Medical Alerts Systems: FAQ

General Questions

What is Dignifyed?

Dignifyed is a publication devoted to reviewing technology and services aimed at preserving seniors' independence and quality of life.

How many medical alert companies are there?

We counted 72 medical alert services in the U.S., but there could be more. Most are offered by regional-based home security companies, and only as add-ons to your standard home security subscription.

How many medical alert systems were considered for review?

We narrowed the list of 72 services to 30. For our review, we considered only the medical alert services that were available everywhere in the U.S., didn't require a prior security system setup and didn't require a long-term contract.

How many medical alert systems were tested?

We tested 21 medical alert systems from 20 individual services: 16 in-home medical alert systems (a wireless pendant and a cellular base unit), and five mobile devices.

Did the medical alert services know you were reviewing them?

No. We bought subscriptions for each medical alert system and set up the accounts under the same name: Frank. As far as the services were concerned, we were just another customer. We did this to avoid favoritism and to make sure they treated us like a normal customer.

Why didn't you review and test Life Alert?

Life Alert is the brand that comes to mind when most people think of medical alert systems. There's a reason for that: The company been running very successful commercials for decades, featuring mostly elderly women falling down stairs, followed by the memorable tagline, "Help! I've fallen, and I can't get up."

However, Life Alert requires a three-year contract that isn't easy to cancel — you must prove that your loved one passed away or that he or she requires 24-hour care in order to cancel the contract. Also, Life Alert is notoriously aggressive with its sales, which is evident in the way the website withholds information in an effort to funnel visitors into a sales call. In addition to the long-term contract, the subscriptions cost significantly more per month than any other medical alert service we considered. For these reasons, Life Alert simply isn't a service we can recommend.  

How many hours of hands-on testing did you perform for this review?

We spent over 120 hours doing hands-on testing. The testing methodology was developed, directed and led by the reviewer, Jeph Preece. He had the help of professional product testers in Purch Labs: Matthew Murray, Frank Parks and Kai Gull. We also performed tests in Matthew's apartment, which he was so kind to allow.

How many hours were devoted to research and evaluation?

The estimated number of hours the reviewer spent on research and evaluation is staggering: over 300 hours. Throughout this process, he spent hours on the phone with sales reps and support reps. He emailed with CEOs and presidents of many of the companies. He read every word on every page of each company's website, including the privacy policies and terms and conditions.

What did you test?

You can read about the tests here, but we tested the wireless pendants, the call center response time and the fall-detection pendants.

FAQs About the System

What is a medical alert system? Why is it important? How does it preserve independence?

Consider the following facts from the Center for Disease Control and Prevention:

  • More than 1 in 4 people over 65 will suffer a fall.
  • 2.8 million seniors are treated for fall injuries each year.
  • 1 in 5 falls results in broken bones or a traumatic head injury.
  • Over 95 percent of hip fractures are caused by falls.

(Source: “Important Facts About Falls.”)

With those statistics in mind, you should think of a medical alert system as a safety net. Medical emergencies rarely occur in convenient locations near phones or people. Medical alert systems simply extend the range of convenience, allowing you to call for help regardless of where the emergency occurs.

In turn, this safety net can help seniors live independently or "age in place." According to AARP, 87 percent of seniors want to stay in their homes as long as possible. Independence is one of the most important factors in a senior's quality of life, and a medical alert system facilitates this by providing the peace of mind to both adult children and seniors.

How do medical alert systems work?

The process is simple:

  1. A person experiences an emergency.
  2. He or she pushes the help button on the pendant (worn at all times, even in the shower).
  3. An operator answers the call (through the base unit or mobile device) and asks if the person needs help.
  4. The operator assesses the situation and contacts local emergency responders, emergency contacts and family.
  5. The operator stays on the line until help arrives.

If immediate medical attention is not required, the user can ask the operator to contact a family member, caretaker or emergency contact, such as a neighbor.  

If the operator can't hear the user, he or she will assume the user is unconscious or unable to respond and will contact local emergency responders.

What is a base unit?

Also sometimes called a "base station" or "home station," the base unit is the core of a traditional or home medical alert system. It is little more than a simple speakerphone with a sensitive microphone. Every base unit comes with a wireless pendant that is worn by the user. All base units have backup batteries that ensure the device will still work in a blackout. The batteries typically last between 24 and 36 hours.

There are two types of base units: landline and cellular. The landline units are typically more affordable. The cellular units, which connect to a cellular network such as one from Verizon or AT&T, are typically the midrange package, costing between $6 and $10 more per month than a landline system and $10 less per month than most services' premium packages, which usually include a mobile device.

What is a pendant?

The pendant is a waterproof wireless device, typically no bigger than a quarter, that the user wears on a lanyard around the neck or on a wristband. You push a button on the pendant when you need help, and a wireless signal tells the base unit to call the monitoring center.

What is the wireless range of an emergency pendant?

It depends on the product, but it can range from hundreds of feet to thousands of feet. For example, Medical Guardian's landline unit has a pendant that has been tested with a straight line-of-sight range of 2,000 feet, while other pendants reached only 600 feet.

However, every pendant we tested had a range that would comfortably cover most homes.

Do I have to wear the pendant all the time?

Nobody is going to force you to wear the pendant. We understand that many seniors are concerned with the stigma associated with medical alert devices. If you're concerned about wearing a pendant, you should read The Dignifyed Checklist: What to Ask Before You Buy. That said, pendants are meant to be worn all the time, even in the shower or bath.

Are the pendants waterproof?

Every pendant we reviewed can be, and should be, worn in the shower. They even work while submerged — an ability we tested.

How reliable are the pendants?

We thought we'd be able to find real-world scenarios that would weaken or interfere with the wireless signal between the pendant and the base unit. For example, we pressed the button on the pendant next to a refrigerator and washing machine. We also pressed it on the floor next to a bed in a room with four walls between the pendant and the base unit. And in every scenario, those obstacles failed to interfere with the pendant's signal. So, yes: The pendants are very reliable, as long as you're within range. 

What does "PERS" mean?

PERS stands for "personal emergency response system." It is often used as shorthand for medical alert systems.

What is a mobile medical alert device?

Typically offered as a part of a company's premium package, a mobile device is like having a base unit and a pendant wrapped into one device. In other words, the pendant you wear (around your neck or on a belt clip) calls the monitoring center and allows you to talk to the operators through the pendant. In this way, mobile systems are essentially simplified cellphones that call only the service's monitoring center.

What is the best system for my loved one?

It really depends on your budget, activity level and location. Check out our article on the subject: What Type of Medical Alert System Is Best for You? Pros and Cons.

How do fall-detection pendants work? Are they worth it?

Fall-detection pendants work by using accelerometers to measure g-forces and a gyroscope to measure the rotation or twist of the body as it goes down. These sensors work in conjunction with proprietary algorithms to determine whether you're falling or simply sitting down quickly or rolling over in bed. The good news is that they do work – in the sense that the pendants can recognize a fall and call for help without requiring you to press the button. The bad news is that they can often be much too sensitive, causing many false alerts.

Simply moving the fall-detection pendants around caused many false alerts in our tests. Many of these pendants consistently activated after being dropped from a mere 6 inches; others barely activated at all, regardless of how hard or soft we fell. And we did fall. 

Still, whether it's worth it depends on you and your budget. A fall-detection pendant is designed for scenarios where the user is unconscious and unable to press the button. So it does provide some peace of mind, which is valuable. However, the pendant adds between $5 and $10 a month to your medical alert system cost.

FAQs About the Call Center

Do companies operate their own emergency-response call centers?

This is a tough question. One of the CEOs we contacted suggested that nearly all medical alert services outsource their call centers to independent call centers. In addition, nearly all of these companies have stipulations in their terms and conditions that allow for third-party contracts and partnerships. However, when contacted, most services were reluctant to respond to questions about those subjects or confirm those facts. Most of these services want you to think they own and operate the emergency monitoring center because it is a core part of their service. However, only two services confirmed to us that they owned and operated their own call centers: GreatCall and ADT.

Some companies may have shareholding stakes in their call center or vice versa. For example, Medical Care Alert, one of the medical alert services we reviewed, outsources its call center duties to Rapid Response, a highly rated independent monitoring center. However, Rapid Response has a shareholder's stake with Medical Care Alert, which makes their partnership arguably close to being "own and operated."

Should I choose a service that owns and operates its call center rather than a service that outsources it?

That's really up to you. In our experience, it really doesn't matter if a medical alert company owns and operates its call center or outsources it to an independent center. You or your loved one still receives help from a highly trained operator in U.S.-based call center that has multiple locations to ensure calls are always answered.

However, we did place a greater value on medical alert services that own and operate their call centers because it shows that the company has a more hands-on responsibility over the quality. For example, if the call center has a fast response time and an excellent call quality, the credit goes to the company that owns and operates the call center, not to the third-party service.

In addition, a third-party monitoring center also has contracts with security system companies, which means that your emergency call competes with burglaries, fires and other home security customers. This might explain why GreatCall had the fastest call-response time in our tests — the company owns and operates its call centers, and those call centers deal only with medical alert emergencies.

Do call centers accommodate foreign languages?

Most emergency monitoring call centers claim to accommodate up to 200 languages. However, we've never seen an actual list of the languages that these call centers can accommodate, and we certainly didn't test the claims. In other words, we don't know if the call centers actually have operators capable of speaking all of these languages at all times. 

If your loved one speaks a language other than English, it's important to confirm that the call center can accommodate that language. Then, we suggest setting up a month-to-month subscription and testing the call center routinely to make sure the operators can effectively communicate with your loved one. If not, cancel the subscription and try another one. Clear and effective communication is essential with a medical alert system.

What are the risks that an emergency call will go unanswered?

There is basically no risk. There are backup monitoring centers, and calls are typically answered in order of priority, which is determined by a computer. So, if power goes out in one call center or all of the operators are occupied, there is always another call center located somewhere else in the country to pick up calls.

How are call-center operators trained?

Operators typically receive the same or similar training as EMTs and are trained to meet 911-operator standards.

What happens if the operator can't hear me?

The base units have very sensitive microphones that are supposed to pick up your voice from other rooms in your home, but that doesn't mean they are always effective in picking up what you're saying. If operators can't communicate effectively with you to assess the emergency, they will assume you need help and will contact your local emergency responders.

Even if you try to cancel an emergency call by hitting the reset button on the base unit, an operator will call your home or cellphone to make sure you are fine. (This happened dozens of times throughout our testing.)

Do I have to worry about false alerts?

Yes and no. False alerts do happen with medical alert systems. It's almost certain that, at some point, you or your loved one will accidentally hit the button or activate the fall-detection pendant. When this happens, you simply tell the operator that you accidentally hit the button and that you're fine. They understand and are happy enough to talk to someone who is OK. Most operators still ask you to confirm multiple times that you're OK, but otherwise, that's the extent of what happens with a false alert.

However, almost every medical alert service has clauses in its terms and conditions stating that you are responsible for any fees associated with abusing the call center or making too many false alerts. What constitutes abuse or how much the fees might be are not defined, but these are potential issues to consider. This is understandable, considering that it's not ideal for emergency responders to take time away from responding to actual emergencies. And if most of these medical alert services have contracted with an independent call center, the call center could fine the service for receiving too many calls. In turn, these fines could be passed on to you.

Basically, you likely won't run into any of these issues as long as you don't hit the help button many times a day just to have a friendly chat with the operators or attempt to fake medical emergencies.

How did you evaluate the call centers?

First, it's worth emphasizing that every interaction we had with emergency response operators was professional. We can't stress that enough. That said, we did evaluate the calls for general quality, and we tested the response time (see below). The evaluation was a simple rating of the operator's demeanor, diction and overall script. Ideally, an operator sounds interested, speaks clearly and doesn't sound too scripted.

We noted when operators sounded bored and eager to end the call, as well as when they seemed genuinely concerned. We noted when operators spoke too fast or had accents (foreign or regional), because strong accents can be difficult to understand over the limited bandwidth of a phone call, and can be especially difficult for people with age-related hearing loss. Clear communication is critical.

For security purposes, we noted whether the operator asked for our name or assumed we were the name on the account. Assuming we were “Frank” meant that anyone could answer affirmatively and it would go unchallenged. By asking for our name, the operators can gauge whether we belonged in the home and send help in the event of a home robbery. We also noted whether they indicated that they were disconnecting at the end of the call. Then, we collated these evaluations and graded the results for an easy comparison.

If I push the help button on the pendant, how long does it take for the operator to answer?

The average response time in our tests was 69.58 seconds. GreatCall was the fastest, with an average of 20.67 seconds — more than twice as fast as the second-fastest response time (LifeFone). The slowest response time was 178.87 seconds (Senior Safety).

Generally, you can expect an operator to start talking to you in a little over a minute. In our opinion, this is too long. Every second counts in an emergency. Any service with a fast call-response time should be high on your list. You can learn more about our tests here.

Which medical alert system has the best call center?

In our evaluation, GreatCall had the fastest response time and tied with MobileHelp (which is contracted with Rapid Response) for the best call quality.

FAQs About the Service

Why are so many medical alert companies so similar?

If you pay close enough attention, as we did, you'll find that most medical alert systems on the market use the same devices and the same call center. This makes the companies little more than intermediaries that control the marketing and sales of someone else's product and service. In this way, the industry is largely composed of companies where the only significant difference is the brand name on the bill.

One example of this is the MyTrex MXD3G, which is manufactured by MyTrex Inc. and was used by six of the services in our review. In addition, the MobileHelp CBS2-01 was used by five services in our review. Several of these medical alert companies have contracts with the same independent call centers. For example, Medical Care Alert and MobileHelp use the same Rapid Response monitoring center.

However, GreatCall, Philips Lifeline and RescueTouch all offer unique products and services that deviate from this.     

What packages are typically offered?

While each service may market the packages differently, most work on the same three-tier model: a base package, a midrange package and a premier package.

The base package is usually a landline device — a traditional home medical alert system that consists of a base unit and a wireless pendant. The average base package costs about $30 a month.

The midrange package is usually a cellular base unit — also a home medical alert system, only it uses a wireless network to call for help. Because cellular base units are newer technology, they often have better speakers than landline systems. The average midrange package costs about $36 a month.

The premium package is usually an mobile device, a mobile two-way pendant that uses a cellular network to call for help. The average premium package costs around $43 per month.

Some companies offer additional packages that include both a home system and a mobile device or tracking sensors and apps, such as the Medical Guardian Family Guardian package.

What is a lockbox? Is it worth it to add the lockbox to my checkout?

A lockbox is a simple container with a combination lock. You put a house key in the container and leave the lockbox somewhere near your front door. This way, emergency responders don't have to break down your door or break windows to get to you.

And yes, lockboxes are worth it. Some services offer free lockboxes; others sell them for as much as $30. Others might allow you to rent one for $2 to $3 a month. We recommend the one-time purchase, unless you can get one for free.

Are bulk payments worth it?

Bulk payments — annual, semiannual or quarterly payments — can save you between $1.33 and $10 a month, depending on the company. On average, we found that bulk payments save you $3.90 per month.

Can I cancel at any time?

Every medical alert service we reviewed allows you to cancel at any time. You should never sign a long-term contract with a medical alert service.

What are the refund policies like?

Most services in our review provide a full refund within a specified deadline ranging from 14 to 90 days. After that, the refunds are usually prorated based on when you canceled (in writing) and how far in advance you paid. However, not every service has the same refund policy, so it's important to contact the company if you have any questions. And make sure you keep good records of your communications with the provider.

If I make a bulk payment and I cancel, can I get a prorated refund?

Most services provide a prorated refund for bulk payments if you cancel, but it's important to check with the company before committing to an annual payment. Some services keep the first three months of any payment you make, and a few don't provide any refunds after the initial refund period, which is typically 30 days.

How aggressive are the sales teams for these companies?

It is fairly common for medical alert companies to design websites based on the sales-funnel philosophy — in other words, marketing tactics that force potential customers into a sales call. The most common tactic is to withhold important information about the product, such as pricing and contract details, and only provide a phone number. Another tactic is to withhold information and require the customer to fill out a personal information form to get a "free brochure." Then, the company uses the info to call the customer. (Of the 20 companies we reviewed, 13 used the free-brochure tactic.)

Another tactic is the "risk-assessment" test. We took these tests, and answered every question with the lowest possible risk — that we were young, lived with others, didn't take medications, haven't experienced any falls, are very active and have no health issues. And even though we had no risk at all, the company still recommended we get a medical alert system. These tests require you to provide personal information so that a sales representative can contact you.

As a result, we expected the sales call to be overly aggressive. We even read many user reviews that suggested as much. However, although these companies certainly have skilled sales teams (all of which are very capable of convincing you that they are the best and most trustworthy medical alert system), we didn't find any that crossed the line in how often they tried to contact us and push their product. In other words, they were aggressive, but also pleasantly respectful and always professional.

We placed a higher value, however, on medical alert services whose websites provided plenty of information on the product: comprehensive FAQs pages, product guides, industry articles, senior and caretaker resources and other information. If a company needs to lure you into a sales call, there is usually a bad reason for it: Either their system costs too much, their product isn't good enough or they have questionable contract stipulations. 

Are there any red flags in the terms and conditions?

We read every service's terms and conditions and privacy policy — more than 40,000 words in total. And in all of that boring material, we didn't find any significant red flags. Mostly, these are boilerplate clauses that are nearly identical from one service to another. Here are some things to consider:

Liability waiver: The services waive all liability to any damage or injuries that you experience from a failure of the device or the call center. Basically, if your loved one dies because the pendant didn't work or the call center sent the emergency responders to the wrong house, you can't sue them.

Max liability clause: But if you do sue them and they are found liable, the max payout can't exceed this specified amount, which ranges from $300 to $1,500. 

False alert fees: Most services had a clause devoted to fees associated with false alerts or call center abuse. These clauses are a little troubling because the companies do not define what constitutes abuse or specify the amount of the associated fees. However, it's worth noting that during our tests, we contacted all of the services' call centers multiple times a day, and we never received any complaints or fees. As such, we suspect this clause would only come into play if your loved one were hitting the help button dozens of times every day just to chat with the operators.

Which medical alert system has the best service?

We prefer GreatCall both as a company and a service. The customer service is very helpful, and the website is very informative. Moreover, the company as a whole is one of the few medical alert companies leaning into the future with smartphones and fitness trackers for seniors.