The short answer is yes! Medicare pays for hospice.

One of the biggest questions for Medicare beneficiaries is whether or not it will pay for hospice care. The answer is yes, but some specific qualifications need to be met in order to qualify.

Medicare covers hospice services if you meet specific criteria:

  • You’re enrolled in Medicare Part A or B
  • You have a terminal illness that can’t be cured or treated
  • You have six months or less to live (but not all hospice care providers require this)
  • You choose hospice care instead of alternative treatments or are incapable of making your own medical decisions

To get started in hospice care, you need your doctor to refer you to a hospice provider. Your doctor’s office can give you information about getting started and finding a local hospice provider that accepts Medicare.

You will also need to understand what qualifies as hospice care services. This includes both medical and non-medical services offered by a licensed hospice agency. These hospice services can include: 

  • 24-hour nursing care
  • pain control and management
  • physical therapy
  • occupational therapy
  • spiritual counseling
  • bereavement support
  • pharmaceuticals
  • respite care (for family members)
  • medications (including cancer drugs)
  • home health aide visits
  • social worker visits
  • respite care at a nursing facility or assisted living facility
  • hospice specific equipment like wheelchairs or walkers

It’s not always easy to know what qualifies you for hospice care. If you’re not sure whether or not you qualify for hospice care, here are three ways you can find out:

Ask your doctor. Hospice is often used to manage pain and symptoms in the final stages of a terminal illness. If you’ve been diagnosed with a terminal illness and want to know if hospice is right for you, check in with your doctor first. They’ll be able to tell you what kind of care they recommend, and if they think it’s time for hospice, they’ll help you learn more about how it works.

Call your insurance provider. Hospice is covered under Medicare and most private health plans at little or no cost to patients (though there may be co-pays). Some states also offer special benefits for people who qualify for hospice services. Check on this with your insurance provider before signing up.

Visit NHPCO (The National Hospice & Palliative Care Organization). They have detailed information about hospice care and how it fits into end-of-life management; it’s good to know what options are available.

You can find more information about Medicare’s hospice coverage here. If you think your loved one could benefit from hospice services, please reach out to us.