Medicare Covers 100% of Hospice
Hospice care costs are covered by Medicare, VA benefits, Tricare, Medicaid and most private insurance policies. These benefits offer patients a dignified and comfortable end of life without overwhelming financial burdens.
For patients with Medicare, benefits covers all services related to the terminal illness. There are no co-pays or out-of-pocket costs.
Care is also covered for patients with Medicare Advantage or Medigap. Care related to a terminal illness follows Original Medicare’s cost and coverage rules. Patients then have the option to keep their Advantage plan or use Original Medicare (Part A and Part B) to cover other health care services not related to the terminal condition.
Medicare and other insurance plans typically cover expenses if these requirements are met
- Your doctor and a medical director from a hospice program certify the patient has six months or less to live, if the illness runs its normal course.
- The patient signs a statement choosing hospice instead of curative treatments for their terminal illness. You can stop hospice and return to curative treatment at any time.
- The patient receives care from a Medicare-approved hospice program
The Medicare Hospice Benefit does not pay for treatments or services unrelated to the terminal illness. However, the standard Medicare benefit still helps pay covered costs necessary to treat an unrelated condition.
Hospice services for patients and families
- Home medical equipment and personal supplies
- Around-the-clock access to care
- Management of complex pain and other symptoms
- Hospice aide for personal care and light homemaking
- Medical social services
- Spiritual care and support
- Physical, occupational, dietary and speech therapies
- Support from volunteers
- Short-term inpatient respite care (relief) for family caregivers
- Ongoing Grief counseling for the patient, family and friends
FREQUENTLY ASKED QUESTIONS
What about Medicare coverage for other services?
You still get Medicare coverage for treatment of illnesses or injuries unrelated to your terminal illness. For example, Medicare would continue to cover diabetes care and medications. However, the costs you usually pay for services will apply. If you decide to keep your Medicare Advantage plan, that plan will be responsible for other costs.
How long can someone receive hospice Medicare beneftis?
The hospice benefit includes two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. Hospice patients receive care as long as the doctor and the hospice medical director certify that the patient is terminally ill.
Are room and board costs at a nursing home or other facility a covered Medicare hospice benefit?
Medicare does not pay anything toward room and board expenses. The exception is short-term inpatient or respite care.
What happens if a patient is eligible for Medicare and also covered by workplace insurance or a spouse’s workplace policy?
The workplace or private insurance is the primary coverage. Medicare serves as secondary coverage.
