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Some things you might want to consider:
Is the company local? Is it staffed 24/7?
Do you have a relative or friend who could be called first, or would you want EMS to be called?
Do you have a lockbox with a combination entry so that EMS or another first responder could get in?
Do you get out or are you primarily spending time at home? This could be an issue if you want to wear your button at all times, given that the GPS technology for medical alert buttons is still being debugged (per the company which provides med alert service for my father).
What activates the button to call the company? I.e., if you change your position does the device sense that and alert the monitoring company? The button we have has that feature. If the life alert button is accidentally dropped, they call within a few seconds.
You wrote that you fall a lot. Ask the companies exactly what happens when you fall, if the device senses and alerts them, or are you required to call yourself? If the latter, cross them off your list.
I'm paying $40/month, which may be a bit higher but I was more pleased with the company that we chose than with others. AARP magazines and bulletins contain ads for these devices, and telemarketers are hyping them with false promises, but I did research online to determine what companies and facilities (including medical) provided life alerts in our area. Then I contacted each one.
The one which took several days to call me back was eliminated immediately. The one which told me that GPS wander management is still in a process of refinement was the one I hired. Other companies bragged that they had GPS features but backed down and admitted grudgingly that they weren't perfected when I challenged them on the effectiveness of GPS management. If they're not brutally honest up front, I don't want them.
I've never heard of $18 a month but that's an absolutely great price if you could find something like that through a senior center. But be sure that they have 24/7 monitoring.