Hospice is covered by Medicare, Medicaid and most private insurance policies. Hospice is a generous Medicare benefit because services related to a life-limiting illness, such as medical equipment, medicines and supplies, are covered – with few or no out-of-pocket expenses.
Medicare typically pays 100% of expenses if these requirements are met.
- The person seeking hospice is eligible for Medicare Part A.
- 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.
- You or your loved receive care from Medicare-approved hospice program.
- Doctor and nursing care
- Medical equipment, supplies and medications for pain and other symptoms
- Medical social services
- Spiritual care and support
- Dietary counseling
- Support from volunteers
- Grief counseling for patient, family and friends
- Hospice aide and homemaker services
- Physical, occupational and speech therapies, as appropriate for the care plan
- Music, pet or massage therapies as appropriate. Call our local locations to see if services are available near you.
- Short-term inpatient respite (relief) care for caregivers
What about Medicare coverage for other services?
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 have a Medicare Advantage Plan, that plan will be responsible for other costs.
How long can someone receive hospice care using Medicare?
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.
If the patient lives longer than six months, hospice care is still available, as long as the hospice medical director or another hospice doctor re-certifies the terminal illness. Hospice eligibility
Room and board costs at a nursing home, hospital or other facility are not covered by the Medicare hospice benefit?
Hospice care services are covered wherever you call home, but Medicare does not pay anything toward room and board expenses. The exception is short-term inpatient or respite care.
The patient will not receive a bill for the services covered under the Medicare Hospice Benefit. Medicare pays the hospice directly.