Determining how to pay for hospice services is one of the first things that patients and their families consider. Below are answers to frequently asked questions about how to pay for hospice:
The Medicare Hospice Benefit, initiated in 1983, is covered under Medicare Part A (hospital insurance). Medicare beneficiaries who choose hospice care receive a full scope of medical and support services for their life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services. Eighty percent of people who use hospice care are over the age of 65 and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the person or family.
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You are eligible for Medicare hospice benefits when you meet all of the following conditions:
*Medicare will still pay for covered benefits for any health needs that aren't related to your life-limiting illness.
Medicare defines a set of hospice core services, which means that hospices are required to provide these set of services to each person they serve.
Medicare covers these services related to a terminal diagnosis and ordered by the hospice team:
You will receive comfort care to help manage symptoms related to your illness. Comfort care includes medications for symptom control and pain relief, physical care, counseling, and other hospice services.
Hospice team members will consult with the hospice physician and will inform you and your family which drugs and/or medications are covered and which ones are not covered under the Medicare Hospice Benefit. The Hospice uses medicine, equipment, and supplies to make you as comfortable as possible. Under the hospice benefit, Medicare won't pay for treatment where the goal is to cure your illness. You should talk with your doctor if you are thinking about potential treatment to cure your illness. You always have the right to stop getting hospice care and receive the "traditional" Medicare coverage you had before electing hospice.
All care that you receive for your illness must be given by your hospice team. You can't get the same type of care from a different provider unless you change your hospice provider.
Room and board aren't covered by Medicare. You may receive hospice services wherever you live, even in a nursing home, however, the Medicare Hospice Benefit does not pay for nursing home room and board.
Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers.
Medicaid benefits vary by state and private insurances offer a wide variety of coverage. Our expert financial staff can help you understand your coverage provisions and will contact Medicaid or your insurance company to determine your specific benefits.
A nurse will come to your home to do an assessment and ask questions about your medical history. From this information a plan of care will be developed with you and your physician. The plan of care will include the services you will receive, how often, and your goals.
You can choose to receive services from any Medicare-certified agency. Your doctor and/or case manager should respect your decision. If you are unhappy with the agency you have been working with, you can change at any time. You need to let both the new and old agency know of your decision.
If you would like more information on this subject; please contact us or go to www.medicare.gov, search publications for "Hospice", or call 1-800-MEDICARE (1-800-633-4227).
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PeopleFirst Homecare and Hospice
PeopleFirst Homecare and Hospice is a national care provider.Find a Location near youPeopleFirst Homecare and Hospice Support Center680 South 4th StLouisville, KY 40202Phone: 502.596.7733Toll Free: 800.877.8574
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