What to Consider Before Buying a Medical Alert System

Are you (or your loved one) willing to wear it?

Be realistic when evaluating your willingness to wear a medical alert device. If the pendant or mobile device spends most of its time on the nightstand, you're just wasting money. Medical alert systems provide a safety net only if you wear the pendant — at all times.

Although some manufacturers attempt to make alert pendants stylish with sleeker designs and beaded lanyards, most of the objects still look like medical devices. This can be a turnoff to fashionable seniors. 

Will you press the help button if you need help?

It may seem obvious: If you fall, you'll press the button. That is, after all, the purpose of a personal emergency response device. However, studies have shown that many seniors are afraid to press their help buttons in an emergency, or just don't do it, for several reasons. Some don't want EMTs or neighbors entering their homes; some worry that requesting help may convince family that they can no longer live alone. And others feel that the emergency isn't serious enough. Whatever the reason, it's clear that there is some anxiety over asking for help, which is only natural.

Most people have been raised to think that you don't call 911 unless it's an emergency and that falsely calling emergency responders can get you in trouble. Those same anxieties exist with medical alert systems. At the beginning of our tests, we were all nervous about hitting the help buttons. However, we quickly learned that it's OK. False alerts happen, and the emergency responders are aware of that. (That said, most services have clauses that say you are responsible for any fines incurred from too many false alerts.)

In fact, seniors are expected to test their devices at least once a month. Not only is this meant to ensure the device is working, but it also helps alleviate the anxiety of pressing the help button and talking to the operator. That way, when you really need help, you won't hesitate.

Will you feel stigmatized or embarrassed about having a medical alert product?

Many seniors view medical alert devices as a visual reminder of their own mortality. Many don't think they are old or frail enough to need a medical alert system. A feeling of independence and youthfulness is a cornerstone to most people's quality of life, regardless of age. It's important to remember that aging is a process, not an event, especially if you're looking to purchase a system for your parent. Your loved one might feel like these devices undermine their youthfulness. It's critical to talk this over with your aging parent before you surprise them with a medical alert device. If they feel stigmatized, they won't wear it.

Will you remember to wear it — or charge it if necessary?

Many seniors struggle with short-term memory, even if they haven't been diagnosed with dementia. So, you need to consider if you or your loved one will remember to wear the pendant and charge a mobile device.

Much of the success of a medical alert systems depends on developing a routine, such as charging the mobile device at night. For seniors who have owned a cellphone, some of these habits, such as charging the device and remembering to carry it, may already be ingrained.

If you're concerned that your aging parent isn't remembering to use the system or won't use it, there are some medical alert systems with tracking apps. Ideally, these are used with seniors who have early dementia or just need a little more monitoring from family members, but these apps are a great way to make sure your loved one is properly using the system.

Are there no-cost or low-cost options instead of a medical alert system?

Seniors are at a high risk of falls. And when they fall, there is a greater risk for injury. Broken hips, shattered wrists and concussions are common injuries in elderly related falls, which could make it very difficult to get up and call for help. This is why medical alert systems are like safety nets. If you fall and can't get up, a medical alert system makes sure you aren't stranded on the floor.

Relying on your own mobile phone is the cheapest option, but it’s important to remember that emergencies aren’t convenient – many people don’t carry their mobile phones everywhere, especially not the shower.

However, if you're not interested in a medical alert system or can't afford one, you can start by minimizing the risk of falling by doing the following:

  • Evaluate the home for potential fall and tripping hazards. (A helpful room-by-room checklist can be found in this brochure.)
  • Have a physician do a medication review to identify medications with side effects that could make you sleepy, dizzy or unsteady on your feet.
  • Take fitness classes geared for seniors, such as tai chi and balance training, to improve balance and increase lower-body strength.
  • Make a point of getting regular eye exams. If you can't see clearly, your risk of tripping over something is high.
  • Make sure you wear proper footwear within the home or outdoors. An Oxford shoe has been proven to provide excellent stability.

Can you afford a medical alert system? Most base-level packages cost at least $1 a day.

Many seniors live on a fixed income. With most companies, the affordable system, which requires a landline, is usually around $30 a month. Additional packages and add-ons, such as fall detection, can increase the monthly cost to as high as $80. As such, it's important to consider what you need versus what you can afford. Some options cost less, however; for example, GreatCall is a mobile alert system that starts as low as $20 per month, which is the most affordable option available.

If you're considering a cellular home system or a mobile alert device, do you have a reliable signal and reception?

The most popular package offered by most medical alert services is the cellular base unit, which usually costs about $36 per month. It differs from the base package in only one way: It uses a wireless network like AT&T, T-Mobile or Verizon to call the monitoring center instead of a landline. Mobile medical alert devices are even more expensive, on average costing about $43 per month.

If you live in an area where the cellular network isn't strong or reliable, then a landline system is your best option. In some areas, it might be your only option. Before you purchase an in-home cellular system or a mobile device, be sure to confirm with the medical alert service which cellular carrier is used and then check whether the coverage is consistent in your area.

Do you have any physical or mental limitations that could make using a medical alert device more difficult?

If your loved one is past the early stages of dementia and really struggles with short-term memory, they are probably not a good candidate for a medical alert system. They might forget to wear the pendant, or they may forget the purpose of the pendant and press the help button repeatedly out of curiosity. In these cases, it's better to have a more structured system in place with closer monitoring.

If you have an implanted cardiac pacemaker, you should talk with your doctor. Ask if wearing a fall-detection pendant that has magnetic closures or a wearing a mobile medical alert device that has radio-frequency energy might interfere with the pacemaker.  

Will you be able to keep track of the billing cycles for a medical alert device?

Most medical alert companies offer a no-contract subscription to their service, and you can choose to pay in monthly, quarterly, semiannual or annual payments. However, these payments are almost always set to automatically recur until the subscription is canceled. This means that you need to be capable of managing recurring payments.

Taking recurring payments is a common policy in most subscription-based services, but many seniors forget or don't realize that this is the case with medical alert systems. We found this to be a common complaint among people who use medical alert systems; the money is automatically taken from their account without notice.

Is a longer-term plan really a better deal?

We looked at the payment options of every service in our review, finding that the average savings per month is $3.90. Some services offer savings as great as $10 per month. Some don't provide any savings at all. We recommend that you start out with a month-to-month or quarterly payment plan. That way, you can gauge the service and the system without committing to a bigger upfront payment. 

Does the medical alert company you are considering have policies that are truly "senior-friendly"?

Do not assume that medical alert companies are senior-friendly simply because they offer a service aimed at seniors. For example, automatic renewals are common within the industry, and refunds can be difficult to obtain.

In addition, a subscription's termination date does not begin on the date when the company is first notified by phone of the intent to cancel. Rather, it typically begins on the date the company has received the returned equipment from the customer and has inspected the equipment and determined that it is in "good condition." And if the company thinks you returned a damaged product, they can send you a bill for between $350 and $500.

How active are you or your loved one?

The downside to many medical alert systems is that the range is limited to the house. But how many people do you know over 65 who never leave the house? Most seniors are very active. Aging in place doesn't mean you have to age in place. It's important to consider your activity level. You should consider a mobile medical alert system if you often leave the house without supervision.

Are you comfortable putting a lockbox with your house key on your porch?

If you get a medical alert system, you should also put a lockbox on or near your front porch. The lockbox is a secured box that contains a key to your home and requires a combination to open. It allows EMTs to enter your home in an emergency without breaking your door or windows.

However, many seniors aren't comfortable with leaving a key to their home so visible, even if it's safely locked away. If so, you might want to get a lockbox that resembles a rock.

Read the terms and conditions agreement carefully.

Many medical alert companies don't require you to sign a contract, but this doesn't mean that you aren't legally bound by the terms and conditions agreement. The first thing to look for is how available the service makes this document. You should be able to find it in a link at the bottom of the website, though sometimes this is the terms of use for the website, which is different.

If this document isn't easy to find and print out, then that's something to be concerned about. Some services don't include it on the website or include it only at the end of the payment process, which is disconcerting. You should have ample time to read and consider the terms before agreeing to a purchase.

Be ready to pay in advance.

A customer will be required to make a first payment on the day the product is ordered, even though he or she has not yet received the medical alert system. The billing cycle is typically set up so that customers pay in advance for the monitoring services that they will receive over the next month, quarter-year, half-year or year, depending on the service plan selected.

Prepare for automatic renewals.

It's a common practice within the medical alert industry to automatically renew a service plan on a certain date. Our reading of customers' complaints suggests that many customers seem unaware of — and upset by — this practice.

Most companies "automatically renew" customers for the same time period that the customer originally signed up for, without notification. This means that at the end of a payment period, the company charges the credit card or other payment method that you used when you signed up for the same period. For example, if a customer originally signed up for a three-month service plan on Jan. 1, the same three-month plan automatically renews on March 1, extending the subscription until June 1, and so on until you cancel.

Double-check the calendar dates of your money-back trial period.

Most medical alert companies offer a money-back trial period during which you can get a full refund if you cancel. However, this trial period can be as short as 10 days or as long as 90 days. For customers to be eligible for this refund, they must return the equipment to the company within the specified period. 

In addition to checking the length of the trial period, pay attention to when the clock starts ticking on this period. Also check how long the company says it takes for the customer to receive the shipment. In many cases, the start date begins on the day the customer places the order and not the date the package is received. The longer it takes for the equipment to reach customers, the less time customers have, after they receive the equipment, to decide whether to keep the system.

Prepare to deal with aggressive marketing practices and high-pressure sales tactics.

Some medical alert companies have a reputation for using high-pressure sales techniques. Others may try to up-sell pricey add-ons or "protection" plans that customers might not need. Many of these companies have websites designed around the "sales funnel" philosophy, in which critical information about the product, pricing and service is withheld. This requires you to call the company's "toll free" number "to learn more."

Don't fall for these tactics. If you're forced to talk to a salesperson "to learn more," then there's usually a reason: The system costs more than most, has a long-term contract, is not easy to cancel, etc. Salespeople are trained to be persuasive. A good salesperson can talk most people into a purchase, even if it's not in the person's best interest. This isn't to say you shouldn't talk to a salesperson. Just make sure the website is designed to provide you with as much information to provide you with an informed purchase first.

Take notes during any calls you make to a medical alert system company, and save that information.

Some medical alert companies have clauses in their terms and conditions agreements that allow the businesses to record, review or use the contents of phone calls, emails or other forms of communication. The purpose of this is to resolve disputes. This is not necessarily a bad practice. In fact, you should do the same – Keep good records and copies of the emails or letters to the company, as well as detailed notes of phone calls, including the date, time and name of the company representative.

Carefully read the company's policy on refunds.

Some companies do not offer any refunds when a subscription is canceled prior to when the plan ends. This is among the most frequent gripes that people have about medical alert companies. Customers report feeling "ripped off" or "scammed" out of their money.

These bad feelings arise if, for example, a customer pays for a one-year service plan in January, but then decides to terminate service in March. That customer may feel entitled to a refund of the unused months, but not all companies offer pro-rated refunds, which means that if you make an annual payment, but cancel your account in March, you won’t get refunded the remaining nine months that you’ve already paid for. If a company doesn't post its refund policy on its website, it's best to assume the business doesn't offer refunds.

We think some customers may feel more comfortable choosing from the companies that do offer a refund. Moreover, we recommend asking exactly how refund amounts are calculated, because companies do this in different ways. Some only provide pro-rated refunds after the first three months. Some charge restocking fees.

Designate a place in your home where you can store the original packaging.

When you buy a medical alert system, you don't actually own the medical alert system; you're actually subscribing to a service that leases the equipment to you. Some companies attempt to make you think you're getting a great deal by getting the equipment for free.

For example, Medical Guardian has a perpetual offer at the top of the website that says, "Free equipment ($300) value." However, when you cancel your account with Medical Guardian, you have to return the equipment in the original packaging. And if the equipment is damaged, you have to pay up to $350 for the base units and up to $150 for the fall-detection pendants.  

It's a good idea to save the box that the medical alert system and its components came in and to store it in a convenient location. It may also be a good idea to write down the actual date you received the system and make a list of all the items sent to you, such as a base station, help buttons and cords needed for installation. That way, it's clear what items you must ship back when canceling.

Be prepared to undertake quite a process if you cancel services.

Canceling your medical alert system is different from canceling a utility service, like electricity or water. With utilities, termination begins the same day the customer notifies the utility that service is no longer needed and you usually get a prorated refund. By contrast, calling a medical alert company to terminate a subscription is just the first in a series of steps to end the service.

We suggest re-reading the termination policies on the company's website and in the terms and conditions agreement before making this call. Most companies require a written cancellation notice and can only be canceled by the person who set up the account. This means that if your sister set up the account for your aging mother, you can't cancel the account. Only your sister can.

When canceling, be sure to clarify exactly which pieces of equipment need to be returned. Find out all the details about packing and shipping the equipment, the correct address to send it to, whether the package needs to be insured, and how long the cancellation process typically takes. Carefully follow any directions you are given. We also suggest taking a few photographs of the equipment before packing it, in case disagreements arise about whether it was returned in "good condition."

Note that the service plan is usually terminated on the date the equipment is checked in, not the day that you canceled. This means that an employee has looked over the equipment and determined that it is in "good condition" and that all the items have been sent back.

Prepare to pay for the return shipping fees when canceling service.

Customers are usually responsible for paying the shipping expenses when returning equipment to a medical alert company after terminating service.

We also suggest asking if there is a time limit on returning the equipment to the company when ending a service plan. Or, check the terms and conditions agreement to see if it mentions one. In some cases, customers have a narrow time frame to return the equipment before another billing cycle starts.

You might be responsible for unknown and undefined fees for making too many false alerts.

Most medical alert systems outsource their monitoring center to an independent, third-party call center that usually also handles fire, security and other alarm calls. This is why there are clauses in the terms and conditions that state that you are responsible for any fees incurred from making too many false alerts to the monitoring center. In other words, if you or your loved one abuses the monitoring center, it could fine the medical alert company. If this happens, that fine is passed on to you. However, the clauses never define what constitutes abuse, reveal whether warnings are given prior to fines or say how much the fees are.