Compare the Medical Alert Contracts Before the First Month: The Monitoring Fee, the Equipment Title, and the Exit Terms

A personal emergency response system is sold as a button on a cord, but the monthly line is only part of the product. Before you compare two of them on price, put both contracts side by side and read the lines that decide what you will pay, what you own, and how you get out.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Who pays for it

Original Medicare generally does not pay for a personal emergency response system, so the monthly fee usually comes from the family, from a Medicare Advantage plan that lists it as an extra, or from a long-term care arrangement that names it. Medicare.gov explains what original Medicare covers and what Medicare Advantage plans may add, and that is the place to start. Ask any plan in writing whether it pays for this specific device and this specific monitoring service, not for a general category. Missouri SHIP counselors can help you read a plan's extras at no cost, and Local Help With Paying for Care lists where to call.

The lines to read

Pull the contract, not the brochure, and find these lines before the sales call ends.

The monitoring fee. Find out whether it is a flat monthly charge, whether the price can change, and what notice you will get before an increase. Ask what the fee covers and what costs extra.

The equipment charge. Ask whether the unit is bought outright, rented, or leased, and who owns it at the end of the term. A leased unit may keep billing after the monitoring has stopped.

The setup and shipping charges. Include any activation fee, and any shipping or return charge if the unit has to go back for repair or replacement.

The term and the renewal. Find the contract length, whether it renews on its own, and the written notice you must give to cancel. Write down the date you gave notice and keep proof that it was sent.

The early-exit terms. Find any fee for leaving before the end of the term, and whether that fee applies if the person moves into a facility or dies.

What the response center does. Ask who answers, whether the center is staffed around the clock, which contacts it calls and in what order, and what it does if no one answers. Ask whether it can reach a family member you name, and whether it needs written permission to share information.

What the unit needs to work. Find out whether it runs on a landline, a cell connection, or both, whether it has a battery, how the battery is replaced, and who pays for that. Ask what happens during a power outage.

Where the device works. Some units work only inside the house, and others also work in the yard or while out. Get the range in writing.

Which features the person needs. Whether a feature such as fall detection is needed is a decision for the family and the person's doctor. The contract should describe what each feature does and should not promise that it prevents a fall.

Compare two offers on the same page

Ask each company for the same written summary: the first-year total including setup and equipment, the monthly fee after the first year, the cancellation notice required, and the steps the response center follows. Ask for a sample contract before anyone pays. If a company will not show the contract until after the card is charged, you have learned how it handles questions. Compare the first-year total, not the monthly line alone, because a low monthly fee with a high equipment charge can cost more than a higher fee with the unit included.

Sign only when the terms are on paper

Do not accept a verbal promise about response time, fall detection, or cancellation. If it is not in the contract, it is not part of the deal. The Consumer Financial Protection Bureau publishes plain guidance on reading consumer contracts and on automatic renewals, and it is worth reading before you sign. If a company will not explain a term, or its cancellation process does not match what the salesperson said, file a complaint with the Missouri Attorney General's consumer protection office. Keep copies of everything, including the cancellation notice you sent.

Stop and call a lawyer if the contract includes a binding arbitration clause you do not understand, if family members disagree about who signed or who may cancel, or if the company holds a person's property or records that you need to recover. The Missouri Bar's lawyer referral service can help you find a lawyer who handles consumer and elder matters. Questions about whether the device is medically appropriate belong with the doctor.

Free help

Missouri SHIP counselors give free help with Medicare plan extras. Aging Ahead serves the St. Louis area as its area agency on aging and can help you find in-home services and talk through what the family can afford. The Sources page lists the public pages behind each claim on this site, and How We Write explains how this desk checks them.