What a personal emergency response system does, and what it costs

A personal emergency response system (PERS) is a device you wear or keep at home that connects you to a monitoring center when you press a button. When you press it, trained operators answer, assess what you need, and can call 911, a family member, or a neighbor on your behalf. You do not have to speak if you cannot — the operator can listen and decide whether to send help.

Most systems cost between $25 and $60 per month for basic service, plus an initial equipment fee of $0 to $100 depending on the provider and whether you own or rent the device. Some systems charge extra for features like fall detection (which calls for help automatically if it senses a fall) or GPS tracking. A few programs reduce or cover the cost for people with low income, though availability varies by state and provider.

The device itself is usually a wearable pendant or wristband, or a base station that sits on a table or counter. Wearables work anywhere — at home, in the car, at the store — as long as they have a cellular signal or a landline connection. Base stations only work at home but do not require you to remember to wear anything.

Key Takeaways

  • A PERS device connects you to a live operator 24/7 when you press a button, and the operator can call 911 or your emergency contacts without you having to speak.
  • Monthly costs range from $25 to $60, with some programs offering reduced rates for low-income seniors through Medicaid or nonprofit partnerships.
  • Wearable devices work anywhere you have cell or landline service; base stations only work at home but do not require you to wear anything.
  • Fall detection is an add-on feature that automatically alerts the monitoring center if the device senses a fall, useful if you live alone and may not be able to reach the button.
  • Medicare does not cover PERS, but some Medicaid programs, Veterans Affairs, and Area Agencies on Aging may help pay for it depending on where you live.

How to choose between wearable and home-based systems

Wearable systems (pendants or wristbands) are best if you spend time outside the home, live alone, or are at risk of falling. You wear them constantly, and they work in your car, at the grocery store, or at a friend's house. The trade-off is that you have to remember to wear them and keep them charged. Most wearables use cellular networks, so they work anywhere you have cell service; some also offer landline backup if you have a home phone.

Home-based systems (base stations) are best if you rarely leave home, have a caregiver who visits regularly, or prefer not to wear something all day. You keep the base station plugged in at home, and you press a button on it or on a wireless remote. They are less expensive than wearables and do not require charging, but they only work inside your home. If you fall in the yard or garage, the system cannot help you.

Some people use both: a base station at home for everyday use and a wearable when they go out. A few providers offer this as a package deal; others charge separately for each device.

What happens when you press the button

When you press the button, the device sends a signal to the monitoring center. A trained operator answers within seconds and can hear you through a speaker in the device. If you can speak, you tell them what happened — you fell, you are having chest pain, you need help — and they ask follow-up questions to understand the situation.

If you cannot speak or do not answer, the operator can still send help. They will call 911 and give the dispatcher your address, medical history, and what they know about why you pressed the button. Some systems also let you program a voice message that plays when the operator answers, so you can say "I fell" or "I cannot speak" without having to press anything else.

The operator will also try to reach your emergency contacts — usually family members or neighbors you list when you sign up — to let them know help is on the way. This means 911 is not the only option; sometimes a neighbor can reach you faster than an ambulance, or a family member can talk you through what to do while waiting for paramedics.

Fall detection and automatic alerts

Fall detection is a feature available on many wearable devices that automatically detects when you have fallen and alerts the monitoring center without you pressing the button. This is useful if you lose consciousness, are too injured to reach the button, or do not realize you need help. When the device senses a fall, it sends an alert to the monitoring center, and the operator calls you to check if you are okay.

Fall detection is not perfect. It can miss real falls if you fall slowly or land on something soft, and it can trigger false alarms if you drop the device or sit down suddenly. Most systems give you 30 to 60 seconds to cancel the alert if it is a false alarm, so you do not get an ambulance sent unnecessarily. The feature usually costs $10 to $20 extra per month.

Fall detection works best if you wear the device all the time — in the shower, in bed, everywhere. Some devices are waterproof for this reason. If you take it off at night or during showers, it cannot detect a fall during those times.

How to pay for a personal emergency response system

Medicare does not cover PERS as a standalone service, but some Medicare Advantage plans include it or offer discounts through partner providers. You would need to check your specific plan's benefits or call the plan directly to ask.

Medicaid covers PERS in some states, usually for seniors who are homebound or have a disability. Coverage and cost-sharing vary widely — some states cover the full cost, others require a copay, and some do not cover it at all. Contact your state Medicaid office or your local Area Agency on Aging to find out whether your state covers it and what the process is.

Veterans Affairs covers PERS for may be able to access veterans through the Aid and Attendance benefit or other VA programs. You would need to contact your VA regional office or work with a VA benefits counselor to determine whether you may have access to and how to set it up.

Nonprofit organizations and Area Agencies on Aging sometimes partner with PERS providers to offer reduced rates or subsidies for low-income seniors. Call your local Area Agency on Aging (you can find it through the Eldercare Locator at 1-800-677-1116) to ask whether they know of any programs in your area.

If you do not may have access to for any of these programs, you pay out of pocket. Many providers offer month-to-month plans with no long-term contract, so you can start and stop service as needed.

Questions to ask before you sign up

Before you choose a provider, ask whether they monitor 24/7 from the United States or whether they use offshore call centers. Ask what happens if the power goes out or your internet goes down — does the device still work? Ask whether the device works on cellular, landline, or both, and whether you can switch between them if needed.

Ask what the cancellation policy is. Some providers charge a cancellation fee or require you to return the device within a certain number of days. Ask whether you own the device or rent it, and what happens if it breaks — do they replace it for free, or do you pay a fee?

Ask how they store your medical information and emergency contacts, and whether you can update it yourself online or by phone. Ask whether they offer a trial period so you can test the device before committing to a contract. Ask whether they offer a discount if you pay annually instead of monthly.

Frequently Asked Questions

Do I need a landline or internet for a PERS device to work?

No. Most modern PERS devices use cellular networks and do not require a landline or internet connection. If you have a landline, some devices can use it as a backup in case cellular service is unavailable. Older base-station systems may require a landline, so ask the provider before you sign up.

What if I press the button by accident?

The operator will answer and ask if you need help. If you say no or cancel the alert, they will not send anyone. There is no charge for a false alarm. Most devices give you a few seconds to cancel before the operator even answers, so accidental presses are usually caught quickly.

Can my family see where I am if I wear a PERS device?

Only if the device has GPS and your family members are set up to receive location alerts. Not all PERS devices include GPS, and it is usually an add-on feature. Ask the provider whether GPS is available and whether your family can track you in real time or only when you press the button.

Will a PERS device work if I travel or go on vacation?

Wearable devices that use cellular networks will work anywhere you have cell service, including out of state and in some cases internationally. Base stations only work at home. If you travel frequently, ask the provider whether they offer roaming coverage and whether there are any extra charges.

What if I cannot afford the monthly cost?

Contact your local Area Agency on Aging to ask about subsidies or reduced-cost programs. Some nonprofits and community organizations also offer PERS devices at lower cost or for free to seniors with low income. Your state Medicaid office can tell you whether PERS is covered under your state's program.