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 such an individual’s life as well as that of their loved ones. Now, if you have a loved one in the same predicament, you are 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 will pay for hospice care if and only if you opt for it instead of other appropriate 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.
That said, most people live longer than in that period.
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 features different parts, with each one covering a different set of services and items. For instance, Medicare Part A pays for doctor visits, including hospice care.
Medicare Part B covers all the other nursing or medical services you may need to be done in the comfort of your home and this includes tests and equipment.
There is a Medicare Advantage plan that allows you to access these benefits but only if you continue paying your premiums.
In case you are not registered for hospice care, Medicare will pay for all your hospice care expenses.
On the other hand, Medicare Part C covers the treatment you need for your ailment as well as those that Medicare’s primary program does not cover.
What is Covered by Medicare?
Medicare does pay for several services and supplies. This comprises speech therapy, occupational, and physical therapy services. Counseling, nutrition, and medical equipment like hospital beds and walkers are covered here.
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, if you want to keep using your Medicare Advantage plan, you get to do it without losing benefits.
How Much Does Hospice Care Cost with Medicare?
As you are probably already aware, hospice care expenses can accumulate pretty fast.
According to the Society of Actuaries, cancer patients in their last months are estimated to receive parts A and B of Medicare, adding up to $44,000.
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, drugs for pain or symptom relief may carry a $5 copay.
Moreover, there may be a 5 percent copay for inpatient respite care if the patient is receiving the care in an approved facility. 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 on earth. It won’t, for instance, pay for treatments required for a terminal ailment.
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.
That said, you can still get services from another healthcare practitioner that your team chose to oversee your hospice care.
Medicare does not pay board and room costs if you are receiving in-home care, in-patient or nursing home care.
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 does not come cheap and this is why it would be a reprieve to have your insurance company cover these costs.
If you are thinking of using Medicare, it would be best to ask your hospice care provider what the plan will cover and what it will not.