Hospice care is covered by Medicare, VA benefits including TRICARE, Medicaid and many private insurance policies. These benefits offer patients and their families end of life care without overwhelming financial burdens.
For eligible patients, Medicare (Part A) provides physical, emotional and spiritual support for patients and their families. It covers medications, personal supplies and home medical equipment related to a terminal illness. Medicare Advantage plans include hospice benefits.
- 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.
- Support is provided in a private home, nursing home, a hospital or anywhere a person calls home.
Some medications may require a 5-percent co-pay. Providers customize a plan of care with input from you and your doctors. Talk with your hospice agency early and often about possible out-of-pocket expenses.
Hospice services include respite care for families needing a short break from in-home care. Patients or their family are responsible for 5 percent of the cost of respite care at a Medicare-approved facility.
Visit the hospice information page on Medicare.gov.
Hospice care is a VA benefit for qualified Veterans in the final chapter of their lives, typically six months or less. The VA works closely with local hospice agencies to provide care at home, in a nursing facility or hospital.
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.
Medicaid hospice benefits vary by state. Coverage is most states is similar to Medicare benefits. Some states require a co-pay for certain hospice services, usually determined by income. Hospice eligibility requirements and services are similar for Medicare and Medicaid.
- 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
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.