A medical alert system with on-call emergency operators can provide peace of mind for older adults and their loved ones.Whether it provides immediate professional support after a middle-of-the-night fall or simply summons help with everyday tasks from a neighbor, friend, or family member, a medical alert system can make life easier for everyone.The available options are far from perfect. We’ve tested 22 systems since 2023, and we’ve found significant drawbacks with all of them. The reliability of some of the devices was dangerously lacking. Also, many of the most recognizable companies — including the maker of a former Wirecutter pick — proved to be overly aggressive in their sales tactics, and a few were downright predatory.While there’s no singular “best” medical alert system, we’ve identified the best options in three different categories. The UnaliWear Kanega Watch is the best on-the-go medical alert device. Alexa Emergency Assist is the best home-based option that you don’t have to wear. And LifeFone At-Home Cellular is the best traditional home-based medical alert system.