Over the last year and a half, the medical and senior care industries have seen a boom in the use of Telehealth, telecare, and other help alert devices to remotely monitor and care for patients.
And over that time, the question has grown louder — will Medicare pay for my device?
Here's the short answer: it depends.
However, the reality is that as the healthcare industry continues to adopt and see the utility in help alert devices, they're slowly starting to reimburse as part of their menu of care. But as always, what's covered by one plan may vastly differ from what is covered by another.
For the sake of brevity, we'll talk about the the most predominant plans among seniors today — Medicare and Medicaid.
The Industry Sees a Growing Need for Help Alert Devices
Despite the lobbying of Congress to reimburse seniors' help alert devices, Medicaid is still hesitant to cover them as they work to decide if such devices are "medically necessary."
But if 2020 and the pandemic has taught the world anything, it's that telecare and remote wellness monitoring from home are the future of care for independently-living seniors.
Does Medicare and Medicaid cover your help alert?
However, Medicaid is still not convinced. And as of this writing, original Medicare — which comprises Medicare Part A and Part B — does not cover help alert devices such as the CareCaller™.
With that said, ground is being made in the fight for Medicare coverage of help alert devices.
Medicare Advantage plans, which seniors can select as an alternative to original Medicare, may now cover help alert devices under a category called "preventative health services."
Additionally, according to a recent article in Medical News Today, some states are also allowing Medicaid to pay for a portion of or all the costs of a help alert device.
As for private health insurance, that's still up in the air. Where one provider considers help alerts a necessary cost, many others may not. If you have private insurance, it's always best to consult them directly for specifics.
Help Alert Coverage is On the Horizon
During the early stages of the COVID-19 pandemic, CMS temporarily expanded coverage to pay for Telehealth services, and the benefits were obvious. Particularly for rural seniors who do not have regular access to doctors, the use of Telehealth and audio-only telecare was found to increase patient engagement.
Since then, healthcare providers and both home care and home health providers have been lobbying to make coverage of Telehealth a regular benefit for seniors. With the data to back it up, the questions is now not "if" insurance will one day cover help alert devices, but when.
Have further questions? Contact our helpful team with any of your insurance, or other help alert-related questions at 800-378-2957, or by email at email@example.com.