Hospice care is covered under the following Medicare program
Hospices provide specialized care for people who are terminally ill and near the end of life. Hospice care is provided at specialized hospice facilities, nursing homes, or at home, depending on the condition and needs of the patient. Medicare covers hospice provided you meet the
eligibility requirements and use a medicare-approved provider. Medicare will cover the cost of hospice care whether you receive it at home, in a nursing home, or in any other
Medicare-approved hospice facility. If you qualify for hospice care, Medicare will cover all the costs for any care you receive that is related to the terminal illness. Hospice care is covered under Original Medicare (Medicare Part A and B). Hospice care is usually covered by Medicare in full under
Medicare Part A benefits. To qualify for this coverage, you need to meet the following criteria: If you have Medicare Part A, all your hospice care costs will be covered by your plan. Hospice services that are fully paid for by your Medicare plan include: Original Medicare covers all hospice care costs for patients who have been certified as terminally ill.
Other parts of Medicare that may help cover expenses associated with hospice care include:
riginal Medicare covers all hospice care costs for patients who have been certified as terminally ill. Medicare hospice benefit exclusionsOnce a patient on Original Medicare is certified to be terminally ill and in need of hospice care, the Medicare hospice benefit takes effect. However, Medicare will not cover the following costs:
Palliative care vs hospice care and MedicareMedicare differentiates between palliative care and hospice care in its hospice coverage. Hospice care is deemed as end-of-life care for terminally ill patients that has no curative intent but focuses on symptom and pain management. In contrast, palliative care may include curative treatments or procedures. Hospice care is usually end-of-life care for patients with a life expectancy of six months or less. Palliative care, on the other hand, can be pursued at any time, including during the diagnosis of an illness, in the course of treatment, or at the end of life. The Medicare hospice benefit does not include coverage for curative prescription drugs or treatments. However, if you have Medicare Advantage or Medicare Part D, the cost of such drugs and treatment may be covered under those plans. Medical equipment, skilled nursing care, social services, and medications for symptom and pain relief are all covered by Medicare Part A for patients in hospice care. However, for patients who need palliative care, Medicare Part B and Medicaid will cover some types of palliative care services, but copays may apply. Medicare guidelines for hospiceMedicare covers terminally ill patients for hospice care if they are certified to have a life expectancy of six months or less. However, Medicare will continue to provide coverage for patients who live longer than six months, provided the hospice doctor recertifies that the patient is still terminally ill and requires end-of-life care. The following guidelines apply to hospice care under Medicare:
How much does hospice cost with Medicare?Hospice care is usually covered under Medicare Part A benefits. If you qualify for hospice benefits under Medicare, you will incur the following costs:
Medicare Advantage and hospiceMedicare covers hospice care under Original Medicare benefits, even for patients who have a Medicare Advantage plan or Medicare Part C. If you have Medicare Advantage, you will continue to receive the added coverages of your plan, like vision and dental care, even while in hospice care. Medicare Advantage may also cover the cost of prescription drugs that are not covered by Medicare Part A, including medications for conditions that are not related to your terminal illness. Shopping Medicare in the digital age is as simple as you make it.Finding a Medicare-approved hospice providerIf you are eligible for the Medicare hospice benefit, you can find and compare Medicare-approved hospice providers in your area. It is important to pick a provider that is Medicare-approved since Medicare will not cover hospice costs from providers not on their list. As a beneficiary of Medicare, you can change your hospice provider once every benefit period. This means that if you are not satisfied with the quality of care or need to switch providers for any other reasons, you have the option to do so. Medicare-certified hospice providers can provide hospice care in your home, in a long-term care facility like a nursing home or an inpatient hospice facility. The best option for you will be determined by your doctor and hospice team based on your condition and circumstances. Stopping hospice careIf your condition is no longer terminal and you no longer need hospice care, you can opt out at any time. You will need to submit a form officially stipulating the date you want to stop hospice care. Your Medicare benefits will remain the same after ending hospice care. If after stopping Medicare you fall ill again and require hospice care, you can go back to hospice care at any time, provided you meet the eligibility requirements. |