Medicare and Hospice Benefit: Your Guide to Coverage [Infographic]

Does Medicare Cover Hospice?

While almost all insurance companies have some type of hospice benefit, did you realize that Medicare also covers hospice? We’ll take a closer look at these benefits, including where you can go for more information.

Yes, There’s Medicare Coverage for Hospice Patients!

You’ll be pleased to know that you or a friend or relative can benefit from Medicare. First, let’s start with a few facts you need to know.

Medicare and Hospice Coverage: The Basics

1. First, you must qualify for hospice.
Before you can begin the process of determining hospice benefits, you have to be sure you qualify for hospice. This means that you or your loved one must have a serious illness with six months or less to live.

2. Second, realize that Medicare will NOT pay for treatments geared toward curing your disease.
Once you enter hospice, all curative treatments have stopped. This means that, for example, if you have cancer, you cannot receive cancer treatments such as radiation or chemotherapy.

3. Third, realize that Medicare will still pay for treatments NOT related to your hospice care.
For example, if you are in hospice for your cancer, Medicare will still pay for treatment related to other conditions, such as diabetes. It will NOT pay for services related to cancer because this is the “hospice-related” disease.

The “non-hospice” diseases will be covered but you may still be responsible for a copay and meeting deductibles, depending upon the type of Medicare plan you have.

Are You Eligible for the Medicare Hospice Benefit?

According to the official government site for Medicare, you’re eligible for the hospice benefit if you have Medicare Part A AND meet all of the following conditions:

• Your doctors certify that you have a life-limiting illness and that you’re expected to live six months or less.
• You accept palliative care instead of treatment for your illness.
• You sign a statement expressing your wishes to choose hospice care.

What Original Medicare Does (and Does Not) Pay For

When you start receiving the benefits for your hospice, original Medicare kicks in and covers several items related to your serious, life-limiting illness.

However, your care MUST be from a Medicare-approved hospice provider.

Medicare WILL Cover:

• Your hospice care
  • Please note that you may still need to give a copayment of $5 for each prescription and products for alleviating pain and controlling symptoms while at home.
  • In addition, you may need to pay 5 percent of the Medicare-approved amount for inpatient respite care
    According to the government’s Medicare site:
    “Once you start getting hospice care, your hospice benefit should cover everything you need related to your terminal illness, even if you remain in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan.”

Medicare Will NOT Cover:

• Room and board if you get your hospice care in your home or in a senior care facility or nursing home.
• Care that is NOT from a Medicare-approved provider.

Check Out This Booklet that Answers “Does Medicare Cover Hospice?” And Other Questions

Yes, we know. Medicare and other government programs can be confusing. That’s why you may find this booklet on Medicare hospice benefits particularly useful.

Be Sure to Follow-up with Your Medicare Representative

These plans can often be very detailed and specific—and they may also change— so we encourage you to contact your Medicare representative for specifics on your hospice plan of care. You can do this by contacting your state hospice organization, and you can find the contact information either at www.medicare.gov/contacts or by calling 1-800-633-4227.

Let Hospice Wise Be Your Source for the Truth About Hospices

There’s simply too much misinformation about hospice out there, and when it is believed, people die without the benefits or comfort they need and deserve.

If you see something online or circulating around social media, check your facts before passing it along. In fact, you may want to share information from Hospice Wise with those in your social network. We always appreciate a tweet or a Facebook share to help us get the truth out there.

Remember, if you’re not sure if your information is reliable, check out Hospice Wise first.