Quoll does not. Once you purchase one of our digital devices, you are given access to our support system without further charge. The only time you will pay more is if you decide to purchase another Quoll device. We offer medical alert pendants for necklaces and bracelets, plus dog tags and plastic medical alert cards that you can keep in your purse or wallet. All are designed to be resistant to corrosion, water damage and heat. Wear yours at the beach, in the pool, in the shower or in any hot or cold climate.