How Do You Pay for Hospice Care?
For those not eligible for Medicare or Medicaid, payment for hospice can come from private insurance or an HMO, since these also include a hospice benefit.
Who Pays for Hospice Care at Home?
The Medicare Hospice Benefit covers end-of-life services related to a patient’s terminal diagnosis in whatever setting the patient calls home, whether that’s a traditional residence, an assisted living facility, or nursing home. Wherever hospice occurs, all services related to the terminal diagnosis are covered up to 100% by Medicare Part A.
Does Medicare Pay for Hospice in a Skilled Nursing Facility?
Yes, hospice services provided in a nursing facility are covered by Medicare. In a nursing home setting, hospice helps patients, families, and nursing home staff by providing end-of-life resources and support. The Medicare Hospice Benefit covers services, medications, supplies and equipment that are related to life-limiting illness.
The Medicare Hospice Benefit
The Medicare Hospice Benefit provides coverage for the following services:
How Medicare hospice care works
Unlike traditional care that seeks to cure the disease, hospice care focuses on maximizing the quality of life by providing comfort and support services.
When to consider Medicare hospice care
Medicare hospice care is an option to consider at the time your doctor renders a terminal prognosis, regardless of your diagnosis or physical condition. You have the right to determine when you feel Medicare hospice care is appropriate (instead of continuing to treat your health condition) and which Medicare-approved program suits your needs.
Covered Medicare hospice services
You can receive Medicare hospice benefits under Original Medicare Part A when you meet these conditions:
How and When Does Medicare Cover Hospice?
Medicare covers hospice care for terminally ill patients whose doctors certify they have six months or fewer to live.
Parts of Medicare and Hospice Coverage
Medicare is broken down into different parts: A, B, C, D, and Medigap. To qualify for the hospice-care benefit from Medicare, you need Medicare Part A, which covers hospital insurance and all other conditions.
Paying for Hospice Care With Medicare
When your hospice-care benefits start, Medicare will cover the costs related to your terminal illness even if you are in a Medicare Advantage Plan or another Medicare health plan. For peace of mind, there is no deductible for hospice care.
Hospice Respite Care for Caregivers
Medicare provides hospice respite care for family caregivers who need a brief period to recharge after caring for a loved one. It can be arranged by a hospice provider, and you can receive inpatient respite care at a Medicare-approved facility such as a hospice inpatient facility or nursing home.
Hospice Care Costs Not Covered by Medicare
Medicare provides comprehensive coverage, but there are certain limitations to what will be covered for hospice care. Below are hospice-care costs that will not be covered by Medicare.
How Long Does Medicare Pay for Hospice Care?
Medicare is able to provide coverage for hospice care through various benefit periods: two 90-day benefit periods and an unlimited number of 60-day benefit periods. A doctor would need to certify or recertify every six months and attest that you are terminally ill and expected to live six months or fewer at the beginning of each benefit period.
How Long Will Medicare Coverage Last for Hospice Care?
You can get Medicare coverage for hospice care for longer than a six-month period. According to Medicare, hospice care can continue for longer if a doctor is able to recertify that you are terminally ill and need continued hospice care.
