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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:

• A hospice doctor (and regular doctor if applicable) certifies that they are terminally ill (defined as a life expectancy of 6 months or less).

• They accept comfort care (palliative care) instead of continuing to try to cure the illness.

• 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:

• Doctors’ services.

• Nursing and medical services.

• Equipment for pain relief and symptom management.

• Medical supplies.

• Drugs for pain and symptom management.

• Aide and homemaker services.

• Physical therapy services.

• Occupational therapy services.

• Speech-language pathology services.

• Social services.

• Dietary counseling.

• Spiritual and grief counseling for you and your family.

• Short-term inpatient care for pain and symptom management.

• 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.

• Any other services Medicare covers as the hospice team recommends.

What it Costs in Medicare:

• Clients pay nothing for hospice care.

• 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.

• The client may have to pay for board if they live in a facility and choose to get hospice care.

• 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.

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What part of Medicare covers hospice

If you are going through a difficult time with a loved one, you may ask; what part of Medicare covers hospice.

First let us explain what hospice is:

Hospice care provides support and comfort to patients who have a terminal illness and have decided to focus on improving the quality of their remaining life rather than seeking curative treatment. Medicare covers hospice care for all eligible beneficiaries. In the next few paragraphs, we’ll take a closer look at how Medicare covers hospice care.

Who is eligible for Medicare hospice coverage?

To be eligible for Medicare hospice coverage, a patient must meet the following criteria:

1. The patient must be eligible for Medicare Part A (hospital insurance).
2. The patient must be diagnosed with a terminal illness and have a life expectancy of six months or less.
3. The patient must choose hospice care instead of curative treatment for their terminal illness.

What services does Medicare hospice cover?

Once a patient is deemed eligible for Medicare hospice coverage, they are entitled to receive a range of services related to their terminal illness. These services may include:

1. Medical care: This includes visits from a hospice doctor, nursing care, medication management, medical equipment and supplies.
2. Support services: Hospice care providers may offer counseling and emotional support to patients as well as their families.
3. Respite care: In some cases, a patient’s caregiver may need a break from providing care. Hospice care providers can offer short-term respite care to relieve the caregiver’s burden.
4. Bereavement services: Hospice care providers may offer bereavement counseling and support to family members after the patient has passed away.
5. Spiritual and religious services: Hospice care providers may offer spiritual and religious support to patients and their families.

How much does Medicare hospice coverage cost?

For most Medicare beneficiaries, Medicare coves 100% of the hospice care cost. This means, the patient does not have to pay out-of-pocket for hospice care. However, patients who receive care from a hospice provider that is not Medicare-certified may end up will a bill for some of the costs.

Please note;  while hospice care is covered 100% by Medicare, other services that a patient may receive while in hospice care, such as treatment for an unrelated illness, may or may not be covered by Medicare.

In conclusion, Medicare covers hospice care for eligible beneficiaries, including medical care, support services, respite care, bereavement services, and spiritual and religious services. Medicare typically covers 100% of  hospice care cost, but it’s important for patients to choose a Medicare-certified hospice provider to avoid any unexpected costs. Hospice care can provide comfort and support to patients with terminal illnesses and their families during a difficult time.

Click here to learn about what Medicare will pay for

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