Hospice care costs are covered by Medicare, VA benefits, Tricare, Medicaid and most private insurance policies. These benefits offer patients a dignified and comfortable end of life without overwhelming financial burdens.
For patients with Medicare, benefits covers all services related to the terminal illness. There are no co-pays or out-of-pocket costs.
Care is also covered for patients with Medicare Advantage or Medigap. Care related to a terminal illness follows Original Medicare’s cost and coverage rules. Patients then have the option to keep their Advantage plan or use Original Medicare (Part A and Part B) to cover other health care services not related to the terminal condition. Learn more about hospice coverage with Medicare Advantage.
- Your doctor and a medical director from a hospice program certify the patient has six months or less to live, if the illness runs its normal course.
- The patient signs a statement choosing hospice instead of curative treatments for their terminal illness. You can stop hospice and return to curative treatment at any time.
- The patient receives care from a Medicare-approved hospice program.
Visit the hospice information page on Medicare.gov.
Most private insurance health plans cover the cost of hospice and palliative care. These plans typically have eligibility requirements that match Medicare and offer the same list of services.
Talk to your insurance provider for details about eligibility, deductibles and possible co-pays. A few insurance plans have unique requirements for respite care or general inpatient care.
- Home medical equipment and personal supplies
- Around-the-clock access to care
- Management of complex pain and other symptoms
- Hospice aide for personal care and light homemaking
- Medical social services
- Spiritual care and support
- Physical, occupational, dietary and speech therapies
- Support from volunteers
- Short-term inpatient respite care (relief) for family caregivers
- Ongoing Grief counseling for the patient, family and friends
You still get Medicare coverage for treatment of illnesses or injuries unrelated to your terminal illness. For example, Medicare would continue to cover diabetes care and medications. However, the costs you usually pay for services will apply. If you decide to keep your Medicare Advantage plan, that plan will be responsible for other costs.
The hospice benefit includes two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. Hospice patients receive care as long as the doctor and the hospice medical director certify that the patient is terminally ill.
Medicare does not pay anything toward room and board expenses. The exception is short-term inpatient or respite care.
The workplace or private insurance is the primary coverage. Medicare serves as secondary coverage.