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Hospice Care

Covered by Medicare

Coverage

Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:

  • Doctor services
  • Nursing care
  • Medical equipment, like wheelchairs or walkers
  • Medical supplies, like bandages or catheters
  • Prescription drugs for symptom control or pain relief
  • Hospice aide and homemaker services
  • Physical therapy services
  • Occupational therapy services
  • Speech-language pathology services
  • Social work 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
  • Any other Medicare-covered services needed to manage your pain and other symptoms related to your terminal illness

You must have Medicare Part A and meet all of these conditions in order to receive hospice care:

  • Your hospice doctor and your regular doctor (if you have one) certify that you’re terminally ill (with a life expectancy of 6 months or less).
  • You accept palliative care (for comfort) instead of care to cure your illness.
  • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.

Costs

You pay nothing for hospice care.

You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it’s covered under Part D.

You may need to pay five percent of the Medicare-approved amount for inpatient respite care.

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

What to Know

Only your hospice doctor and your regular doctor (if you have one) can certify that you’re terminally ill and have a life expectancy of 6 months or less. After 6 months, you can continue to get hospice care as long as the hospice medical director or hospice doctor recertifies (at a face-to-face meeting) that you’re terminally ill. Hospice care is usually given in your home but may also be covered in a hospice inpatient facility.

Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions, but this is unusual. When you choose hospice care, you decide you no longer want care to cure your terminal illness and/or your doctor determines that efforts to cure your illness aren’t working. Once you choose hospice care, your hospice benefit will usually cover everything you need.

Medicare By State

Medicare is regulated by the federal government. However, private insurance companies are allowed to offer various parts of Medicare, and these plans can differ from state to state.

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