Will Medicare Cover Hospice Care?

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Hospice care is a type of health care that helps people with a terminal illness and are not likely to live longer than six months. Medicare beneficiaries can receive hospice care as long as their provider is approved by Medicare and declares it to be medically necessary.

Who Qualifies For Hospice Care?

Any individual that qualifies for Medicare is eligible to receive hospice care. However, to receive hospice care benefits, you must meet these criteria:

  • A doctor must validate that you’re terminally ill and likely have less than six months to live.
  • You must accept palliative care that offers comfort instead of medical care that’s intended to treat or cure your illness.
  • You must sign a statement showing your willingness to receive hospice care instead of other treatments covered by Medicare for your particular condition.

With Medicare, you qualify for a one-time consultation with a hospice specialist to discuss your needs. You don’t have to opt for hospice care even if you agree to choose it at the meeting.

What Is Covered By Medicare?

Medicare provides coverage for many services, medication, and supplies related to the sickness that made you seek hospice care. The services and items covered by Medicare include:

  • Nutrition counseling
  • Doctor and nursing services
  • Speech, physical, and occupational therapy
  • Drugs required to control pain or relieve symptoms
  • Medicare equipment such as hospital beds and walkers
  • Short-term inpatient care to help manage symptoms or pain
  • Grief counseling and social work services for you and your family
  • Short-term respite care, allowing your caregiver to have about five days of rest if you’re receiving outpatient care

If you’re receiving hospice benefits, Medicare will still cover other nonterminal conditions and illnesses you may have.

A senior woman discussing what Hospice Care is not covered by Medicare.
The cost of the hospice services you received will be paid directly to your hospice provider.

What Hospice Care Is Not Covered By Medicare?

While Medicare will pay for most services and items that you’ll need during your hospice care, here are a few things it doesn’t cover:

  • Room and board expenses
  • Any treatments to cure or treat the terminal illness
  • Hospice care received at an outpatient healthcare center
  • Services received from a hospice care provider that wasn’t approved by your team

So With Medicare, What Does Hospice Care Cost?

The cost of the hospice services you received will be paid directly to your hospice provider. When you enter a hospice program, you don’t need to meet a deductible for your care. However, some hospice care-associated costs may apply, and they include:

  • You’ll continue to pay monthly premiums for Medicare Parts A (when required) and B.
  • You will pay a copayment of about $5 for each prescription drug to manage pain and symptoms.
  • You may also pay 5 percent coinsurance for Medicare-approved amounts for inpatient respite care.

Let The Medicare Experts Help

If you have additional questions about Medicare coverage for hospice care, contact Bobby Brock Insurance. Our team of experts is ready to answer any and all Medicare-related questions — so call today!

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Justin Brock

President & CEO of Bobby Brock Insurance