Does TRICARE Cover Medical Alert Systems?

TRICARE is the United State’s healthcare insurance program for uniformed service people (active and retired) and their families. There are several insurance plans offered to eligible individuals through TRICARE. Among these plans is TRICARE for Life, an insurance plan for TRICARE-eligible beneficiaries enrolled in Original Medicare (Part A and Part B).

If you or a dependent family member needs a medical alert system, you may be wondering if TRICARE will pay for it. The answer is somewhat complicated. TRICARE insurance plans do not cover medical supplies for the purposes of safety, such as medical alert systems. However, TRICARE for Life may help cover the cost of a medical alert system, provided you also have a Medicare Advantage (Part C) plan that offers this type of coverage.

How Much Does a Medical Alert System Cost?

Senior man in a blue shirt using a medical alert necklace

Medical alert systems are in-home or on-the-go wearable devices that allow you to call for help in the event of an emergency. There can be many factors that play a role in the cost of a medical alert system, but on average, you can expect to pay somewhere between $20–$60 a month. Home systems, such as those that are wall-mounted or physically stationed in your house, usually range between $20–$40 per month, while mobile options are typically between $20–$60 per month. It’s also worth noting that most medical alert systems have upfront equipment costs. While certain medical alert systems allow you to rent the equipment on a monthly or yearly basis, others require that you purchase all of the equipment initially, which can cost upwards of $200. In an AgingInPlace.org Survey of 1,000 respondents, improving the price of medical alert systems ranked just under improving battery life.

What Is TRICARE?

Tricare Logo

TRICARE is part of the military health care system. It provides several health insurance plan options for people who have served in the uniformed armed forces, as well as their families. It combines the military health system with civilian healthcare resources. Family members who qualify for TRICARE coverage include spouses, children, dependent parents, and dependent parents-in-law. Eligibility categories for TRICARE include:

  • Active-duty service members and their families
  • Retired service members, including reservists and their families
  • National Guard and Reserve members and their families
  • Families of fallen service members
  • Unremarried former spouses (in some instances)
  • Foreign Force members and their families
  • Medal of Honor recipients and their families

Eligibility can be checked by visiting milConnect.

What Is TRICARE for Life?

TRICARE for Life is one of the many TRICARE plans available. It provides Medicare wraparound coverage, working together with Medicare to coordinate health care benefits and coverage for eligible beneficiaries. Generally speaking, Medicare Part B pays first, then any leftover cost is covered by TRICARE for Life. Enrollment in TRICARE for Life is automatic once you turn 65 if you have Medicare Parts A and B, and it continues as long as you pay Part B premiums.

What Does TRICARE Cover?

TRICARE covers medically and psychologically necessary health care required to diagnose or treat an illness or injury. It also covers pregnancy and well-child care. TRICARE generally covers treatments, procedures, drugs, or devices that are deemed “medically necessary.” To be considered medically necessary, it must be categorized as appropriate, reasonable, adequate for your condition, and considered proven. Treatments or medications that are unproven or in the experimental phase are not covered. There are many other exclusions, including visits to alternative medicine (depending on the diagnosis for the care being sought) or naturopathic practitioners, homeopathic drugs, and some home modifications, to name a few.

Unfortunately, TRICARE does not include coverage for many forms of health care that we may feel fit the description of being “medically necessary,” medical alert systems included.

Will TRICARE Cover Medical Alert Systems?

The short answer is, “no,” TRICARE generally does not pay for safety equipment such as medical alert systems. “TRICARE for Life covers anything that Medicare Part B covers,” explained Mary Marshall, a Medicare broker. “Unfortunately, that does not include medical alert systems.”

Other Medical Alert System Coverage Options for Veterans

Two generations of US Military veterans

Medicare Part C (Medicare Advantage)

You may be able to get full or partial coverage for some medical alert systems, provided you have a Medicare Advantage (Part C) plan that covers medical alert systems. Medicare Part C covers everything that regular Medicare covers, plus extras that vary from plan to plan, so those seeking extra coverage often add Part C to their regular Medicare and pay about $20 extra per month for that additional coverage.

The various Medicare Advantage plans differ in what they cover, so speak with a Medicare broker when first selecting a plan in order to determine if it covers medical alert systems. Or if you already have Medicare Advantage in place, simply call to inquire if such a system is covered.

Veterans Affairs

Veterans can get a medical alert system through the United States Department of Veterans Affairs (VA). If you retire and qualify for VA benefits, you can use those benefits and TRICARE insurance to pay for some healthcare services. The VA provides coverage for two medical alert systems:

  • MedEquip Alert Personal Emergency & Medical Alert Device: monitored (24/7 access to a call monitoring center) but does not have automatic fall detection
  • Latitude Mobile Alert (formerly Live Life Personal Mobile Alarms): unmonitored, but can be programmed to call 911. Does include automatic fall detection.

To get a medical alert system through the VA, a VA-approved provider will have to attest that you have a medical need for a system. TRICARE will not pay for a portion of the cost. The VA will cover the entire cost of the system, provided you qualify for it and are approved to receive it.

Private Health Insurance

Private health insurance companies sometimes cover medical alert systems. This can only be determined by contacting the insurance company directly.

Long-Term Care Insurance

Long-term care insurance is designed to meet the needs of people, including older adults, who need ongoing or long-term medical or daily life skills services and support. While policies vary, long-term care insurance is most likely to provide coverage for medical alert systems.
These policies typically work within a daily dollar limit. They may also have a time limit, although many policies last for your entire lifetime. Not everyone is eligible for long-term care insurance. If you have a chronic illness or disability, or you are already receiving care for daily living skills, you may not qualify for certain policies.

Medicaid

Medicaid may help pay for medical alert systems. Medicaid’s Home and Community Based Services program provides waivers for older adults to receive long-term care services at home rather than in a long-term nursing care facility. These waivers provide about $20–$70 in monthly funding, which may cover the monthly fee of standard medical alert systems.

Medicaid also offers Personal Care Services, which provides funding for assistive care. Medicaid does not specify that these funds be used for medical alert monitoring but instead leaves it up to the consumer to decide how best to use the money.

Discounts Offered by Medical Alert System Companies

Sometimes medical alert system companies offer discounts for veterans, Triple A (AAA) members, or American Association of Retired Persons (AARP) members. Companies also may offer various discounts throughout the year for marketing purposes. It’s definitely worth asking about when inquiring about a medical alert system.

Bottom Line

TRICARE is health insurance for active and retired uniformed service members and their families. It does not pay for safety equipment such as medical alert systems. Your best bet for getting coverage for a medical alert system is through Medicare Part C (Medicare Advantage), Medicaid, or long-term care insurance. Veterans may also be able to get a free medical alert system through the VA or various discounts directly from system providers.

Corey Whelan contributed to this article.

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WRITTEN BY

Lauren Sherman, M.S., is a health content writer with a master's degree in human genetics from the University of Colorado Anschutz Medical Center, laboratory experience at National Jewish Health, and clinical experience at Children’s Hospital Colorado. She has extensively researched products to help those wanting to age in place such as medical alert systems, walk-in tubs, adjustable beds, and oxygen concentrators.

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MEDICALLY REVIEWED BY

Christopher is a Board-Certified Geriatric Nurse Practitioner and Holistic Nurse. As a Nurse’s Aide, Registered Nurse and now Nurse Practitioner, he has loved working with older people since 2004. He earned his Master’s Degree with Honors at Yale University, completed an Advanced Practice Nurse Fellowship in Geriatrics at New York University, and gained comprehensive experience working with people with dementia (and their families) at Upstate Medical University in Syracuse, NY.

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