Who Pays for Hospice Care?

A common myth we often hear is that hospice care is expensive. In fact, it’s a model of care that’s designed to lower healthcare costs by preventing unnecessary ER visits and hospitalizations, and it’s covered by Medicare, Medicaid and most private insurance plans.

Qualifying for Hospice Care  

Hospice is supportive care for people with a terminal illness. Most insurance plans require a prognosis of six months or less if the illness runs its normal course. Unlike other types of healthcare, the patient and family together are considered a unit of care under the hospice benefit.

Hospice offers relief from the pain and other distressing symptoms of serious illness, and is most often provided in a home setting, but it can also be provided in nursing homes, assisted living centers or hospitals. Care is covered no matter where the patient lives.

The hospice benefit covers all services through a team-based approach that addresses not only the physical symptoms of illness, but also the patient and family’s emotional and spiritual needs. The hospice care team includes a physician, nurse, certified nursing assistant, social worker, chaplain and volunteer.

Services typically covered include:

• Visits from all members of the hospice care team, wherever a patient calls home
• Companionship visits from a volunteer, if the patient and family choose
• All medications (prescription and over-the-counter), medical equipment and supplies related to the patient’s terminal illness
• Lab and diagnostic tests required for optimum pain and symptom management
• Inpatient care for pain and other symptoms that cannot be managed at home
• Respite services for the family caregiver
• Bereavement services for the family for up to 13 months following their loved one’s death

Medicare and Hospice

Medicare is a federally funded program that provides health coverage for adults age 65 and over, and some adults under age 65 who have with a disability. Medicare has covered hospice care since 1982. In fact, most people who receive hospice services have Medicare.

Medicare covers up to 100% of the cost of hospice care related to a patient’s terminal illness, with no deductible or copayment, and very few out-of-pocket costs. This benefit goes a long way toward alleviating the financial burdens usually associated with caring for a terminally ill patient.

Medicare will also pay for a hospice physician to consult with a terminally ill patient who is not yet ready to enter hospice. The consultation may include an assessment of their pain and other symptoms, and counseling on their care options and advance care planning.

Take Advantage of Your Hospice Benefit

Medicaid and most private insurance plans also have a very robust hospice benefit, and cover most if not all of the same services as Medicare. Check with your insurer to find out what services are included in your plan.

We believe no one should go without comfort and dignity at the end of life. Because Hosparus Health is a not-for-profit organization, we care for anyone who is eligible for our services, regardless of their financial situation. Thanks to our generous donors, we may be able to provide services through our financial assistance program to those who are uninsured or underinsured.

Call us today at (800)-HOSPICE or contact us online to learn if you or your loved one would benefit from our services.