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How to Choose a Medical Alert System

As technology advances, the range of options has grown

spinner image How to Choose a PERS or Medical Alert System
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A medical alert system — often referred to as a personal emergency response system (PERS), medical emergency response system (MERS), health monitor or fall monitor — can provide increased independence for loved ones and peace of mind for family caregivers.

How do you find the one that's best for your situation? It can be complicated. Medical alert systems have evolved far beyond a basic, wearable device (like a bracelet or pendant) with a button that triggers a call to a response center in case of emergency.

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Now a medical alert device might include GPS, cellular connectivity, fall detection or prevention, in-home health and well-being monitors, activity trackers, movement sensors and more. Alert services might come with smartphones or as a feature of home security systems.

Start by evaluating your loved ones’ specific needs and abilities, present and future. For example, if she has dementia, will she understand how to operate a system — or is something automatic, like a fall-detection device, more appropriate? Does he have a disorder that could hinder communication with a call center, like aphasia or hearing loss? Will limited fine motor skills make putting on a device or pushing a button too difficult?

Here are some key things to think about and questions to ask in choosing a medical alert system. Once you've made a selection, be sure to monitor how it is working for your loved ones. Don't hesitate to switch to another service if it isn't a good fit — it could save a life.

What do you need it to do?

  • Fall detection. Falls are perhaps the most common motivator for obtaining a medical alert system. Nearly 36 million older Americans a year experience a fall, and more than 1 in 5 falls causes an injury, according to the U.S. Centers for Disease Control and Prevention.

  • Call for help. Devices with help buttons can connect the wearer to a live person at a response center or to emergency services such as the police or fire department. The button sends a signal to a base unit connected to a phone, which makes the call.

  • Medical monitoring. Some systems can be set to monitor vital signs and provide medication reminders.

  • Cellular. Mobile MERS can be used anywhere cellular service is available.

  • Location detection and tracking. A device with GPS is especially useful if your loved one is still driving and relatively independent.

  • In-car. These compact devices plug into your vehicle's 12V power outlet (what used to be the cigarette lighter) and have GPS capability. Some can be connected to a smartphone via Bluetooth.

  • Movement monitoring. Motion detectors and beacons track movement in the home.

  • Daily check-in services. Some monitoring companies will check in with your loved one every day, electronically or via a live phone call.

  • Activity and fitness tracking. These have features like step counters to monitor healthy activity and fitness goals.

  • Virtual family connections. Some systems enable users to make or receive ordinary calls, making it easy for family members and friends to check in.

  • Display time. Alert devices might include a watch feature. Or vice versa: Some smart watches include health monitoring and fall-detection apps.

  • Home security monitoring. The system detects danger from fire, smoke and carbon monoxide.

What kind of equipment will work best?

  • Is it wearable? You'll want a device your loved one finds comfortable. Look out for sharp edges, or strap materials that may irritate fragile skin. Also, is it attractive or unobtrusive enough that he or she will be willing to wear it?

  • Is it fully waterproof? Can it be worn in the shower? Can it be fully immersed in water? Many falls happen in the bathroom and kitchen, so this is vital.

  • What's the range? With an in-home system, find out how far the wearable help button can be from the base unit and still operate. That could be a real problem if, for example, your loved one falls in the yard or garage, or several rooms away from the base.

  • Is the speaker loud enough? A care recipient with hearing loss might have trouble hearing the person at the response center speaking through the device or the base unit.

  • How's the battery life? Also ask about the charging method and how you'll know if the battery is low.

  • Will it need technology updates? If so, ask if the updates are implemented automatically or manually, and make sure you or your loved one is tech-savvy enough to manage them.

  • How do you set it up? If there's a base unit or console, will you need more than one to cover the entire home and yard? Should the unit sit on a table or be wall-mounted? Is it plug-in or battery-operated? (If the former, does it have a battery backup if the power goes out?) Does it require a landline, and does it include cellular in case regular phone service is interrupted? Can you add stationary buttons around the home?

  • Is the system movable? Not all medical-alert providers offer nationwide service (see below). If your loved ones move, can the system move with them?

  • Does it include a lockbox? Some companies offer to install a lockbox that emergency medical personnel can access if they need to enter the home when the resident is incapacitated.

  • Can others connect via the device? Some devices allow you to check in with your loved one through the alert system, using a monitoring app on your smartphone, tablet or computer.

  • Can it be added to a home security system? Check with your home security provider. Be sure to ask if there is an additional fee.
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How do monitoring and response work?

  • Call routing. Can you designate how you want various types of alerts/calls (urgent, nonurgent, emergency) routed? Is the system “monitored” (connected directly to a response center) or “non-monitored” (it dials numbers you designate, such as to a family member, neighbor or emergency services)? Some systems offer both options.

  • Response center. Does the company operate its own response center or contract externally? Is the center certified? What's the average response time? (It should be a matter of seconds.) Will your loved one be able to talk with a live person via the wearable device, and can the center communicate in your loved one's preferred language if it is not English?

  • Customer service. Quality customer relations are key. There should be a live person you can call 24/7 with questions about the service. You should also be able to contact the company via email or live chat. Look as well for an easy-to-navigate website with a comprehensive FAQ section.

  • Cybersecurity. How does the company protect private information and prevent hackers from accessing your system?

  • False alarms. It's not uncommon for people to accidentally push the help button — is there a negative consequence if they do? Unlimited false alarms is a great feature.

How much does it cost?

  • Fees. Beware of complicated pricing plans and hidden costs like activation fees. Some companies include the cost of the device itself in the monthly service fee, while some charge extra for the equipment. Ask for a complete price breakdown; some features, such as fall detection, may cost more. Look for a company with no extra fees related to equipment, shipping, installation, activation, or service and repair. Watch out for offers of free service or “donated or used” equipment — they're scams.

  • Contracts. Don't enter into a long-term contract. You should only have to pay ongoing monthly fees that typically range from $20 to $70 a month, depending on selected features. Be careful about paying for service in advance since you never know when you'll need to stop it temporarily (due to a hospitalization, for instance) or permanently.

  • Guarantees and cancellation policies. Look for a full money-back guarantee, or at least a free trial period, in case you are not satisfied with the service. And you'll want the ability to cancel at any time with no penalties (and a full refund if monthly fees have already been paid).

  • Discounts. Ask about discounts for multiple people in the same household or for veterans. There might also be special deals available through membership organizations, health insurance or via a hospital, medical or care organization. See if the company offers reduced prices or a sliding fee scale for people with lower incomes.

  • Insurance. For the most part, Medicare and private insurance companies will not cover the costs of a medical alert system (although some insurers offer discounts or referrals; check with your provider). In some states, Medicaid may cover all or part of the cost.

  • Tax deductions. Check with your tax professional to find out if the cost of a medical alert is tax deductible as a medically necessary expense.

Is it available where you live?

Many national companies offer medical alert services, but they may not all be available near you, so call and inquire about service areas. Local companies may be an option, too. In addition to companies that have been in the medical alert business for decades, technology and home security firms are now increasingly offering these services as well.

  • Do an online search. Use keywords such as “medical alert systems,” “personal emergency response systems,” “fall detection devices” and “urgent response devices” along with the name of your city or state to find companies that serve your area. Check for customer reviews and complaints with the Better Business Bureau or your state's attorney general or consumer protection agency.

  • Contact your local Area Agency on Aging. Find your local Area Agency on Aging via the federal government's Eldercare Locator and ask if it has a list of companies offering medical alert services locally. (I contacted mine, and it immediately emailed me a list of 16 national and local companies, including one that is offered through the agency itself.)

  • Check with your senior facility. If you or your loved ones live in a senior community, it may offer an in-house or external medical alert system among its services. Beware of facilities that only have pull cords in a few places throughout the room or apartment — people don't always fall or become ill within convenient reach of the cord.

  • Get referrals. Ask friends and family members if they can recommend any medical alert systems they have used.

Editor's note: This article, originally published in April 2017, has been updated with more recent information.

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