How to Choose a Medical Alert System: Questions to Ask First

To choose a medical alert system, start with how your parent actually lives (mostly home, or out and about), then ask who answers the button, how the device connects, how often it needs charging, whether it can go in the shower, and how you get out of the contract. Treat fall detection as a backup, not a promise. Don't buy on an unsolicited phone call, and don't count on Original Medicare to pay for it.

This guide doesn't rank companies or quote prices. It gives you the questions that separate a good fit from a bad one, a checklist for the sales call, and the details the monitoring center needs from you on day one.

Start with where your parent spends the day

The National Institute on Aging describes an emergency medical alert system as an electronic monitor a person wears that alerts emergency personnel when they become lost, fall, or need urgent medical help. That covers a few kinds of equipment, and the right one depends on your parent's routine more than on any feature list.

The other big fork is monitored versus unmonitored. AARP's guide to choosing a medical alert or monitoring system (updated May 2026) explains that monitored systems connect to a call center with live agents, while others connect directly to 911 or to family contacts. Unmonitored can work if the contacts reliably pick up. If you're the first contact and your phone is face down in a meeting, a staffed center starts to look better.

If your parent already wears a smartwatch, check what it can do before buying anything new. Our walkthrough on setting up emergency info on a parent's phone covers the phone and watch settings.

Fall detection is a backup, not a guarantee

Automatic fall detection sounds like the answer for a parent who won't press a button. It can help, but no fall detector catches every fall, and ordinary movement can set one off. The research asks you to keep expectations modest.

• A small pilot study published in the Journal of the American Geriatrics Society in 2015 followed 18 older adults living at home with one wearable fall detector. Of 84 fall alarms, 83 were false. The device caught one fall and missed three others that happened while it was being worn. Eight more falls happened while people weren't wearing it, half of them with the device in the charger, early in the morning or at night.
• A 2008 BMJ study followed people over 90, mostly in Cambridge, England. Nearly all of them had some kind of call alarm, either a pendant or a call bell in their room. Yet in 80 percent of the falls where someone was alone and couldn't get up, they did not use it to call for help. Some weren't wearing the pendant, one had taken it off for bed, and some chose not to press it because they wanted to manage on their own or feared going to hospital.

None of that means skip it. It means the device has to be worn, charged and used, and your parent has to believe pressing the button is allowed even when they feel silly. Ask how the company handles false alarms; AARP notes that accidental presses are common and calls unlimited false alarms a great feature. And talk about the 3 a.m. bathroom trip, since that's when the pendant is most likely to be on the nightstand.

If a fall has already happened, our guide to what to do after an elderly parent falls covers what to write down and what to change in the house.

Who actually answers the button?

Some companies run their own response center. Others contract with an outside monitoring company. AARP suggests asking which it is, whether the center is certified by an organization such as UL Solutions, what the average response time is, and whether operators can talk with your parent in their preferred language. Add a question about hearing: can the operator be heard clearly through the speaker in the farthest room?

You may also hear "Five Diamond." The Monitoring Association, a trade group, grants its Five Diamond designation each year to monitoring centers that commit to random inspections by a nationally recognized testing lab, to having all operators certified through its training (with recertification every three years), to reducing false dispatches, and to customer service. It's a voluntary industry credential, not a government license. If a company claims it, ask whether the center that would answer your parent's calls holds it.

Then ask what the operator does when the button is pressed and your parent doesn't answer. Send an ambulance straight away? Call you first? The answer should match what your family wants, and you should be able to change it.

Will it still connect in five years?

Medical alert devices ride on phone networks, and phone networks get retired. The FCC's guide to the 3G network phase-out explains that the major carriers shut down their 3G networks in 2022, and that certain medical devices, smartwatches, home security systems and devices using cellular as a backup could be affected. Its advice was to contact the monitoring company to confirm how a device connects.

Landlines are changing too. The FCC's page on the tech transition says providers are retiring old copper phone lines, that upgraded phone service may not work in a power outage without a backup power source, and that customers should check whether medical monitoring systems are compatible with the new network.

So ask:

• Which network does this device use, and what happens when that network is retired? Will you replace the device, and who pays?
• If it plugs into a home phone line, will it still work if the phone company moves the house off copper?
• How long does the base unit run on its backup battery in a power cut, and does it tell anyone the power is out?
• How good is coverage at my parent's address, and can we test it before the trial ends?

The daily stuff: charging, showers and range

These sound minor, and they're why devices end up in a drawer.

Charging. Ask how long the battery lasts in real use, whether there's a low-battery alert, and who gets it. AARP asks the right follow-up: will your parent go without the device while it charges, and does it come off at night when falls are more likely? Plan a charging time that fits their routine, like during breakfast, rather than overnight.

Water. AARP points out that many falls happen in the bathroom and kitchen. Ask whether the device can be worn in the shower every day, and get the answer in writing. "Water-resistant" doesn't always mean that.

Range. For in-home systems, test the button from the farthest places your parent goes: the basement laundry, the garage, the mailbox, the back steps. Walls and floors shorten range. Do the test calls during the trial, not after it.

Hands and ears. AARP also suggests thinking about fine motor skills (can they press the button, fasten the strap, work the charger?) and whether they can hear and be understood through the speaker.

Contract terms to read before anyone signs

Monitoring is a subscription. In a March 2026 release, the FTC said it still receives thousands of complaints each year about negative option programs (the kind that keep billing until you act), including more than 100,000 in the past five years.

You may have heard about a federal "click to cancel" rule. The FTC adopted it in 2024, but a federal appeals court vacated the rule in July 2025, days before it was due to take effect. In March 2026 the FTC started over, asking for public comment on whether and how to change its older Negative Option Rule. That's an early step with no proposed rule text, so don't count on a federal rule to make cancelling easy. Some states have their own automatic renewal laws, but the contract itself matters most.

Before anyone gives a card number, get written answers to these:

• Is there a free trial, how long is it, and does it start when you order or when the device arrives?
• Is there a minimum term, and what does it cost to leave early?
• How do you cancel, and can you cancel the same way you signed up?
• Does the plan renew automatically, and will you send a reminder first?
• Does the equipment have to be returned, by when, and who pays shipping?
• Can service pause during a hospital or rehab stay, and what happens if your parent moves? AARP suggests looking for the ability to cancel, temporarily or permanently, without penalties.
• Are there activation, installation or membership fees beyond the monthly charge?

Keep the answers, dated and with the rep's name, with the contract.

Questions to ask on the sales call

Keep this open during the call. If a salesperson can't answer one, ask them to email the answer before you buy.

• Is this monitored by a staffed center, or does it call 911 or family directly?
• Is the center your own or contracted, and is it certified by UL Solutions, a similar lab, or Five Diamond?
• What's your average answer time, and what happens if my parent doesn't speak?
• Who gets called, in what order, and how do I change that?
• Can operators speak my parent's language? How do you handle hearing loss?
• Is fall detection included or extra, and what do you tell customers about falls it misses?
• Is there any charge or penalty for false alarms?
• Which network does it use, and what happens when that network is retired?
• How long does the base unit run on backup battery?
• What's the real battery life of the wearable, and who gets the low-battery alert?
• Can it be worn in the shower every day?
• Can we test the range and coverage during the trial?
• Is there a caregiver app, and does it show whether the device is being worn or charged?
• Trial length, minimum term, cancellation cost, auto-renewal, equipment return?
• Will you hold a lockbox code and give it to responders?
• Will someone help set it up and run a test call with us?

Does Medicare pay for a medical alert system?

Usually not, if your parent has Original Medicare. Part B covers durable medical equipment, which Medicare.gov describes as equipment used for a medical reason, typically only useful to someone who is sick or injured, used in the home, and expected to last at least three years. Its examples include canes, walkers, hospital beds and oxygen equipment. Medical alert systems aren't on that list. An attorney at the Center for Medicare Advocacy told Fortune that traditional Medicare and Medigap do not cover medical alert systems, explaining that Medicare is mainly about treating problems, and these devices are mainly preventive.

Other routes worth checking:

• Medicare Advantage. Medicare.gov notes that Medicare Advantage plans may offer extra benefits Original Medicare doesn't cover, and the same attorney said some may cover medical alert devices. Search your parent's Evidence of Coverage for "personal emergency response system" or "PERS," or call the number on their card.
• Medicaid. She also said some Medicaid programs may cover personal emergency response services. Rules differ by state.
• Veterans. AARP suggests veterans ask their VA primary care provider whether they're eligible for a device.
• Local help. AARP also suggests asking the local Area Agency on Aging, which may have a list of companies in your area.

If a plan does offer this benefit, ask which companies it works with before you sign with anyone.

"Free" medical alert calls are a red flag

If your parent gets a recorded call offering a free medical alert device, the safest move is to hang up. The FTC says a robocall trying to sell you something is illegal unless the company got your written permission, and that pressing a number to speak to someone or to get off the list will probably just lead to more robocalls.

This pitch has a history. The FTC and Florida's attorney general sued one company that, they alleged, made at least a billion robocalls pitching supposedly "free" medical alert systems, claimed endorsements from groups like the American Heart Association, and often told people a system had already been bought for them. According to the FTC's refund page (April 2025), consumers later learned they owed monthly monitoring fees and that it was hard to cancel without paying a penalty.

The New York Department of State's warning about medical device robocalls adds: never give personal or financial information on these calls, including a Medicare or Social Security number, and report them to the FTC.

It's the same rule your family uses for urgent money requests: hang up, and call back on a number you found yourself. Our guide to the grandparent scam has a call-back routine your parent can use for both.

What to give the monitoring center at setup

The monitoring center is only as good as the file it has on your parent. As AARP puts it, detecting an emergency is only the first step: responders still need to get inside. Have these ready when you activate the account.

Our emergency contact list for seniors explains how to choose the calling order. The medical facts also belong on an emergency information sheet for paramedics on the fridge. When a medicine changes, update the sheet and call the center so the two match.

Then test it. Ask the company how it wants test calls done, press the button from each room your parent uses, and repeat after a move, a change in phone service or a long power outage. A short test on the same day each month keeps everyone in practice.

If the alert system is one piece of a bigger plan, our guide to an emergency plan for a parent who lives alone covers daily check-ins, keys and power outages.

Frequently asked questions

Is a medical alert system worth it for a senior who lives alone?

It can be, if they will wear it and use it. In the BMJ study of people over 90, most falls where someone was alone and couldn't get up ended without the alarm being used. Pick a device your parent is willing to wear all day, agree on when to press it, and test it together.

Do medical alert systems need a landline?

Many don't. Plenty of in-home systems connect over cellular, and mobile devices always do. If your parent's system uses a home phone line, ask whether it will still work if the phone company upgrades the line, and what happens in a power outage.

Does fall detection work if my parent falls slowly or slides down?

Not always. In the 2015 pilot study, the device missed a light fall into someone's lap and two falls from a seated position. Make sure your parent knows to press the button too.

Keeping the alert company's file and yours the same

The button is the easy part. The harder part is the paperwork around it: the contract terms, the account number, the lockbox code, the calling order, and a medical summary that matches what's on the fridge. You can gather all of that yourself with this page and a folder.

If you'd like help, Emergency Binder Now walks you through about 25 minutes of guided questions and turns the answers into a printable binder for your parent, with emergency contacts, doctors and medications, a one-page sheet for paramedics, and space for services like a medical alert account. You can see a sample binder first.

This article is general information, not medical, legal or financial advice. Device features, coverage and contract terms vary by company, plan and state, and change over time. Get answers in writing from the company and your parent's insurance plan, and ask their doctor which risks matter most for them.