It depends on the device. Some medical alert systems connect through a home landline or Wi-Fi, while others use a built-in cellular connection to reach a 24/7 monitoring center. Some cellular-enabled devices require you to have a separate cellular plan. The Kanega Watch uses both cellular and home Wi-Fi to provide the strongest possible signal throughout your home to ensure help can be accessed in every room. Cellular connectivity is included in the monthly Kanega Watch service fee.