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What Are Unmonitored Medical Alert Systems, and Should You Get One?

Juliette Siegfried, MPH
What Are Unmonitored Medical Alert Systems, and Should You Get One?
As you grow older, you’re more prone to injury and accidents, which makes it harder to feel safe and maintain your autonomy.

Medical alert systems are an excellent solution to this problem, especially monitored medical alert systems. But what about unmonitored systems? Do they work as well, and should you get one?

Before purchasing an unmonitored medical alert system, be sure to consider the following points.

1. How Do Unmonitored Medical Alert Systems Work?

There are 2 primary types of unmonitored systems:

  1. Those that sound an alarm on your property - designed for seniors who have in-home caregivers, to summon them in case of need
  2. Those that call an external number - designed for people who live independently and who need to make an external phone call to get help

Among the latter types, most allow you to program a list of people to call and the order in which to call them. So you can instruct the device to call family or a caregiver first, and to call 911 only as a last resort, or to call 911 first if you are injured and can’t respond.

Some of these systems allow you to actually talk to the person who answers the call, while others play a recorded message to them, informing them that there is a medical emergency at the registered address. 

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2.  Cost Differences

One of the advantages of unmonitored systems is that there is no monthly fee because you don’t subscribe to a dedicated call monitoring center. But the disadvantage of this approach is obvious—you aren’t connected to a call center and must rely either on the people you list or on a direct call to 911.

Another advantage of unmonitored systems is that you own the base station and wearable devices as opposed to renting or leasing them. This may involve a higher upfront cost, but it eliminates the need to return the devices if you cancel the service. The most affordable unmonitored systems cost $200-$300. 

An advantage of unmonitored systems is that there is no need to sign long-term contracts. Most monitored systems require such contracts, which can be problematic for seniors because they lock you into the system for a year or more and often contain fine print with high cancellation or device return fees if you cancel early. 

3.  Does the System Support Voice-Activated Help?

Whether you decide on a monitored or unmonitored system, consider whether it supports voice activation. Help buttons are fine in theory, but given the stress of an actual emergency, it may not be possible for you to find or press the button.

Many systems supplement the physical button by allowing users to summon help by speaking a special keyword or phrase. 

4.  Unmonitored Systems Can Support Multiple Users

One advantage of unmonitored systems is that they can support multiple users in the same household. This enables seniors who live together (for example, married couples or members of an extended family) to share the same base station and then pay only an equipment fee for additional wearable devices.

Monitored systems don’t offer this and charge an additional monthly subscription fee for each person who requires monitoring, even if they’re using the same system. 

5.  Will You Use the System Both Inside and Outside the Home, or Inside Only?

This is an important question. If you rarely leave your home, a home-based system connected to a landline is fine. But if you go out and beyond the range of the base station, the wearable devices require a cellular connection.

Some unmonitored systems allow you to connect via your cell phone, but this requires that you always carry the phone with you, in addition to the wristband or pendant. Other unmonitored systems charge a bit more for wearable devices with a built-in cellular connection and GPS location detection. 

6.  Does the System Allow You to Converse, or Only Deliver a Message?

An important concern for many seniors is “What happens when I push the help button? Can I actually speak to the person who answers the call?”

This is possible with some unmonitored systems, but not all. The others only deliver a message to the people on your call list, informing them that there is an emergency at your location, while telling them that this is an automated message and that they must contact you directly. 

7.  Who Actually Gets the Call When You Call for Help?

When you signal for help with an unmonitored system, only the people designated on your personal contact list are notified. If they don’t answer, the system calls 911 and gives them your location information, but it doesn’t always allow you to talk with emergency services. If the ability to talk to a real person during an emergency is important to you, make sure that the unmonitored systems you’re considering can do that. 

8.  Reliability—Will Someone Be There to Respond to Your Call?

This might be the biggest issue when it comes to monitored versus unmonitored medical alert systems. With a monitored system, there will always be a call center, and it will always be staffed with trained operators who are available 24/7 to interact with you. These operators can stay with you verbally while you’re waiting for help to arrive and can coordinate communications between emergency services and your family or caregivers until the situation is resolved. 

With unmonitored medical alert systems, the first person you listed will be called. If they don’t answer, the next person will be called, and so on. If the system gets to the end of your call list and none of your contacts have answered, it calls 911. 

The obvious drawback with this situation is that the people on your call list might be unavailable when a help call arrives. And, unlike the operators in a monitored system’s call center, your friends, family, and caregivers probably haven’t been trained in how to handle an emergency or in how to determine if it actually is an emergency. 

9.  Is Fall Detection an Option?

When considering an unmonitored medical alert system, ask whether it supports automatic fall detection. Why is this so important? Organizations such as the World Health Organization and the Centers for Disease Control and Prevention tell us that 1 in 3 adults over 65 suffers a fall each year. Over 37 million falls severe enough to require medical attention occur every year, and at least 684,000 people die from those falls. 

Falls among seniors are a huge concern, and most unmonitored medical alert systems don’t provide fall detection as part of their systems, even as an option. So be sure to ask if they support fall detection and what it costs, and compare your findings to the best monitored systems. Two such systems are the Medical Guardian system and the medical alert system offered by Unaliwear.

10. Who Are Unmonitored Systems Best For?

Unmonitored medical alert systems are good for those who live at home and have a strong in-house support network of caregivers. If these users rarely leave home, a simple base station and alarm system may serve all their needs. If they go out often, wearable mobile options may still work by keeping them in contact with their support network, or in an extreme situation, emergency services.


The main advantage of unmonitored medical alert systems is that they have a lower overall cost, because there are no monthly monitoring fees and no need for long-term contracts. 

On the other hand, the best monitored systems are safer and more reliable because of the 24/7 availability of call center operators trained to respond to emergencies. Despite their greater cost, monitored systems can be better for users who want to actually talk with a trained person until help arrives.

These days, monitored medical alert systems come in various forms, such as wristbands or necklaces, medical bracelets or medical alert buttons, so you can choose the style that’s most comfortable for you.

Juliette Siegfried, MPH
Juliette Siefried contributes to Top10.com as a biomedical writer, editor, and translator with over 30 years of experience. After working as a health communications specialist for the National Institutes of Health in Bethesda, Maryland, and its contractors, Juliette established ServingMed.com, a medical communications business for hospitals, universities, research foundations, and individual healthcare professionals.

The author of this article has been paid by Natural Intelligence to write this article. Neither the author nor Natural Intelligence provide medical advice, diagnosis, or treatment. If you think you may have a medical emergency, call your doctor or your local emergency number immediately.