Preparing for and coping with your loved one’s terminal illness can be a lot to bear, and can be a significant cause of distress for many caregivers. Unfortunately, assessing your loved one’s health care options often isn’t any easier, either, making finding what they are eligible for, and what they can afford, a complex challenge. Thankfully, hospice care is a type of Medicare-covered end-of-life care that is available for patients who have less than 6 months or less to live. In this article, find out what specific hospice-care services are covered by Medicare, and the benefits of Medicare-covered hospice care for your loved one.
When Hospice Is Covered By Medicare
Hospice care is available for patients who currently have Medicare Part A (hospital insurance) and who meet all of the following requirements:
- Your loved one’s regular or hospice doctor has provided a referral for hospice care; essentially certifying that your loved one is terminally ill and is expected 6 months or less to live.
- Your loved has opted to receive palliative care (for comfort) as opposed to remedial care (to cure their illness)
- Your loved one has signed a statement choosing hospice care instead of other Medicare-covered treatments to their terminal illness and related conditions
If your loved one is still alive in 6 months, they can continue to receive hospice care as long as their hospice medical director or hospice doctor recertifies that they are terminally ill at a face-to-face meeting. Face-to-face recertification meetings are required prior to each subsequent 60-day benefit period and must take place no earlier than 30 days before the new benefit period begins.
Situations When Hospice Is Not Medicare-Ensured
Keep in mind that by choosing to being hospice care, your loved one has decided to refrain from curative treatment in exchange for ‘free’ palliative care For these reasons, Medicare will not cover any of the following services once your loved one’s hospice care benefit begins:
Remedial Care & Medication
Medicare will not cover treatment (or medication) intended to cure your loved one’s illness or their related conditions, only to mitigate its symptoms. If you or your loved one are considering getting treatment, talk to your doctor, and know that you always have the right to discontinue hospice care at any time.
Keep in mind that if your loved one needs medication that is not directly related to their terminal illness, their Part-D plan will still cover them under its normal cost-sharing requirements, however your loved one’s medical provider will have to notify their Part-D plan that the medications are unrelated to their terminal condition.
Room & Board
As hospice care is typically given in the patient’s home, Medicare does not usually cover the cost of room and board in facilities like nursing homes, unless the patient is receiving respite care. If a hospice patient receives respite care, the patient will be billed 5 percent of the Medicare-approved cost of inpatient care, and Medicare will pay the other 95 percent.
Other services
Other services Medicare will not pay for include outpatient care (going to the emergency room in a hospital), ambulance transportation, and any other care that has not been arranged by the hospice medical team. Moreover, Medicare coverage only extends to the hospice provider you choose; you can not get professional care from a different care provider, unless you change your hospice provider.
Contact your hospice care team before you get any of the aforementioned services to avoid paying the entire out-of-pocket cost.
The Benefits Of Medicare-Covered Hospice
Medicare-covered hospice care includes a comprehensive range of life-limiting medical and support facilities and services including:
- Doctor services & nursing care
- Medical equipment and supplies
- Prescription drugs (for symptom control and pain relief)
- Hospice aide and homemaker services
- Physical and occupational therapy
- Speech-language pathology services
- Social workers services
- Dietary counseling
- Grief and loss counseling for patients and their family
- Respite care for up to 5 days per session
What You Pay For Hospice Care
Again, hospice care is fully covered by Medicare. There is no deductible. Your loved one will only have to pay:
- Their monthly Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) premiums.
- Copayments of up to $5 per prescription for outpatient prescription drugs for pain and symptom management.
- 5% of the Medicare-approved amount for inpatient respite care, if applicable.
Speak to Harbor Light Hospice For More Information
Considering hospice care for your loved one? Contact Harbor Light Hospice today! Our hospice care program provides comprehensive hospice care services for all kinds of patients coping with a life-limiting illness. Discover how our caring and responsive hospice care teams and extensive network of volunteer staff can make life better for you and your loved one today!
To learn more about Medicare eligibility, coverage, and costs, visit Medicare.gov, for more information.
