Medicare/Medicaid and Elderly Monitoring — What's Covered

This is one of the most common questions families ask when looking into safety monitoring for an aging loved one — and the answer requires some nuance.

Traditional Medicare (Parts A and B) does not currently cover personal emergency response systems (PERS), daily check-in services, or most consumer monitoring devices. Traditional Medicare is primarily designed to cover medical services — hospital stays (Part A), doctor visits and outpatient care (Part B), and prescription drugs (Part D). Consumer safety devices, even those with clear health benefits, fall outside the scope of traditional Medicare coverage.

However, this doesn't mean Medicare offers no pathways to monitoring support. There are important exceptions and alternative programs that families should be aware of.

Medicare Advantage Plans (Part C) offer a different story. These are private insurance plans that contract with Medicare to provide all Part A and Part B benefits, and they often include additional benefits beyond what traditional Medicare covers. Many Medicare Advantage plans now include supplemental benefits that can be applied toward personal emergency response systems, wellness devices, and in some cases, daily check-in monitoring services.

According to the Centers for Medicare and Medicaid Services (CMS), Medicare Advantage plans have expanded their supplemental benefits significantly in recent years, particularly in the area of fall prevention and in-home safety. If your loved one is enrolled in a Medicare Advantage plan, it's worth contacting the plan directly to ask about monitoring device coverage or wellness benefit allowances.

Medicare Advantage plans have become increasingly generous with supplemental benefits related to elderly safety. Here's what to look for:

Personal Emergency Response System (PERS) Coverage: Many Medicare Advantage plans now cover the cost of a medical alert device — either fully or partially. This typically includes the device itself and a monthly monitoring fee. Plans may require that the device be obtained through an approved vendor.

In-Home Safety Assessments: Some plans cover professional home safety assessments, which evaluate fall risks and recommend modifications. These assessments may recommend monitoring systems as part of a comprehensive safety plan.

Wellness and Prevention Allowances: An increasing number of Medicare Advantage plans offer annual wellness stipends — typically $50 to $500 per year — that can be used toward health-related products and services, including monitoring devices and subscriptions.

Telehealth and Remote Monitoring: Medicare Advantage plans have expanded telehealth and remote patient monitoring benefits, particularly following regulatory changes. While this typically refers to medical-grade remote monitoring (like blood pressure monitors or glucose monitors), some plans interpret this broadly enough to include daily safety check-in services.

Fall Prevention Programs: Some plans offer structured fall prevention programs that include exercise classes, home modifications, and monitoring devices. These programs recognize that falls are the leading cause of injury-related death among adults 65+ and that prevention is far more cost-effective than treatment.

To find Medicare Advantage plans in your area that offer these benefits, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). You can compare plans side by side and filter by supplemental benefits.

Medicaid — the joint federal and state program for low-income individuals — often provides more comprehensive coverage for elderly monitoring than Medicare, particularly through Home and Community-Based Services (HCBS) waivers.

Home and Community-Based Services (HCBS) Waivers: Most states offer HCBS waiver programs that provide services designed to help elderly and disabled individuals remain in their homes rather than moving to institutional care. PERS and monitoring devices are among the most commonly covered services under these waivers.

How HCBS Waivers Work: Each state designs its own HCBS waiver program within federal guidelines. To qualify, an individual typically must meet both financial eligibility requirements (income and asset limits) and functional eligibility requirements (demonstrating a need for the level of care provided in a nursing facility). Once approved, the waiver can cover a range of in-home services, including personal emergency response systems.

State Medicaid Plan Services: In addition to waiver programs, some states include PERS and monitoring devices as a standard benefit in their Medicaid state plans. This means that any Medicaid-eligible individual in the state can access these services without needing a specific waiver.

Program of All-Inclusive Care for the Elderly (PACE): PACE is a comprehensive care program available in many states that serves individuals 55+ who qualify for nursing home care but prefer to remain in the community. PACE programs typically include monitoring devices and daily safety check-ins as part of their service package. PACE participants receive all their healthcare and supportive services through the PACE organization.

For a broader view of government-supported safety services, see our guide to elderly safety services in the United States.

Because Medicaid is administered at the state level, coverage for elderly monitoring varies significantly. Here's a general overview of what to expect:

States with Robust PERS Coverage: States like New York, California, Massachusetts, Texas, Florida, and Pennsylvania have well-established HCBS waiver programs that explicitly include personal emergency response systems as a covered benefit. In these states, qualifying individuals can receive monitoring devices and monthly service at no cost.

States with Emerging Coverage: Many states have expanded their HCBS waiver programs in recent years to include technology-based monitoring solutions. As evidence grows that in-home monitoring reduces Medicaid spending on institutional care, more states are adding these benefits.

Eligibility Requirements: While specific requirements vary, most states require that the individual be aged 65+ (or disabled), meet income and asset limits, and demonstrate a functional need for monitoring services. A healthcare provider's recommendation or a home safety assessment may be required.

How to Apply: Contact your state's Medicaid office or Area Agency on Aging to learn about HCBS waiver programs and PERS coverage in your state. The Eldercare Locator (1-800-677-1116) can help you find the right contact for your area.

Wait Lists: Some HCBS waiver programs have waiting lists due to limited funding. If your loved one is eligible, apply as soon as possible — even if they don't need monitoring immediately. Having an approved application in place ensures faster access when the need arises.

I'm Alive's four-layer safety model aligns well with the goals of government-funded elderly monitoring programs, which prioritize keeping seniors safe at home while minimizing institutional care costs.

Layer 1 — Daily Check-In: A simple daily tap confirms safety without requiring expensive equipment or professional monitoring center subscriptions. This low-cost approach fits within the budget constraints of government programs while still providing meaningful safety verification.

Layer 2 — Smart Escalation: When a check-in is missed, the system escalates through a predefined contact sequence. This automated escalation reduces the burden on government-funded care coordinators while ensuring timely response.

Layer 3 — Emergency Contacts: By leveraging family and community connections rather than paid monitoring centers, the emergency contact layer provides an effective safety net at minimal cost — an important consideration for programs funded by taxpayer dollars.

Layer 4 — Community Awareness: The community layer extends the safety net beyond individual contacts to include neighborhood networks and community organizations, many of which already receive Medicaid or other government funding for elderly support services.

This model demonstrates that effective elderly monitoring doesn't have to be expensive — a principle that aligns with the cost-effectiveness goals of both Medicare and Medicaid.

Beyond Medicare and Medicaid, several other government programs may help cover or subsidize elderly monitoring:

Veterans Affairs (VA) Benefits: Veterans who are enrolled in VA healthcare may be eligible for Home Telehealth (now called Connected Care) programs that include monitoring devices and daily safety check-ins. The VA has been a leader in adopting remote monitoring technology for aging veterans.

Older Americans Act (OAA) Programs: Funded through the Administration for Community Living, OAA programs support a range of services for older adults, including home-delivered meals, transportation, and in some areas, safety monitoring services. Contact your local Area Agency on Aging for information about OAA-funded programs in your area.

State-Funded Programs: Many states have additional programs beyond Medicaid that support elderly safety. These may include state-funded PERS programs, fall prevention initiatives, or technology assistance programs. Your state's Department of Aging or equivalent agency can provide information.

Supplemental Security Income (SSI): While SSI doesn't directly cover monitoring devices, the additional income may help offset the cost of a monitoring subscription. Some states also provide supplemental payments to SSI recipients that can be used for health-related expenses.

Tribal Programs: Native American elders may be eligible for monitoring services through tribal health programs, Indian Health Service (IHS), or Title VI programs under the Older Americans Act, which specifically serve Native American, Alaska Native, and Native Hawaiian elders.

For a comprehensive comparison of affordable monitoring options, visit our guide to the cheapest elderly monitoring options and our overview of PERS alternatives.

Applying for government-funded monitoring benefits can feel overwhelming. Here's a step-by-step guide to simplify the process:

Step 1: Determine Eligibility. Start by understanding which programs your loved one may qualify for. Key factors include age, income, assets, veteran status, and functional needs. Your local Area Agency on Aging can help assess eligibility across multiple programs.

Step 2: Contact the Right Agency. For Medicare Advantage benefits, call the plan directly. For Medicaid HCBS waivers, contact your state Medicaid office. For VA benefits, contact your local VA medical center. For OAA programs, contact your Area Agency on Aging.

Step 3: Gather Documentation. Be prepared to provide proof of age, income verification, medical records demonstrating the need for monitoring, and possibly a physician's recommendation. Having these documents ready speeds up the application process.

Step 4: Apply Early. Many programs have waiting lists, especially HCBS waiver programs. Apply as soon as your loved one may be eligible, even if the need isn't urgent yet.

Step 5: Appeal if Denied. If an application is denied, you have the right to appeal. Denials are often based on incomplete information or technicalities that can be addressed. Don't give up after an initial denial — request a review and provide any additional documentation needed.

Step 6: Consider Interim Solutions. While waiting for government benefits to be approved, consider affordable monitoring options like I'm Alive, which provides daily safety check-ins at a fraction of the cost of traditional medical alert systems. This ensures your loved one is protected during the application process.

The landscape of government support for elderly monitoring is evolving rapidly. Several trends suggest that coverage will continue to expand:

Rising Aging Population: By 2030, all baby boomers will be 65 or older, creating unprecedented demand for aging services. Government programs are already expanding to meet this demand, and monitoring benefits are a cost-effective way to support the growing elderly population.

Cost-Effectiveness Evidence: Research consistently shows that in-home monitoring is far less expensive than institutional care. A nursing home costs an average of $95,000 per year, while monitoring services cost a fraction of that. As this evidence accumulates, government programs have stronger justification for covering monitoring services.

Technology Advancement: As monitoring technology becomes simpler, more affordable, and more effective, government programs can serve more people at lower cost. Simple app-based solutions like daily check-ins represent the most cost-effective tier of monitoring — making them ideal candidates for broad government coverage.

Regulatory Support: CMS has been progressively expanding the types of supplemental benefits that Medicare Advantage plans can offer, particularly in the areas of fall prevention, social isolation reduction, and in-home safety. This regulatory direction suggests continued growth in monitoring coverage.

For families navigating the current landscape, the key takeaway is this: government-funded monitoring support is available, but you may need to be proactive in finding and applying for the right programs. The investment of time in the application process can result in significant financial support and, more importantly, meaningful safety for your loved one.