How to Choose A Medical Alert System To Meet Your Needs

Updated: Jul 17, 2022

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How to Choose a Medical Alert System 

Many seniors find joy and meaning when they can live independently at home. At the same time, families and caregivers want the comfort of knowing their loved ones are staying safe and healthy. 

If you’re concerned about yourself or a loved one being alone or unable to call for assistance during an emergency, you may need to make adjustments in the home to ensure a safer environment. That’s where a medical alert system can help. At the push of a button, emergency services, a monitoring center, or a loved one is contacted, ensuring a quick response when you need it the most. 

Here, we take an in-depth look at medical alert devices and share our expert tips on choosing the right system to meet your needs. 

How to Choose A Medical Alert System To Meet Your Needs

Pro Tips

  • A medical alert system only works if you wear it, so consider which device will most appeal to you. With many systems, you can choose a pendant necklace help button, a wristband-style help button, or a smartwatch-style help button that sometimes features activity tracking. 
  • Most medical alert companies offer a home system and mobile system plan. Both use a wearable help button to alert the response center in an emergency. Some people need both types of medical alert devices, while others only need one. If you spend most of your time at home and do not leave without a caregiver, an in-home system is probably sufficient. If you’re active and want coverage while at home and on the go, consider a mobile wearable device with GPS tracking. 
  • If budget is a deciding factor, compare the monthly fees for each medical alert system, including add-ons like automatic fall detection or medication reminders. You can save a lot of money by going with a basic package over one with costly premium features that you may not use.
  • Not all medical alert devices come with automatic fall detection. If this is one of your requirements, read the fine print to see if the medical alert system you’re considering features fall detection. 
  • If you want to use a medical alert device while away from home, choose a system that uses cellular services to connect with the monitoring center. It should also have GPS-tracking abilities, allowing caregivers and emergency responders to pinpoint your exact location.
  • There are two types of medical alert devices. Monitored medical alert systems require a monthly fee to connect to a response center operator who can assist you in determining the kind of help you need. An unmonitored medical alert system does not have a fee, but only connects to emergency responders or a designated contact. Monitored systems are ideal for an older adult who wants the ability to call for help but to not always be connected directly to emergency services. 


Medical alert systems are important for overall safety and peace of mind for the person wearing the device, as well as family members and loved ones not nearby. This is especially the case if an older adult is at an increased risk of falling. According to the Centers for Disease Control and Prevention, more than one in four older adults falls every year. 

Many older adults want to live independently as they age. Keeping them safer at home with quickly accessible help for emergencies allows them to do so. Plus, wearing a device with emergency help just a button-press away can lead to their receiving faster medical attention when needed. 

Deciding to purchase a medical alert system is the first step. You also need to research different companies, types of systems, wearable devices and add-on features you might like included with your system. It’s also essential to understand how the systems work, their cost, and how a device can fit into your lifestyle. Here, we go over all the details you need to know about how to choose a medical alert system. 

What Is a Medical Alert System?

A medical alert system, also called a personal emergency response system (PERS), is an in-home or on-the-go wearable device that allows you to contact emergency services in the event of a fall or medical incident. You can also use it for other emergencies, such as a home invasion. Medical alerts are either monitored or unmonitored, giving you the freedom to choose who you want to contact during an emergency. 

The wearable device, or help button, that comes with a medical alert system is often a pendant you wear around your neck or a wristband-style button that fits like a watch. Some companies also offer a smartwatch or help button you can carry in a purse or bag.

Discover the key differences between the types of systems to be better equipped to choose the right one for your needs.

In-Home Medical Alert System

An in-home medical alert system is ideal for seniors who opt to age in place but rarely leave the house alone. This provides an older adult the comfort of knowing that professional care is available in an emergency.

Pressing the help button on the device, or talking into it if it’s voice-activated, will connect you to an operator or dispatcher at the company’s call center, most of which are available 24 hours a day, seven days a week, 365 days a year (24/7/365). This person will help you determine if you need an emergency responder or if a caregiver can be contacted. Often, the operator will remain on the line with you until help arrives, which is a comforting feature for many seniors.

With an at-home system, you will connect to the monitoring center through the base station, which works with an existing landline or cellular service provided by the medical alert company. The base station has a limited coverage range, which is something to be aware of if you have a larger home. You can only connect to the monitoring center if you are within the designated range. The range is as much as 1,400 feet for some systems, but it can be as little as 200 feet for others.

Mobile Medical Alert System

A mobile medical alert device is an excellent system to consider if you’re active or often leave the house on your own because of the freedom and independence it provides. Mentally agile and mobile seniors may opt to use a medical alert device because they live alone or simply want additional support as they age. Unlike an in-home system that has a maximum range, a mobile medical alert system connects to the call center via cellular service, so it will work anywhere there is a cellular connection. In addition, most help buttons are equipped with GPS tracking abilities, allowing the operator to see your location even if you cannot identify it yourself. A device with GPS can also provide caregivers and family members the peace of mind of being able to locate their loved ones at any given time.

Medical Alert Systems vs. Medical ID Bracelets 

Medical alert systems and medical ID bracelets and necklaces are not the same. In fact, the only thing they have in common is safeguarding your health and safety. A medical ID bracelet or necklace is something you wear on your wrist or around your neck that contains your medical and contact information. Emergency responders often look for an ID bracelet when responding to a medical emergency to see if you have any conditions that require specialized care or treatment. It can also serve as personal identification if you do not have a driver’s license or another form of ID on you. 

Monitored vs. Unmonitored Medical Alert Systems

There are two types of medical alert systems—monitored and unmonitored. A monitored system requires a monthly fee, but this gives you access to a 24/7/365 monitoring center staffed with dispatchers waiting to take your call. This human interaction is invaluable since it allows you to decide what to do in each situation. The monthly fee sometimes includes the costs of leasing the devices while using the monitoring services. 

However, if you’re using an unmonitored medical alert system, you control who is called based on the contacts you program into the device. This may include a designated family member, a caregiver, or emergency services. You do not have access to a staffed call center. This system style requires an upfront cost for the equipment, which you own outright. While you save money on monthly expenses, unmonitored medical alert systems are not for everyone. Since you don’t have the opportunity to talk to a call center to determine what help you need, you may incur costly medical bills if emergency services are sent to you immediately. What’s more, even though a list of contacts can be automatically dialed, this may not always be accurate or reliable, delaying help when you need it the most.

Who Should Use a Medical Alert System?

You might be wondering who should use a medical alert system. A medical alert system is ideal for older adults in many situations, including:

  • After a fall, for those prone to falling, or for those at risk of falling due to a medical condition or medication 
  • A medical condition that may impact a senior’s ability to seek medical attention, such as dementia, Parkinson’s, multiple sclerosis, diabetes, low blood pressure, heart disease, seizures, vertigo, or any other condition that may affect balance or mobility 
  • Living alone or staying alone for long periods without access to a caregiver 
  • A desire for monitoring abilities with GPS tracking
  • Frequently on the go and concerned about calling for help during a medical emergency
  • Taking medication that causes side effects that may require medical attention 
  • When recovering at home after surgery

Medical alert systems can benefit seniors aging in place because the sooner they receive care after a medical emergency, the better their chances are for an optimal outcome and being able to return home. Medical alert systems are not a replacement for caretakers, especially for people with mobility or cognitive challenges. However, these devices do provide users with a lot more independence and freedom to do things by themselves, which may help improve their overall quality of life.

How To Choose a Medical Alert System

Purchasing a medical alert system that meets your needs may make it more likely that you will regularly wear and use the help button. Here are some things to evaluate before signing up for a medical alert system. 

Price and Subscription Models 

  • Equipment fees: All unmonitored medical alert systems have an equipment fee, while only some monitored systems have one. The difference with an unmonitored system is you’re required to purchase the device and manage it yourself. With a monitored system, you will lease the equipment while paying a monthly call center fee. Then, when you’re ready to cancel the service, you return the equipment. Some monitored medical alert companies have devices that require an upfront fee, such as the Medical Guardian Mini Guardian or the Bay Alarm Medical SOS smartwatch.
  • Monthly fees: Monthly fees only apply to monitored medical alert systems. You will see this fee during the checkout process on the medical alert company website. Pay special attention to the difference between the month-to-month cost compared to paying quarterly, semi-annually, or annually. Most companies offer savings if you pay for multiple months upfront. This fee covers access to the 24/7/365 emergency response call center. It also includes equipment fees if you lease the base station and wearable device.
  • Initiation fees: Some medical alert companies charge an initiation or activation fee. In general, this fee can range from $50-$200. If you see an installation fee, ask if it is a required cost. If the price is associated with installation services, you may be able to reduce or eliminate the charge by setting up the system yourself. Sometimes setup is as easy as plugging the unit into an electrical outlet and pressing the help button to test it.
  • Add-on fees: These fees can increase your overall monthly costs significantly, so pay close attention to the price of any features not included with the standard monthly fee. This may consist of automatic fall detection, medication reminders, access to a caregiver app, jewelry-type pendants, wall mount buttons, extra help buttons and more. While the additional cost associated with add-ons might not seem significant, some charges end up adding an extra $20 per month to the price you pay. 
  • Plan discounts: Many medical alert companies offer a discount on the monitoring center fee if you sign up for a quarterly, semi-annual, or annual plan. Look at all the price points and decide for yourself if the monthly savings is worth being locked into a set number of months. 

Online Reputation

Taking time to evaluate the online reputation of a medical alert company is a critical step in choosing a system. The key to a successful research experience is to read a mix of reviews from different sites. For example, read the customer comments on the company’s website, but also cross-reference them with reviews on sites not affiliated with the medical alert company. Here are some good places to start:

Company Policies

  • Return policy: It’s important to go with a medical alert company with a clearly stated return policy. Bonus points are received if the policy allows you to return the equipment and cancel the services with no extra charges. You will likely be required to pay shipping charges to return the equipment. Also, ask if the company refunds prorated fees for quarterly, semi-annual, or annual plans, and also for the policy if you cancel before the pre-paid period is up.
  • Warranty: Always ask about the warranty on the base station, charging stations, and wearable help buttons, especially if you are using an unmonitored system that requires you to purchase all the equipment up front. If you have a monitored system, the company may cover certain things during your service time, but it is important to still ask about any out-of-pocket expenses you could incur while using the system. Some medical alert companies offer an extended warranty or protection plan for an additional monthly fee.
  • Trial periods and money-back guarantee: Some top medical alert companies offer a risk-free trial period between 14-30 days. Ask the customer service department if you do not see a trial period advertised. A trial period gives you the freedom to try the system, and if you don’t like it, you can return the equipment and cancel the subscription for a full refund if you do so before the trial period ends.
  • Contracts: Be cautious of any long-term contracts that lock you into paying a monthly fee for a designated amount of time. You should always have the choice to go month-to-month and cancel at any time, without consequences.

Key Features

  • Automatic fall detection: According to the National Institute on Aging, a fear of falling is more prevalent in people as they age, leading them to decrease of participation in activities like walking or attending social functions. Fall detection is a safety feature you can add to most medical alert systems. Some companies require an additional monthly fee of $5-$10, while others include the cost in the monthly charge. This feature automatically detects a fall based on motion and contacts the response center even if you can’t activate the help button. If you have concerns about falling, consider a medical alert system with fall detection
  • Mobile or in-home: Before settling on a medical alert system, determine if you want an in-home system, a mobile system, or both. Some companies offer packages that bundle at-home and mobile devices for a discount. In general, an in-home system is sufficient if you spend most of your time at home and the base station range covers the distance you travel around the house. But, if you often leave home alone or are active, consider a dual mobile and in-home system. Some older adults will opt for a mobile system only if they feel they don’t need protection at home. This may be the case if you live with another person and only want access to a help button when you are out and about. 
  • Water-resistant devices: Many medical alert devices, and more specifically, the wearable help button, are either water-resistant or waterproof. A water-resistant help button can withstand a certain amount of dampness, but it cannot be submerged in water for an extended period of time. On the other hand, a waterproof device can withstand more water exposure than its water-resistant counterpart. However, you’ll want to know the maximum depth and time limitations before submerging a waterproof medical alert device in water. 
  • Battery life: Many mobile medical alert devices require frequent charging. Most companies advertise a battery life that ranges from 18 hours to several days, depending on use. When it comes to in-home systems, the biggest concern is a power outage or experiencing an issue with the charger. In these cases, having a backup battery is essential. Many in-home device backup batteries can last up to 72 hours.
  • In-home range: The in-home unit range is how far you can be from the base station and still have coverage. This is a critical feature to consider if you are using a medical alert device at home. For example, some medical alert systems will work up to 1,400 feet from the base station, while others only provide coverage up to 200 feet. If you have a large home, opt for a medical alert company that provides a range of at least 800-1,000 feet, if not more. 
  • Emergency call button: The emergency call button, or help button, is what you will press to connect to a monitored system’s call center or emergency services, or a designated caregiver through an unmonitored system. This button is generally large enough to see and activate. However, it may be smaller on smartwatch-style devices, which is something to be aware of if dexterity is an issue. The help button is front and center on a base station, neck pendant device, or wristband-style device. 
  • Two-way communication: Two-way communication is a feature on some medical alert devices. This allows you to talk through a voice-activated speaker in the device without pressing the help button. The emergency response is triggered when you speak into the device, alerting the call center that you need help. Wall-mounted buttons, smartwatches, and some wristbands and neck pendants have this feature.
  • GPS tracking: GPS tracking and location services enable a loved one, call center operator, or emergency responder to pinpoint your exact location in case of emergency, even if you cannot communicate your location yourself. This feature is generally available on a mobile medical alert system that uses cellular service to connect, but you should always double-check before settling on a system.
  • Connection type: While at home, most medical alert companies give you a choice between a landline or cellular connection for the base station. If you have spotty cell service, consider going with a landline system. All mobile systems connect to the call center via a cellular network, generally AT&T, Verizon, or T-Mobile. The medical alert company provides this service.
  • Monitoring: Medical alert systems are either monitored or unmonitored. If you go with a monitored medical alert system, you will pay a monthly fee but have 24/7/365 access to a call center staffed with operators. On the other hand, an unmonitored medical alert system does not provide a staffed response center. Instead, these systems put you in touch with emergency services (911) or a designated caregiver. You will only be responsible for a one-time device fee instead of a monthly subscription fee. 

Optional Features

  • Medication reminders: Medication reminders are generally an add-on feature with a medical alert system that you program through a user portal or app. This is an excellent tool for older adults who forget to take medication. The medical alert device will notify you when to take a specific medication. 
  • Wellness checks: This feature, which costs extra, provides daily, bi-weekly, or weekly check-ins with a care professional from the medical alert company. Most people who add wellness checks opt for a daily check-in. If the care professional cannot make contact, they will proactively respond to the situation based on your personalized care instructions. Wellness checks are only offered by a few medical alert companies.
  • Multilingual support: Several call centers offer multilingual support. If you speak a language other than English, this is an important feature to consider. It will ensure that the operator answering your call can support your language needs.
  • Activity tracking: Activity tracking is generally reserved for smartwatch-type medical alert devices. Like a fitness tracker, this allows users to track various metrics like steps, calories burned, exercise time and more. If you have a fitness tracker and want to consolidate devices, this might be a good option. 
  • Lockbox: Some medical alert systems come with the option to add a lockbox. This may be included in the price, cost extra each month, or be charged as a one-time fee. A medical alert lockbox stores a house key. It is placed somewhere on your property, either on an outdoor handle, railing, fence post or other location that is accessible to emergency personnel. The lockbox is opened with a combination or code available from the monitoring center. 
  • Spouse monitoring: This feature allows you to add another adult living in your home to the plan. Some companies charge an additional monthly fee for spouse monitoring, while others include it as part of the subscription plan. 
  • Mobile app or caregiver app: Several medical alert companies now offer a mobile app or caregiver app as part of the system. These apps allow caregivers and family members to stay connected with you, with some even offering advanced location tracking. Many also include a feature that allows you to chat with a care partner. The app is often included with the monthly subscription, or you can add it for a fee. 
  • Style: For some people, style is a non-negotiable feature. Medical alert devices are generally worn around your neck, on your wrist, clipped to a belt buckle or carried in a purse or bag. You can also purchase a smartwatch-style help button that resembles a fitness tracker. Some pendants are large, which stops many people from using a medical alert system altogether. The good news is most companies now sell a smaller version of their main pendants. Plus, some help buttons come with the option of adding a jewelry clip to them, giving them the appearance of a necklace.

Response Times

Response time refers to the time it takes for an operator to pick up your call after you activate the help button. While each company has its own guaranteed time, this can generally range from 12-60 seconds, most responding within 20-30 seconds. However, several factors can impact this time, making it longer or shorter, such as the time of day the call is placed, the cellular connection, and the number of staffed operators available. Take some time to read online customer reviews that discuss response times, then compare them to the advertised response times. 

Medical Alert Companies to Consider

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Medical Guardian is known for its excellent product variety, features, signal range, long battery life, and for having a fair price point. The company currently has five plans to choose from, including in-home and mobile medical alert systems.

Monitoring fees for Medical Guardian average $29.95 a month for the in-home landline system and $34.95 a month for the in-home cellular system. The mobile systems are priced slightly higher, with the Mini Guardian coming in at $39.95 a month. The Active Guardian starts at $44.95 a month, and the Mobile 2.0 is priced at $39.95 a month. You will need to pay an upfront fee of $124.95 for the Mini Guardian. 

Medical Guardian also has a new device in their lineup called the MG Move, a smartwatch and activity tracker that doubles as a help button. Other notable features include automatic fall detection, TMA Five Diamond–designated monitoring center, voice-activated wall-mounted buttons, and the MyGuardian portal and app. Some of these features require an additional monthly fee.

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Mobile Help is an excellent choice if you have a large space and plan to use a medical alert system mostly at home. The in-home base station has a device range of 1,400 feet, making it ideal for people who move around within a larger space. The company also offers six different systems and packages, giving potential buyers many options. 

Monitoring fees for Mobile Help begin at $19.95 a month for the in-home landline plan, $24.95 a month for the in-home wired plan, $37.95 a month for the Solo—a GPS-enabled mobile unit, $29.95 a month, plus a one-time equipment fee of $79.99 for the Micro, and $41.95 a month for the MobileHelp Duo, which includes two help buttons and in-home and mobile plans. Other notable features of MobileHelp medical alert systems include automatic fall detection, medication reminders, health tracking, access to MDLive and the Connect app, which provides notification and tracking for family members and caregivers.

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Bay Alarm Medical has in-home and mobile medical alert systems. One thing that makes Bay Alarm stand out from competitors is the low in-home monthly fee—one of the lowest in the industry. It also has one of the best smartwatches, which works as a help button. Another unique service this company offers is an in-car alert package called the Splitsecond® In-Car Alert. This feature gives you 24/7/365 in-car monitoring with automatic crash detection and location tracking. However, it’s not included in the price of any system. 

Monthly monitoring fees for Bay Alarm Medical range from $19.95 for the in-home system to $29.95 for the mobile GPS and $39.95 for the in-home and GPS bundle. The SOS Smartwatch mentioned above costs $159, but you will own the device after paying for it. Other notable features include a generous base station range, automatic fall detection, wall-mounted buttons, lockboxes and a TMA Five Diamond–certified monitoring facility that supports over 170 languages. Some of these features require an additional monthly fee.

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LifeFone consistently ranks high as a top-rated medical alert company. The company offers in-home and GPS-enabled mobile device systems that fit most needs. The in-home system comes with a neck pendant or wristband-style help button that connects to the monitoring center through the base station, which has a great range of up to 1,300 feet. If you want a mobile device that also works at home, the company’s Voice-In-Pendant (VIP) wearable is a small and lightweight help button that can work as a necklace or clip to your belt. You can add fall detection to the home or mobile systems for an additional fee. 

Monitoring fees range from $24.95 a month for the at-home landline system to $39.95 a month for the at-home and on-the-go system and $45.95 a month for the VIPx system. Other notable LifeFone features include a caregiver app, activity assurance, medication reminders, location service, wall-mounted help buttons, daily check-ins, and fire, smoke, and carbon monoxide detection. Some of these features require an additional monthly fee. 

Final Thoughts

The right medical alert system gives you the freedom to be more independent since you have a safety net of knowing that someone can help if you need it. And in some cases, it may improve the chances for an optimal outcome if you’re able to get appropriate care soon after a medical emergency occurs. Medical alert systems are not a replacement for caregivers, especially if you have mobility or cognitive challenges that may require more assistance. In these situations, a medical alert device can supplement the support you may be receiving from a caregiver at home or an assisted living facility.

Why You Can Trust Us

Aging In Place strives to create honest, helpful reviews backed by firsthand shopping, testing, and research. Our content is medically reviewed and unbiased to help you choose the right medical alert system for you or your loved one. 

From more than 1,000 hours of research, we chose 13 of the top brands we believe are the best medical alert systems. We did the following throughout our research process: 

  • Consulted with geriatricians and adult caregivers
  • Mystery-shopped the brands
  • Surveyed medical alert system users
  • Tested various medical alert systems
  • Interviewed experts in the field
  • Read hundreds of verified customer reviews from trusted third parties, such as Better Business Bureau (BBB) and Trustpilot

Frequently Asked Questions

If you have Medicare benefits, you might be wondering if the costs associated with medical alert systems are covered under your plan. Unfortunately, most PERS expenses are not covered by Medicare Part A and Part B. Some Medicare Advantage Plans, also called Part C, may provide benefits for medical alert systems. It’s best to contact the benefits department to ask about your eligibility.

Pricing accurate as of April 20, 2022.


Sara Lindberg is a freelance writer specializing in health, fitness, senior care and nutrition. With a master’s in education and bachelor’s in exercise science, she has worked as a personal trainer and group exercise specialist for older adults. Her work has appeared in several national print and media publications. In her own life, caring for a parent with health issues has allowed her to see firsthand how critical it is for seniors and their families to have accurate, compassionate, and relatable information as they make decisions about aging in place.