Who Pays for Hospice?

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

If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice will work with the person and their family to ensure needed services can be provided.

Medicare Hospice Benefit

The Medicare Hospice Benefit 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 support the family and loved ones of the person through a variety of services.

 

More than 90% of hospices in the United States are certified by Medicare.  Eighty percent of people who use hospice care are over the age of 65, and are entitled to the services offered by the Medicare Hospice Benefit. This benefit covers all of the care related to the terminal illness (and related illness) that is determined medically necessary by the hospice physician. If there is a medical condition that is not related to the terminal illness or related illness, the Medicare coverage you had before electing the hospice benefit will cover these illnesses.

 

In addition, most private health plans and Medicaid in 48 States and the District of Columbia cover hospice services.

 

Sometimes a person’s health improves or their illness goes into remission. If that happens, the hospice physician may feel that you no longer need hospice care. If this happens, you will be discharged from hospice and return to the care and the Medicare coverage you had before electing the hospice benefit.

 

Also, you always have the right to stop receiving hospice care at any time and for any reason. If you stop your hospice care, you will receive the type of Medicare coverage that you had before electing hospice. If you are eligible, you can go back to hospice care at any time in the future.

Who is Eligible for Medicare Hospice Benefits?

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 or related illnesses.