Getting Help Fast: Falls, Emergencies, and Alert Systems

Picture a woman in her mid-80s who slipped on her kitchen floor one evening. She was not badly hurt, but she could not get up, and her phone was on the counter. A neighbor found her the next morning. Now her son wants her to get a medical alert system, and she is not sure.

Staying home safely is not only about preventing falls. It is also about getting help quickly when one happens. This guide covers how often falls happen and how medical alert systems work and what they cost. It also covers free programs that lower the risk of falling, and a simple plan for emergencies.

Why getting help fast matters

Over 14 million older adults, about 1 in 4, report falling every year. Falls are the leading cause of injury for adults 65 and older¹.

Many people cannot get up after a fall. In a UK study of people over 90, 80% of those who fell could not get up without help at least once. And 30% lay on the floor for an hour or more. Most had call alarms. But in most of the long waits on the floor, the alarm was not used².

That study was small and of very old adults. Its lesson applies widely, though: help works best when it comes quickly, and an alarm only helps if it is used.

What a medical alert system is

A medical alert system, sometimes called a personal emergency response system, lets you call for help by pressing a button. The button is usually a pendant or wristband. Most are water-resistant, so you can wear them in the bathroom³.

• In-home systems use a base unit with a speakerphone, placed in the middle of the house.
• Mobile systems use a cell phone signal and often GPS location, so they work away from home.
• Monitoring: pressing the button connects you to a monitoring center that answers day and night. Staff there can call a neighbor, family, or 911.
• Fall detection is an add-on that calls automatically when the device senses a fall, even if you cannot press the button.

How the cost is set

Companies set their own prices, which depend on the type of system, the monitoring, and add-ons. As of May 2026, monitoring typically ran about $20 to $65 a month. Fall detection added about $10 to $15 a month. Some companies also charge a one-time equipment fee⁴.

Over a year, that can be several hundred dollars. Before you sign, ask about contract length, cancellation fees, and whether the price goes up after the first year.

What you get, and what you do not

You get a way to reach a person at any hour without getting to a phone. For someone who lives alone, that can mean the difference between help in minutes and a long wait.

You do not get someone who comes in. The monitoring center calls others to come. And an alert system only helps if it is worn and used, including at night and in the bathroom.

Who pays, and ways to lower the cost

Coverage for alert systems depends on your plan, your state, and your situation. Here is how to find out if your coverage pays:

• Original Medicare. Look the item up on Medicare.gov's coverage pages, or call 1-800-MEDICARE (1-800-633-4227) and ask⁵.
• Medicare Advantage plans. These plans can offer extra benefits that Original Medicare does not⁶. Some pay part of the cost of an alert system⁷. Check your plan's Evidence of Coverage, the booklet that lists what the plan covers and what you pay⁸. Or call the number on your plan card.
• Medicaid. Each state designs its own Medicaid waiver programs. A waiver program pays for care at home or in the community instead of in a nursing home⁹. Some cover alert systems. Indiana, for example, lists them in several of its waiver programs¹⁰. Ask your state Medicaid agency.
• The VA. The VA may provide a medical alert device to an eligible veteran when a VA clinician finds it is needed for the veteran's care¹¹. Ask your VA care team.
• A free counselor. Your State Health Insurance Assistance Program offers free, one-on-one Medicare counseling¹². Call 877-839-2675.

Other ways to lower the cost:

• Your Area Agency on Aging may know of local programs that help with the cost. Find yours through the Eldercare Locator, 1-800-677-1116.
• Free fall prevention classes lower the risk in the first place (see below).
• Home safety repairs can be money well spent. See Help with housing costs, state by state for repair and home modification programs where you live.

Free and low-cost ways to prevent falls

Classes can build strength, balance, and confidence. The National Council on Aging lists programs that research shows work, including¹³:

• A Matter of Balance: an eight-week group program to ease fear of falling, get more active, and make changes at home.
• Tai Chi for Arthritis and Falls Prevention and Tai Ji Quan: Moving for Better Balance: tai chi classes to build strength and balance.
• Stepping On and Stay Active and Independent for Life: classes on confidence, strength, and balance.

These programs run in senior centers, libraries, YMCAs, churches, and hospitals. Some are offered by video. Federal funds for older adults may support them¹⁴. Fees vary by location, so ask the provider. Find one through the council's program finder or your Area Agency on Aging.

Talk to your doctor, too. The CDC, the nation's public health agency, has a program that helps doctors check your fall risk. It helps them find what can be changed and lower the risk¹⁵. Ask, "Am I at risk of falling, and what can I do about it?"

A simple emergency plan

• A phone you can reach. Keep a phone within reach of the bed and the floor, or carry one.
• An emergency contact list. Put names and numbers by the phone and in your wallet.
• A way in. Leave a key with a trusted neighbor, or use a lockbox and share the code with people you trust. That way responders can get in quickly.
• Medical information where responders can find it. Some local agencies offer a "File of Life." It is a magnetic holder for the refrigerator door. The card inside lists your medicines, allergies, health problems, doctor, and emergency contacts. For example, the fire department in Manchester, Connecticut, gives out free supplies. It trains its responders to look for the holder on the refrigerator¹⁶. Ask your fire department or Area Agency on Aging about a local version.

What can change it

Changes to the home can lower the risk of falling and make help easier to reach. Think grab bars, a second stair rail, brighter lights, and clear paths. Our guide Making Your Home Safer to Age in and to Share walks through them.

Changes in the household matter too. If someone moves in, agree on how you will reach each other in an emergency. If they pay rent, see Will Sharing My Home Affect My Benefits?

An extra set of hands

When someone else is in the house, help after a fall can come in minutes instead of hours. That person might be a family member, a friend, or another person who lives in the home.

• What it accomplishes: someone to hear you call, dial 911, and unlock the door for responders.
• What it protects: against the long wait on the floor, and the harm that can follow.
• What it preserves: your independence, and your family's peace of mind.
• What it offers: a daily rhythm. Someone notices if you do not come down for breakfast.

An alert system is the paid stand-in for having someone there, at about $20 to $65 a month³. A daily check-in call from a friend costs nothing. Some Area Agencies on Aging offer telephone reassurance, where staff or volunteers call to make sure you are okay. Virginia's agencies, for example, list it among their services¹⁷.

Help is optional and agreed in advance. Being present is not caregiving. No one in the home should be expected to lift someone who has fallen or to give medical care. Skilled or risky work, such as roofs, trees, electrical, plumbing, gas, and anything on a ladder above the first floor, belongs to licensed professionals. That includes the grab bars and stair rails that help prevent falls. Our guide Help Around the House Is Not Caregiving explains the line.

Watch for

• "Free" alert system offers. Robocalls told people a medical alert system had been bought for them "at no cost." Later they owed monthly fees and a penalty to cancel. The Federal Trade Commission returned more than $1.8 million to them¹⁸. Hang up on unexpected calls.
• Long contracts and cancellation fees. Read the terms before you sign.
• A device in a drawer. A pendant only helps if it is worn. Choose one comfortable enough to wear every day.

Conversation starters

If you are an adult child or friend talking with an older adult:

• "If you fell and couldn't get up, how would you want us to find out?"
• "Would a quick call every morning feel like support, or like checking up?"
• "Want to try a balance class together?"

If you are an older adult talking with family or caregivers:

• "I'll wear a pendant if I get to choose one I like."
• "Let's agree on who has a key and who gets called first."
• "I'd rather prevent a fall than just plan for one. Help me find a class."

Help works best when it comes quickly, and an alarm only helps if it is used.

Last reviewed October 15, 2026