Medicare Covers Advance-Care Planning, Which is Tough but Necessary

Addressing the topic of end-of-life care is certainly not easy for Medicare beneficiaries and their families. But it is an important matter to discuss. End-of-life consultations, also known as an advance-care planning session, are covered by Medicare. No matter how difficult the discussion may be, seniors should take advantage of the consultations to make sure that they and their family members are on the same page.

An advance-care planning session is covered by Medicare Part B as part of the yearly wellness visit. Medicare recipients don’t pay anything for the session, as long as the doctor who provides the appointment accepts the assignment. The primary purpose for the session is to produce a written document that states how you want medical decisions to be made regarding your health when you lose the ability to make them yourself or if you lose the ability to speak about it for yourself. In addition to addressing treatment preferences, the session may also involve the creation or amending of a living will and durable power of attorney for your healthcare.

You’re not alone if the idea of an advance care session is concerning. At the same time, however, you are certainly not alone if you take advantage of the opportunity to sit down and make these important decisions. According to Kaiser Health News, 574,621 Medicare beneficiaries participated in an advance-care planning session. That’s nearly twice the number of recipients that the American Medical Association originally projected to participate in the program. Yet, the numbers only represent about 1% of Medicare beneficiaries.

Medicare’s coverage of advance-care consultations was first approved in 2015, and 2016 was the first year that reimbursement was made available to healthcare providers who provided an end-of-life consultation. It pays providers up to $86 for the first 30 minutes and about $75 for additional meetings. Supporters of the coverage call it a win-win situation, noting the consultation helps the patient identify his/her preferences for official review and that the planned care helps reduce healthcare costs such as tests and/or treatments that the patient would not need or want.

Some providers were not at first aware that reimbursement was available. Will the coverage continue? Representative Steve King of Iowa introduced the Protecting Life Until Natural Death Act to stop Medicare’s coverage of advance-care consultations, which some circles have referred to as “death panels.”

Whether it’s during a yearly wellness visit or a different appointment, Medicare beneficiaries should ask their doctor about an advance-care planning session. Of course, they should address it with their families as well. By discussing the difficult topic early, you can save time, stress and finances.

Up Next...

blog image

Medicare World Blog

CA Residents: Privacy Notice for California Residents |