As long as it’s a Medicare-approved hospice program, Medicare covers most aspects of hospice care for little to no cost to beneficiaries. When it comes to long-term care planning, it’s important to understand what is covered by Medicare. Here’s a guide to Medicare coverage and hospice.
How do you qualify for Medicare hospice coverage?
In order for Medicare to cover hospice care, you must have Medicare Part A (hospital insurance) and meet the following criteria:
- Your hospice doctor and your regular doctor (if you have one) certify that you’re terminally ill (you’re expected to live 6 months or less).
- You accept comfort care (palliative care) instead of care to cure your illness.
- You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.1
Hospice Care Services Covered by Medicare Include:
Hospice care involves a variety of care. Medicare has assembled a list of services that all hospices are required to provide every hospice patient. You can expect that Medicare Part A will cover these services when needed during terminal illness and related condition(s), and ordered by your hospice care team:
- Doctor services
- Nursing care
- Medical equipment (like wheelchairs or walkers)
- Medical supplies (such as bandages and catheters)
- Prescription drugs for symptom control or pain relief (you may need to pay a small copayment)
- Hospice aide and homemaker services
- Physical and occupational therapy
- Speech-language pathology services
- Social worker services
- Dietary counseling
- Grief and loss counseling for you and your family
- Short-term inpatient care (for pain and symptom management)
- Short-term respite care (may need to pay a small copayment)
- Any other Medicare-covered services needed to manage your pain and other symptoms related to your terminal illness, as recommended by your hospice team.
Medicare Does Not Cover:
When it comes to hospice care, there are a few instances in which Medicare may not cover:
- A treatment or prescription medications intended to cure a terminal illness
- Any care not set up by an approved hospice care team
- Your room and board should you receive hospice care where you live
- Any E.R. care, inpatient care or ambulance transport not related to your terminal illness or not arranged by your hospice care team
How long will Medicare pay for hospice care?
Hospice care is for those with a life expectancy of 6 months or less. You can still get hospice care after 6 months, as long as the hospice medical director or other hospice doctor recertifies that you’re terminally ill.
Still have questions about Medicare hospice coverage? SelectQuote can help.
It’s easy to be left confused by Medicare. At SelectQuote, we can help you better understand Medicare and its coverage for long-term and hospice care. In just minutes we can compare coverage from some of the most trusted insurance companies in the nation on your behalf to find the right coverage for you.
1https://www.medicare.gov/Pubs/pdf/02154-medicare-hospice-benefits.pdf
