Does Medicare Cover Hospice ?
How to Qualify for Hospice Care:
Your clients qualify for hospice care if they have Medicare Part A and meet the following conditions:
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A hospice doctor (and regular doctor if applicable) certifies that they are terminally ill (defined as a life expectancy of 6 months or less).
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They accept comfort care (palliative care) instead of continuing to try to cure the illness.
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They sign a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness and related conditions.
Your clients can usually get Medicare-certified hospice care in their home or other live-in facility like a nursing home. They can also get hospice care in an inpatient hospice facility.
What is Hospice Care:
Depending on the terminal illness and related conditions, a hospice team will create a plan of care that can include any/all of these services:
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Doctors’ services.
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Nursing and medical services.
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Equipment for pain relief and symptom management.
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Medical supplies.
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Drugs for pain and symptom management.
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Aide and homemaker services.
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Physical therapy services.
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Occupational therapy services.
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Speech-language pathology services.
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Social services.
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Dietary counseling.
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Spiritual and grief counseling for you and your family.
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Short-term inpatient care for pain and symptom management.
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Inpatient respite care, which is care provided in a Medicare-approved facility (like an inpatient facility, hospital, or nursing home), so that the usual caregiver can rest.
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Any other services Medicare covers as the hospice team recommends.
What it Costs in Medicare:
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Clients pay nothing for hospice care.
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Clients pay a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management. In the case the hospice benefit doesn’t cover a drug, the client’s hospice provider should contact the Medicare plan to see if Part D covers it.
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The client may have to pay for board if they live in a facility and choose to get hospice care.
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To learn more about what is covered under Hospice Care, visit Hospice Care Coverage.
Find out what Medicare covers
Click here to learn 5 things Medicare does not cover.
If you would like more information on Medicare enrollment, you can find it at Medicare.gov.