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Palliative care is for those with a life-threatening illness. It’s care aimed at improving the quality of life of the patient.
You may receive palliative care in a hospital, nursing home, palliative clinic, or even your home. A common question many people have about this type of care is, “does Medicare cover palliative care?”
In this article, we answer this question in clear, plain English. You will also find the average costs of palliative care.
The short answer is yes; Medicare will cover the cost of palliative care. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your palliative care. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for palliative care. However, Medicare will only cover palliative care if the following conditions are met. Those conditions consist of:
Medicare Part A will provide coverage for palliative care costs if the service is given in a hospital, skilled nursing facility, or an inpatient setting. Medicare Part A will cover the following:
Medicare Part B will cover the cost of palliative care if you receive it outside of hospice care. Medicare Part B will cover the following:
Medicare Advantage plans (Medicare Part C) also provides coverage for palliative care as they cover everything Original Medicare covers. However, out-of-pocket costs will vary depending on the plan provided by the plan providers.
There are private insurance companies that partner with Medicare Part C to offer Special Needs Plans (SNPs). SNPs provide additional medical services as well as more versatile services for patients diagnosed with a life-threatening illness.
Medicare Part D provides coverage for the prescription medications that the patient needs while he/she is in palliative care. Prescription drugs covered by Medicare Part D may include medications that treat anxiety, pain, nausea, fatigue. Coverage for prescription drugs will be 100% or 95%.
The cost of palliative care varies based on a number of different factors. But here are some average number to give you an idea of what this type of care costs.
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.
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 Rehab?