The Medicare Hospice Benefit, initiated in 1983, is covered under Medicare Part A (hospital insurance). Medicare beneficiaries who choose hospice care receive a full scope of medical and support services for their life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services.  Eighty percent of people who use hospice care are over the age of 65, and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the person or family.

You are eligible for Medicare hospice benefits when you meet all of the following conditions:

• You are eligible for Medicare Part A (Hospital Insurance), and
• Your doctor and the hospice medical director certify that you have a life-limiting illness and if the disease runs its normal course, death may be expected in six months or less, and
• You sign a statement choosing hospice care instead of routine Medicare covered benefits for your illness*, and
• You receive care from a Medicare-approved hospice program.

*Medicare will still pay for covered benefits for any health needs that aren’t related to your life-limiting illness.

Medicare defines a set of hospice core services, which means that hospices are required to provide these set of services to each person they serve.

Medicare covers these services related to a terminal diagnosis and ordered by the hospice team:

Nursing care
Doctor services
Medical equipment (e.g. wheelchairs, walkers, oxygen, hospital bed)
Medical supplies (e.g. bandages and catheters)
Drugs for symptom control and pain relief
Short-term care, including inpatient and respite care for pain and symptom management
Home health aide and homemaker services
Physical and occupational therapy
Speech therapy
Social work services
Dietary counseling
Grief support to help you and your family

Treatment intended to cure your illness.
You will receive comfort care to help manage symptoms related to your illness. Comfort care includes medications for symptom control and pain relief, physical care, counseling, and other hospice services.

Medications not directly related to your hospice diagnosis are not covered under the Medicare Hospice Benefit.
Hospice team members will consult with the hospice physician and will inform you and your family which drugs and/or medications are covered and which ones are not covered under the Medicare Hospice Benefit. The Hospice uses medicine, equipment, and supplies to make you as comfortable as possible. Under the hospice benefit, Medicare won’t pay for treatment where the goal is to cure your illness. You should talk with your doctor if you are thinking about potential treatment to cure your illness. You always have the right to stop getting hospice care and receive the “traditional” Medicare coverage you had before electing hospice.

Care from another provider that is the same care that you are getting from your hospice.
All care that you receive for your illness must be given by your hospice team. You can’t get the same type of care from a different provider unless you change your hospice provider.

Nursing Home Room and Board
Room and board aren’t covered by Medicare. You may receive hospice services wherever you live, even in a nursing home, however, the Medicare Hospice Benefit does not pay for nursing home room and board.

Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers.

Medicaid benefits vary by state and private insurances offer a wide variety of coverage.   Our expert financial staff can help you understand your coverage provisions and will contact Medicaid or your insurance company to determine your specific benefits.