Coverage for a Device

Seniors who receive insurance coverage for medical alert systems may still have some out-of-pocket expenses. Depending on your plan, you may need to pay the device cost and subscription fees yourself, then submit receipts for reimbursement. It’s unlikely that your insurance provider is going to pay the medical alert company directly.

You may also have expenses that aren’t covered by your insurance plan, such as activation fees, cancellation costs or shipping charges. Your insurance company may offer to pay a set amount monthly for monitoring, and the plan you choose may exceed that amount. Make sure you can afford these potential costs before you commit to a medical alert system.

A medical alert system can save your life when a medical emergency arises, but your insurance company may not help with the cost. Plan benefits change regularly, so contact your insurance provider if you have questions about coverage.

SOURCE: https://www.caring.com/best-medical-alert-systems/does-medicare-pay-for-medical-alert-systems/