Medicare Hospice Coverage
Hospice care provides palliative care and comfort management for people facing terminal illness.
Most patients receive hospice care in their home, but Medicare also covers hospice inpatient facilities.
Many Medicare Supplement plans also help cover hospice costs.
Qualification for Hospice Care
A Medicare beneficiary can receive hospice if the condition meets all of these conditions:
- Your physician(s) certify you have a terminal illness with 6 months or less diagnosis
- You accept palliative (comfort) care instead of curative treatment
- You sign a statement saying you chose hospice care over other treatment
Cost of Hospice Care
If you have Medicare A, you will pay nothing for hospice care and services.
Hospice is one of the cases in which Medicare Part A covers prescription drugs, less a $5 copay per medication.
If Medicare Part A does not cover a necessary medication, your Medicare Part D plan might cover it.
Medicare also covers up to 5 days of respite care per stay. Medicare pays for 95% of inpatient care.
Some hospice patients receive care from a family member. Occasionally they need a rest. The patient can stay in a Medicare-approved facility while the family takes a break. The hospice provider will set up this care. Medicare permits more than one respite stay, but it's meant for intermittent care.
If you receive hospice care in your home or in the nursing home where you live, Medicare does not pay for room and board.
Hospice Care Coverage
Medicare can cover the following service:
Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:
- Doctor and nursing services
- Medical supplies and equipment
- Short-term inpatient care for pain and symptom management
- Hospice aide and homemaker services
- Prescription drugs for pain relief or symptom control
- Social work, occupational therapy, physical therapy, and speech-language pathology services
- Dietary counseling
- Short term respite care
- Grief and loss (bereavement) counseling for the patient and family
- Any other pain management Medicare-covered services to manage terminal illness symptoms recommended by your hospice team
Medicare does not pay for any curative treatment if you receive hospice care. Your physician will recommend and arrange for hospice. Treatments not set up by your hospice team are not covered. Also, Medicare does not cover treatment in an emergency room unless it's unrelated to the terminal illness.
AARDY Can Help You Enroll in Medicare
AARDY is the nation's fastest Medicare insurance marketplace. You can compare Medicare supplements and Medicare Advantage plans to find the one that best fits your needs.