• Our top pick for best overall fall protection from a medical alert necklace is the Medical Guardian Mini. At only 0.08 pounds, the MGMini is the lightest and smallest medical alert necklace on the market. It has an extended battery life of 5 days and add-on features like real-time emergency contact alerts.
  • For on-the-go fall detection, we recommend MobileHelp Micro for its sensitive detection and multi-day battery life.
  • Fall detection is usually $25–$35 per month. MobileHelp offers the lowest starting monthly cost at $19.95. Common additional costs include activation fees, equipment fees, and fall detection.
  • Individuals who are at risk of falls due to age, medical conditions, or mobility issues could benefit from using a fall detection necklace.
  • When purchasing a medical alert necklace with fall detection, consider features such as range, water resistance, battery life, and reliable 24/7 monitoring services to ensure comprehensive safety coverage.
Best Overall
9.9 Exceptional
Detected 5/6 falls.
Average response time: 46-60 seconds.
Score: 9.9/10.
9.9 Exceptional

When Charlene H.’s mother passed away, she realized she’d be living alone and wanted extra protection. Her mother had used a medical alert necklace, so the High Point, North Carolina resident decided to get herself one as well.

“It has given me a sense of security that I know if anything happens, I can press the button and be responded to,” she says.

Charlene emphasizes that her medical alert necklace doesn’t interfere with her regular activities, and she only notices she’s wearing it when she’s exercising. Fortunately, she hasn’t had to use her necklace during an emergency. 

“I have not needed them (the monitoring center) in an emergency. I have it just in case, but I have been very fortunate to not have needed any assistance in regards to an emergency,” she adds.

If you’re a caregiver researching medical alert necklaces, remember they’re not the same as medical ID necklaces. While both are crucial safety tools, they have different purposes. Medical alert necklaces connect to a 24/7 monitoring center with a button. Medical ID necklaces list health conditions, current medication, and other important health information if you can’t communicate them during a medical emergency.

Medical alert necklaces are more than a help button that connects to the monitoring center—you can also choose features like fall detection and location tracking to help support your caregiving plan. 

The Handbook Team wants to make your search for the best medical alert necklace as simple as possible, so we narrowed our choices to three clear winners after hand-testing 16 necklaces. 

Which medical alert necklace is right for you?

What you need to know about the best medical alert necklaces

Here are the five most important things to know about the best medical alert necklaces.

Medical Alert Necklaces
We tested all of our medical alert necklaces on both slow and fast falls. We tested all of our medical alert necklaces on both slow and fast falls.
The Medical Guardian MGMini is the lightest of all the medical alert necklaces. The Medical Guardian MGMini is the lightest of all the medical alert necklaces.
Bay Alarm Medical SOS Home and MobileHelp Micro detected all slow and fast falls. Bay Alarm Medical SOS Home and MobileHelp Micro detected all slow and fast falls.
Average response time for the best necklaces: Under 60 seconds. Average response time for the best necklaces: Under 60 seconds.
All four of the best medical alert necklaces are water-resistant. All four of the best medical alert necklaces are water-resistant.
of research
6,500+   hours
of research
35   devices
14   brands
10   experts

Our testing experience

Just like we determined the best medical alert systems, the Handbook Team picked our top medical alert necklaces based on our actual experience wearing and using the devices. 

We tested 16 medical alert necklaces across eight brands: 

  • Bay Alarm Medical 
  • GetSafe
  • HandsFree Health 
  • LifeFone
  • Lively
  • Medical Care Alert 
  • Medical Guardian
  • MobileHelp

Our team considered well-known brands with a generally positive reputation when choosing medical alert systems to test. We picked brands with various pricing options, device designs, and safety features.

Our testing process looked like this:

Our Medical Alert System Testing Process
Purchase medical alert systems as mystery shoppers. Purchase medical alert systems as mystery shoppers.
Follow the user guide to set up the system and call the monitoring center. Follow the user guide to set up the system and call the monitoring center.
Record how long it takes to reach the monitoring center. Record how long it takes to reach the monitoring center.
Conduct six fall tests (three slow and three fast falls) with fall detection devices. Conduct six fall tests (three slow and three fast falls) with fall detection devices.
Test GPS location tracking for mobile systems. Test GPS location tracking for mobile systems.
Charge devices. Charge devices.
Download and test caregiver app. Download and test caregiver app.

We spent most of our testing contacting the monitoring center since this is the most important feature of any medical alert system.

From our tester

“The MobileHelp Micro registers falls with verbal confirmation, and we like that the monitoring center agent verified the user’s name every time we called. The necklace’s speaker is also very sensitive—we were able to speak with the agent about 2 feet away from the device.”

We also conducted six fall tests with each necklace that had fall detection. Research shows that the best placement for accurate fall detection is on the chest or worn as a necklace. While many medical alert brands now offer medical alert watches, these devices are still most accurate when worn at chest level.

Although we rigorously test each fall alert necklace by simulating multiple falls, our fall detection testing isn’t 100% accurate. Researchers estimate we’d need to record about 100,000 days of activity to create enough real-world fall data

How we tested fall detection necklaces: 

  • Our team conducted three “slow” and three “fast” test falls while wearing the fall detection device. We started all slow falls by sitting in a chair at 90 degrees and dropping to our knees before falling face down on a mat. 
  • For the fast fall, we dropped the device from shoulder height to the mat to replicate a fast, hard-impact fall.

Generally speaking, a hard fall is a fall that can be difficult to stop, happens quickly, and results in a strong impact to the body. A slow fall is a fall that occurs more gradually, and the impact is likely weaker. However, individuals are not immune to injury after a slow fall.

Sean Marchese, a registered nurse with more than 20 years of experience.

We also evaluated each medical alert necklace by asking the following questions during testing: 

  • Can monitoring center agents see our correct GPS location? (on-the-go devices)
  • Did the necklace initiate an emergency call when it shouldn’t have?
  • Is the necklace comfortable to wear?
  • Is it comfortable to sleep in? 
  • Are there low battery alerts? 
  • Is it easy to place the device in the charging cradle? (on-the-go devices) 
  • Does the device alert you when it’s fully charged?

From our tester

“The MobileHelp Micro was much more comfortable than the Solo model. It doesn’t have a magnetic clasp and the lanyard material seems a little cheap, but it rests more comfortably on the chest and is lightweight.”

Compare the best medical alert system necklaces of 2024

Starting monthly price $39.95 $39.95 $24.95 $39.95
Fall detection monthly fee $10 $11 $10 $10
Fall detection accuracy 5/6 6/6 6/6 5/6
Average response time (seconds) 46-60 seconds 1-45 seconds 60+ seconds 1-45 seconds
In-home range (feet) <1,299 ft N/A 1,000 N/A
Mobile device battery life (days) 5 days Up to 5 N/A 3

Reviews of the best medical alert system necklaces

1. Best Overall: Medical Guardian MGMini

9.9 Exceptional
Medical Guardian MGMini
Starting monthly price: $39.95
5-day battery life
Hourly GPS location updates

Our verdict

We chose the MGMini Guardian as our top pick overall because of its excellent customer service, small and light size, extended battery life, and add-on features like real-time emergency contact alerts.


  • In-home range: >1,229 feet.
  • Mobile device battery life: Up to five days.
  • Connection type: AT&T, Verizon, 4G LTE, GPS.
  • Standout feature: Small size, approximately the height of two stacked quarters.

More information

Touted as the smallest and lightest wearable medical alert necklace on the market, the MGMini Guardian is only 0.08 pounds and 1.7 inches high, about the size of two stacked quarters. Its claim to fame is that it can easily be worn on an adjustable lanyard, on the included non-adjustable lanyard, or simply clipped onto your bag or clothing waistband (the clip is also included).

Users press a button and are connected to 24/7 U.S.-based call operators who talk you through your situation-if the operators determine emergency services are needed, they will call 911 for you and provide the operators with the details necessary for emergency personnel to reach them. Even if the event is determined not to be an emergency, the operators will still talk through the situation with the user. The operator will call any family or friends listed as contacts if non-emergency help is needed, so someone can check and assist the necklace user.

Medical Guardian’s customer service is highly regarded as one of the best in the business and their services connect with you in seconds when the help button is pressed or a fall is detected.

The system works through an online portal as well as a phone app and lets users see both activity and inactivity as well as step tracking. You don’t need WiFi for the device, but if WiFi is available, it will act as a backup for location services.

We appreciated the simple setup of the MGMini, which only takes three steps:

  1. First, plug in the charging cradle, which has a very clear LED light indicator that will turn green when the cradle has been properly installed and plugged in.
  2. Then, insert the alert device, which will vocally announce “Device Ready” when it’s connected to a network.
  3. You’ll also hear a vocal announcement “Device Charging” when the device is correctly inserted and charging on the cradle.

The LED light also is a battery indicator. A green color means the device is fully charged. We appreciated all of the different voice notifications the MG Mini offers, from announcing when the device is charging to when a fall is detected. The device also clearly vocally described when it is going to call for help and gives the user the option to press a button to cancel the call for help.

Like many medical alert necklaces, the MGMini is water-resistant, so you can wear it while showering or around water activities.

Even with the MGMini, Medical Guardian offers many different add-ons that can provide peace of mind for families, like real-time emergency contact notifications and additional products like a wireless wall button or a 911 speaker box.

Best overall

2. MobileHelp Micro: Best On-the-Go Fall Detection

Best On-the-Go Fall Detection
9.6 Excellent
MobileHelp Micro
Starting monthly price: $39.95
Multi-day battery life
24/7 U.S. based monitoring
Our verdict

We think the Micro is an excellent on-the-go medical alert necklace with sensitive fall detection and a multi-day battery life.

  • In-home range: N/A.
  • Mobile device battery life: Up to five days.
  • Connection type: AT&T 4G LTE, GPS.
  • Standout feature: Separate test button to test monitoring center connection.
More information

The MobileHelp Micro is a compact on-the-go device with sensitive fall detection that detected all six of our test falls.

We appreciate verbal cues that help users know what’s happening during an emergency. After each test fall, our Micro announced “Fall detected” and “Contacting emergency services.”

If you’re worried about a steep learning curve to set up the device, we think you’ll appreciate that the setup instructions are broken down into small, easily manageable steps. Verbal and light cues guided us through the setup process, and it took about one minute to set up and test our Micro.

From our tester

“The testing process for the Micro was clearly laid out with numbered instructions and pictures. We also like that there’s a separate test button on the device, so you can test your connection to the monitoring center without pressing the help button.”

So, what’s it like to actually wear the Micro? The device was lightweight and rested comfortably on our chest, even if the strap wasn’t adjustable. We wish it was a tad more compact and discreet. It was difficult to tuck the medical alert pendant under our shirt without it being noticeable.

Micro medical alert necklace around neck against a green shirt

A Handbook Team tester models the MobileHelp Micro necklace.

We do love that the Micro has a magnetic detachable lanyard, making it easier to switch the device from a necklace to tucking it into your pocket or purse. The device is water-resistant, so you can wear it in the shower.

MobileHelp doesn’t mention in the user manual whether or not you should sleep while wearing the device. Our team thinks the Micro is too bulky to sleep in and may trigger a false alarm since fall detection is sensitive.

We like that there are two types of alerts when the necklace battery is low: visual (flashing red light) and verbal (“Your battery is low; please connect to a power source”). This helps accommodate users who are visually impaired or have low hearing. Unfortunately, no verbal alerts confirm when the device is charging and when it’s fully charged. There are only visual alerts.

A customer service representative recommended charging the Micro like a cell phone every night since battery life can vary depending on usage and connection strength.

The MobileHelp Connect app is free with any MobileHelp medical alert system. Although the app feels a little outdated, it has a few helpful features for caregivers, including:

  • Checking cellular network connection and battery status.
  • Access to user’s health information.
  • Location tracking (30 location pings per month included and 30 additional pings available for $6).

3. Bay Alarm Medical SOS Home: Best At-Home Fall Detection

Best at-home fall detection
9.3 Excellent
Bay Alarm Medical SOS Home
Starting monthly price: $24.95
Sensitive fall detection
Consistent response times
Our verdict

The SOS Home is our top pick for an at-home medical alert necklace if you want sensitive fall detection, consistent response times, and the option to disguise your necklace as jewelry.

  • In-home range: 1,000 feet.
  • Mobile device battery life: N/A.
  • Connection type: AT&T or Verizon cellular, GPS, landline.
  • Standout feature: Bella Charms to beautify help button necklaces.
More information

The Bay Alarm Medical SOS Home is our favorite at-home medical alert necklace: It detected all test falls, the base station has a 1,000-foot range, and you can accessorize (and disguise) your necklace as jewelry (not available for fall detection necklaces).

We received two necklaces since we opted to include fall detection—a standard help button necklace and a fall alert necklace.

Black help button and white fall detection necklaces on a wooden table.

The SOS Home includes the standard help button necklace (right), and the fall detection pendant (left) is an add-on.

From our tester

“The SOS Home necklaces are lightweight and rest comfortably on the sternum. They’re also adjustable, which not all medical alert necklaces are.”

You’ll pay a $30 one-time fee and an additional $10 per month when you include fall detection with your SOS Home. While a monthly fee for fall detection is standard, we didn’t like that we were charged an extra fee on top of that. Despite the additional fee, we were impressed with the SOS Home fall detection necklace: It was the only at-home medical alert necklace to detect all slow falls and all hard, fast falls. 

The SOS Home fall alert necklace registered falls quickly compared to some necklaces we tested. Within three to seven seconds after each test fall, the base station announced, “Calling for help” and initiated a call to the monitoring center.

We like that the base station verbally confirms when the necklace registers a fall and contacts the monitoring center. Keep in mind that you’ll only hear this verbal confirmation if you’re near the base station (at-home necklaces don’t have a built-in speaker).

As for the base station’s speaker strength, we were impressed monitoring center agents could hear us more than 5 feet from the speaker, even if it was a tad spotty on our end. If you call for help from your medical alert necklace and you’re within 5–6 feet of the base station, you can speak with the agent through the base station. And if you press your button but aren’t within range to speak with the agent, they’ll still dispatch emergency services and call emergency contacts.

Another perk of the SOS Home is Bella Charms. This fun accessory disguises your help button as a colorful necklace by attaching it to the back of your button. Our testers enjoyed modeling these charms, but we wish this accessory was also available for the fall alert necklace. Bella Charms are $25 each.

A person in a white shirt wearing a Bella Charm necklace.

The help button is disguised with Bella Charm jewelry in the top picture. The bottom picture shows the back of the help button and Bella Charm.

A person in a white shirt wearing a Bella Charm necklace flipped over to show the help button necklace.

The Bay Alarm Medical app is free and available for caregivers. The app includes the following features:

  • Checking cellular network connection status.
  • Updating safety plan, including emergency contacts and home entry info.
  • Managing account and payment information.

4. Medical Care Alert Home & Away Ultra: Fastest Response Time

Fastest Response Time
9.3 Excellent
Medical Care Alert Home & Away Ultra
Starting monthly price: $39.95
Comprehensive app for caregivers
Medically certified monitoring center agents
Our verdict

With fast response times, medically certified monitoring center agents, and a rare tracking option called geofencing, the Medical Care Alert Home & Away Ultra is a reliable safety tool.

  • Starting monthly price: $39.95.
  • In-home range: N/A.
  • Mobile device battery life: Three days.
  • Connection type: AT&T or Verizon 4G LTE, GPS.
  • Standout feature: EMT/EMD-certified monitoring center agents.
More information

Every second matters during an emergency, so we were impressed with this necklace’s average response time of 1-45 seconds. Besides having the fastest response time of the top medical alert necklaces, all Medical Care Alert monitoring center staff are EMT- (emergency medical technician) and EMD- (emergency medical dispatch) certified.

From our tester

“We had very pleasant experiences with each monitoring center agent. They thank you for testing and always confirm that neither you nor anyone you’re with needs help.”

The necklace detected five out of six test falls (it didn’t detect one slow fall), and we could cancel each call by holding down the help button for at least two seconds.

We confirmed with an agent that they tracked our correct location every time we contacted the monitoring center. Correct GPS tracking is crucial for mobile necklaces if you have an emergency outside your home and aren’t able to tell the monitoring center agent your exact location.

We also want to highlight rare Home & Away Ultra features: location entrance and exit alerts and Emergency Alert System (EAS) broadcasts.

Location entrance and exit alerts, also known as geofencing, use GPS to tell you when the device enters or leaves a certain location. For example, you could set up a 500-foot radius around your care recipient’s home to get alerts when they leave. If you don’t receive a return notification in a timely manner, you’d know to check their current location or call their phone.

EAS is a national service that warns of severe weather events and delivers other urgent information to the public. The broadcasts come through the device’s speaker and could help your care recipient seek shelter during a tornado, for example, or stay up-to-date on other emergency events they may not learn about otherwise.

Another of our favorite features of the Home & Away Ultra is the step-by-step verbal prompts that guide users through setting up and testing the device. It prompts you to conduct a test call immediately so users can get a feel for how the necklace works.

While we like that the device is pretty small (about the same height as a chapstick tube), it felt heavier around our neck than the Bay Alarm Medical and MobileHelp medical alert necklaces. The strap design also made it rest farther down our chest than others.

Medical Care Alert necklace around neck against a purple shirt.

A Handbook Team member models the Home & Away Ultra necklace.

Like the other two medical alert necklaces in this review, the Home & Away Ultra is water-resistant (splashed with water but not submerged). The user guide advises charging the device at night beside your bed, which implies not wearing it while you sleep.

The Medical Care Alert RemoteCare 24/7 app is a comprehensive free tool for caregivers. We love all the monitoring features that allow caregivers to:

  • View real-time GPS location tracking and location history.
  • “Ring” the device if it’s misplaced.
  • Check battery life and signal strength.
  • See the user’s health and lifestyle information (allergies, directives, medical conditions, prescriptions, doctors, pharmacies, and familiar places).
  • Check if the device is on or off the charging cradle.

Pros and cons of medical alert system necklaces

What we like about medical alert system necklaces

  • Optional fall detection is available. 
  • Fall detection is usually more accurate in necklaces than wrist-based devices. 
  • Can speak with a monitoring agent through on-the-go devices.  
  • Depending on the size, they can be hidden under a shirt.

Having style options to choose from was nice. The watch required dexterity my mom no longer has. The necklace works perfectly, she likes to hide it under her shirt.

Mea S., a caregiver for her mother in Vermont

What we don’t like about medical alert system necklaces 

  • Some have non-adjustable lanyards.
  • At-home help button necklaces don’t have two-way speakers. 
  • Not safe or comfortable to wear while sleeping.  
  • Sensitive fall detection may mean more false alarms.

Handbook Team Tip #1

Most medical alert necklaces allow you to cancel a false alarm by holding down the help button. If you don’t cancel the alarm in time, tell the monitoring center agent it was a false alarm. You’ll never be penalized for accidental calls.

How much do medical alert system necklaces cost?

The main cost of your medical alert necklace is the monthly monitoring fee, which is usually $25–$40 per month and varies by brand and device. When budgeting for a medical alert necklace, remember the monthly monitoring fee is usually not the final cost. 

Most medical alert systems offer the following features for an additional monthly fee: 

  • Fall detection. 
  • Add-on accessories, like wall buttons, lock boxes, and extra medical alert necklaces.
  • A protection plan in case equipment is damaged, stolen, or lost.

Also, consider possible one-time fees that may get added to your medical alert necklace, such as: 

  • Activation fee. 
  • Equipment fee. 
  • Shipping costs.

Handbook Team Tip #2

Most medical alert system brands offer discounts with an annual payment plan, such as a free service month, waived shipping fees, or a free lockbox.

Top features to look for in medical alert necklaces

Key Features to Look For in Medical Alert Necklaces
Fast response time Fast response time
Fall detection Fall detection
Connection range (at-home) Connection range (at-home)
GPS location tracking (on-the-go) GPS location tracking (on-the-go)
Water-resistant or waterproof material Water-resistant or waterproof material

I recommend this (GPS location tracking) particularly for patients with dementia or Alzheimer’s because they sometimes wander off and get hurt. The fall detection feature should also be factored in when buying the necklace. Generally, older adults and their families feel more secure knowing that help can still find them if they’re not able to reach for the device.

Nancy Mitchell, a registered nurse and geriatric director of care in Atlanta.

How to choose the best medical alert pendant for you

The right medical alert necklace for you or your care recipient will vary depending on your lifestyle and needs. Review our table below to help you narrow down the most important features.

Medical alert necklace featuresWho benefits most from this option?
At-homeUsers who only need monitoring in and around their home because they are accompanied by a caregiver outside the home.
On-the-goUsers who enjoy independent activities outside their homes like driving, running errands, and visiting family and friends.
Fall detectionThose with a history of falls or a high risk of falling due to medical conditions, mobility, and other factors.
GPS trackingUsers who have a more independent lifestyle.
Water-resistantThose who primarily shower instead of taking a bath.
WaterproofUsers who prefer soaking in a bathtub instead of showering.

Handbook Team Tip #3

Always involve your care recipient in the shopping process. If they’re still hesitant to wear a medical alert necklace, frame the company’s trial period as a chance for them to see if they like wearing and using it.

Our final verdict

After testing 16 devices across eight brands, we believe Medical Guardian, MobileHelp, Bay Alarm Medical, and Medical Care Alert offer the best medical alert necklaces.

The Medical Guardian Mini is our overall pick for a life alert necklace because it’s small and lightweight, easy to set up and operate, and can last up to 5 days on a single 4-hour charge. The customer service is also top-notch, which is especially helpful if this is your or your family’s first time using a life alert necklace.

The MobileHelp Micro and Medical Care Alert Home & Away Ultra are both excellent on-the-go options, but MobileHelp fall detection sensors performed slightly better than Medical Care Alert. The Micro detected six out of six falls, while the Home & Away Ultra detected five out of six falls. Medical Care Alert is also one of the only brands with EMT- and EMD-trained monitoring center staff. We like this option for users with more serious or multiple medical conditions. 

The Home & Away Ultra had the fastest response time of the three medical alert necklaces: 29 seconds. 

As a caregiver, we encourage you to offer multiple options to your care recipient when helping them choose the right medical alert necklace. No matter how discreet or helpful the device is, your care recipient may still hesitate to wear it as part of their daily routine. Help them feel empowered by letting them decide which emergency necklace style and brand work best for them. 

“Aging can be emotionally challenging, especially for people who were always independent,” says Mitchell. “Having a medical alert device can be a difficult transition for these people. In those cases, the less obvious the device, the better. They’re more likely to wear the alert system if they don’t feel embarrassed about it.”

Frequently asked questions

Some Medicare Advantage (Part C) plans cover medical alert necklace costs, but Original Medicare (Part A and B) does not. Coverage varies by insurance plan and state, so you should always check with your insurance provider.

Medical Guardian, MobileHelp, Bay Alarm Medical, and Medical Care Alert offer some of the best medical alert necklaces based on our testing. The right necklace for you or your care recipient will depend on specific needs, such as medical conditions, activity level, care environment, budget, and other considerations.

Bay Alarm Medical SOS Home starts at $29.95 per month, making it the lowest-priced medical alert necklace in our review. Medical Guardian, MobileHelp Micro, and Medical Care Alert Home & Away Ultra all start at $39.95 per month. Remember that these are base prices without extra features like fall detection added to the monthly price.

Medical alert necklace costs can range from about $20–$40 per month, depending on the brand and type of device you choose. Typically, mobile systems cost more than at-home systems, and some mobile devices include an extra $100–$200 equipment fee. Including fall detection with your medical alert necklace adds $10–$11 to your monthly cost.

A medical alert necklace is best if you want accurate fall detection or an on-the-go system that contacts the monitoring center outside your home. Most on-the-go devices are designed to be worn as necklaces, but sometimes you can purchase a bracelet that connects to the mobile system. You can wear the discreet bracelet while tucking your mobile system in your pocket or purse, but most mobile systems won’t activate fall detection unless the device is worn around your neck.

  1. Lee, Y. (2023). Experimental Study: Deep Learning-Based Fall Monitoring among Older Adults with Skin-Wearable Electronics. Sensors, 23(8). Link
  2. Broadley, R. (2018). Methods for the Real-World Evaluation of Fall Detection Technology: A Scoping Review. Sensors, 18(7). Link