Medicare Coverage of Hospice Care
Facing a serious illness can be overwhelming, but hospice care helps provide comfort, dignity, and support for beneficiaries and their families during end-of-life care. One of the most common questions people ask is about Medicare coverage of hospice services. We will go over the different types Medicare plans and how they cover hospice.
Hospice Coverage Under Original Medicare (Parts A & B)
Medicare Part A covers hospice for beneficiaries who:
- Have a terminal illness with a life expectancy of 6 months or less, as certified by a doctor.
- Choose comfort-focused treatment instead of curative treatment.
- Elect hospice care through a Medicare-approved hospice provider.
What Part A covers:
- Doctor and nursing services
- Medications related to pain relief and symptom management
- Medical equipment and supplies (wheelchairs, walkers, oxygen, bandages, etc.)
- Physical, occupational, and speech therapy when needed for comfort
- Social worker and counseling services
- Short-term inpatient or respite care
Costs under Original Medicare:
- $0 for hospice care itself
- A small copay (up to $5) for each prescription related to pain/symptom management
- 5% of the Medicare-approved amount for inpatient respite care
Hospice Coverage Under Medicare Advantage (Part C)
Even if you’re enrolled in a Medicare Advantage (MA) plan, hospice benefits are still provided directly by Original Medicare, not the MA plan.
Here’s how it works:
- You continue to be a Medicare Advantage member, but hospice services are billed through Medicare Part A.
- Your MA plan may still cover other non-hospice services (like supplemental benefits, prescription drugs, and other medical care unrelated to your terminal illness).
- You should confirm with your hospice provider and MA plan how coverage will coordinate for services not related to your hospice care.
Hospice and Medicare Supplement (Medigap)
If you have a Medicare Supplement (Medigap) policy along with Original Medicare:
- Your hospice care costs are already minimal under Part A.
- A Medigap plan may help cover other related costs, such as Part A coinsurance or costs for services outside the hospice benefit.
- Medigap coverage varies by plan, although policies help reduce out-of-pocket expenses for services you may still need while receiving hospice care.
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Key Takeaways
- Original Medicare covers hospice care under Part A with very little out-of-pocket cost.
- Medicare Advantage members receive hospice care through Original Medicare, while their MA plan may still cover other unrelated health needs.
- Medicare Supplements work alongside Original Medicare to reduce additional out-of-pocket costs, but hospice itself is already well-covered.
Hospice is one of Medicare’s most comprehensive benefits, ensuring comfort, support, and dignity in a person’s final months. Whether you’re on Original Medicare, a Medicare Advantage plan, or have a Medigap policy, Medicare provides hospice coverage when it’s needed most.