Hospice is the kind of treatment, care, and services that a person receives when he/she has 6 or fewer months of life expectancy. However, the cost of staying in a hospice is expensive and not everyone who needs it can easily afford it.
So a common question many people have is, “does Medicare cover hospice?” In this article, we answer that question in clear, plain English. You will also find the average costs of hospice and other helpful info.
Does Medicare Cover Hospice?
The short answer is yes; Medicare will cover the cost of hospice. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your hospice. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for hospice. Coverage for hospice is provided by Medicare Part A. Medicare Part A provides coverage for hospice care as long as your hospice provider is enrolled in Medicare and accepts Medicare coverage.
Medicare Part A provides coverage for hospice care if your healthcare provider guarantees that your life expectancy is not longer than 6 months due to your terminal illness. You must also sign a statement that confirms that you:
- Choose to have palliative care
- Do not want to continue seeking treatment to cure your illness
- Choose hospice care rather than other Medicare-approved services to treat your illness
Though most people in hospice care have a life expectancy of fewer than six months, some people live longer than that. After six months, Medicare Part A will still provide coverage for your hospice care as long as you need it. Medicare Part A will cover two 90-day benefit periods. After that, you can recertify for an unlimited 60-day benefit period.
Medicare Part A provides coverage for the following hospice services:
- Dietary counseling along with other nutrition services
- Medical supplies and equipment
- Prescription medications to relieve symptoms or control pain
- Doctor and nursing services
- Social work services for both the patient and the family
- Semi-private room
- Occupational therapy
- Physical therapy
- Speech-language pathology
- Short-term respite care (up to five days at a time)
Medicare Part A may also provide coverage for treatment for other non-terminal illnesses and medical conditions that you have while under hospice care.
Part C and Part D Coverage for Hospice
Medicare Advantage plans (Medicare Part C) also provide coverage for hospice. They cover everything Original Medicare covers, as well as some additional benefits. However, exactly what it covers and your out-of-pocket costs will vary depending on the specifics of your plan.
Medicare Part D provides coverage for medications that are not related to the patient’s terminal condition.
How Much Does Hospice Care Cost?
Hospice care may cost $500 per day. One of the factors that may affect the overall cost depends on the level of care the patient requires.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover immunotherapy for cancer?