Does Medicare Pay for Hospice? - Grants for Medical

Does Medicare Pay for Hospice – Overview

Hospice care refers to the services and treatments that ailing individuals whose life expectancy is less than six months receive.

This is a crucial time in an individual’s life and that of their loved ones. If you have a loved one in the same predicament, you may be wondering if Medicare will cover the cost of hospice care.

This article seeks to answer that, so you may want to read on.

Under What Circumstances Does Medicare Cover Hospice

Medicare covers hospice care if a doctor certifies that you’re terminally ill with a life expectancy of 6 months or less, regardless of whether you opt for other treatments.

When an individual is put under hospice care, that simply means that their physician has certified their life expectancy to be no more than six months.

As such, Medicare will pay only for six months of hospice care but that doesn’t mean that one stops receiving the care they need.

What Medicare Parts Cover Hospice Care

Medicare has different parts, each covering a different set of services and items. For instance, Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

There is a Medicare Advantage plan that allows you to access these benefits but only if you continue paying your premiums.

Medicare covers hospice care costs if you’re enrolled in Medicare Part A and meet specific conditions, such as accepting palliative care for your terminal illness instead of treatment intended to cure it.

On the other hand, Medicare Part C (Medicare Advantage) offers an alternative way to receive your Medicare benefits, which include all Part A and Part B services, except hospice care; hospice care is covered under Original Medicare even if you’re enrolled in a Medicare Advantage Plan.

What is Covered by Medicare

Medicare pays for several services and supplies. These comprise speech therapy, occupational therapy, and physical therapy services. Counseling, nutrition, and medical equipment like hospital beds and walkers are also covered.

If you are signed up for hospice care, you may want to note that Medicare Part A continues to cover all the other services and treatments you may need, even if they are unrelated to your illness.

Moreover, you can keep using your Medicare Advantage plan without losing benefits.

How Much Does Hospice Care Cost with Medicare

As you probably know, hospice care expenses can accumulate pretty fast.

This figure comprises in-home and hospital treatments not deductible under Medicare.

Most hospice patients don’t have to pay for specific prescriptions and services. For example, pain or symptom relief drugs may carry a $5 copay.

Moreover, if the patient is receiving inpatient respite care in an approved facility, there may be a 5 percent copay. This gives your caregivers some time off.

What is Not Covered by Medicare

Unfortunately, Medicare will not cover all the services you may require in your last days. Medicare covers care intended to relieve symptoms and pain associated with a terminal illness as part of hospice benefits. Still, it does not cover treatments intended to cure the terminal illness.

If you want the same, you will be required to stop receiving hospice care and pursue those treatments.

Meanwhile, if you receive care from a provider other than the one picked by your care team, Medicare will not pay for the services.

You can still get services from another healthcare practitioner your team chose to oversee your hospice care.

Medicare doesn’t cover room and board when you get hospice care in your home or another facility (like a nursing home).

It only covers hospice care in an outpatient facility such as an acute care facility or freestanding hospital.

The Bottom Line

The last days of an individual on earth need to be as comfortable as possible and that’s what hospice care does.

However, the service is not cheap, so having your insurance company cover these costs would be a reprieve.

If you are considering using Medicare, it would be best to ask your hospice care provider what the plan covers and what it does not.