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A medical alert system lets someone call for help with the press of a button, even if they cannot reach a phone. Choosing one comes down to where the person spends their time, how they would call for help, and who should answer.
The three main types
In-home systems
An in-home system has a base unit that plugs into the wall, plus a button worn as a pendant or wristband. When the button is pressed, the base unit places the call. Some base units use a landline, and others use a cellular signal. The button only works within a certain range of the base, so it may not work out in the yard or at the mailbox.
Mobile GPS systems
A mobile device works at home and away from home. It has a built-in cellular connection, and usually GPS so help can find where the person is. Many have a speaker and microphone right in the pendant. These need regular charging.
Smartwatches
Some smartwatches have emergency calling and fall alerts. They can be a good fit for someone who already likes using a watch and phone. They may need a phone nearby or a cellular plan, and charging is often daily. The screens and settings can be confusing for some older adults.
| Type | Works where | Charging | Good for | Keep in mind |
|---|---|---|---|---|
| In-home (landline or cellular) | Home, within range of base | Base plugs in; button battery lasts a long time | People who are home most of the day | Will not work away from home |
| Mobile GPS | Home and away, where there is cell service | Often every few days | People who go out alone | Must remember to charge it |
| Smartwatch | Depends on phone or cell plan | Often daily | Tech-comfortable users | Setup and screens can be confusing |
Automatic fall detection
Many devices offer fall detection. The device senses a sudden drop and calls for help on its own, even if the person cannot press the button. That can matter a lot if someone faints or hits their head.
But fall detection is not perfect. It can miss slow falls, such as sliding out of a chair. It can also send false alarms when the device is dropped. Teach the user to press the button whenever they need help, and not to rely on fall detection alone. The CDC notes that falls are a leading cause of injury among older adults, so getting help quickly matters.
Browse medical alert devices on Amazon
Monitored vs. unmonitored
Monitored systems connect to a call center staffed 24 hours a day. A trained operator talks with the person, then calls family, a neighbor, or emergency services as needed. These usually have a monthly fee.
Unmonitored systems call or text a list of family members or friends. There is often no monthly monitoring fee. The risk is that no one answers, especially at night. If you choose this kind, make sure several people are on the list and agree to keep their phones on. Some devices can also call 911 directly.
Features to compare
Range
For in-home systems, check how far the button works from the base. Test it in every room, the garage, and the yard.
Battery life
Ask how long the button and the base backup battery last. For mobile devices and watches, think honestly about whether the user will remember to charge it. A charging dock by the bed can help build the habit.
Water resistance
Many falls happen in the bathroom. The device should be water-resistant enough to wear in the shower or bath. Check what the maker says about showering. A device left on the counter cannot help. See our bathroom safety checklist for ways to lower the risk.
Wearing style
Pendants, wristbands, belt clips, and watches are common. The best one is the one the person will wear all day. Let them try it on and choose.
Two-way talk
Look for a clear speaker and microphone. If the user has hearing loss, ask whether the volume can be turned up.
Costs, contracts, and cancellation
Costs can include the equipment, setup or activation fees, a monthly monitoring fee, and add-ons like fall detection. Some services lease the equipment, so you must return it when you cancel. Before signing up, ask:
- Is there a long-term contract, or can I cancel anytime?
- Is there a fee to cancel or a trial period?
- Do I own the equipment, or do I have to send it back?
- Does fall detection cost extra?
- What happens if the user moves to assisted living or a hospital stay?
Get the answers in writing. Be wary of high-pressure sales calls or offers of a "free" device from someone who calls you out of the blue.
Testing and setup tips
- Use the test button or test mode once a month, as the maker suggests.
- Keep the emergency contact list up to date.
- Write down any health conditions and medicines the service should know about.
- Think about a key lockbox outside the door. It lets first responders get in without breaking the door. Many services can share the code with emergency crews.
- Practice pressing the button together so the user knows what to expect.
Does Medicare cover medical alert systems?
Original Medicare does not cover medical alert systems. Some Medicare Advantage plans may offer them as an extra benefit, and some state Medicaid waiver programs may help pay for them. Check with your plan or your local Area Agency on Aging. Learn more in our guide: Does Medicare cover home medical equipment?
Frequently asked questions
Do I need fall detection?
It can help if the person lives alone, has fallen before, or has fainting spells. It is not perfect, so they should still press the button when they need help.
Can I wear a medical alert device in the shower?
Many are made to be worn in the shower. Check the maker's water rating. Wearing it in the bathroom is important because many falls happen there.
What if the person does not have a landline?
Many in-home systems use a cellular signal instead. Mobile devices and smartwatches also use cellular service. Check that coverage is good where the person lives.
Is a monitored service worth it?
A monitored service means someone always answers, day or night. If family cannot reliably answer calls at all hours, monitoring gives more peace of mind.