Hospice Payment Options

Medicare and Hospice

100% Coverage if These Four Requirements Are Met:

  • The patient is eligible for Medicare Part A (Hospital Insurance)
  • The patient’s doctor and a hospice medical director certify that the patient is terminally ill and has six months or less to live if the illness runs its normal course
  • The patient signs a statement choosing hospice care instead of other Medicare-covered benefits to treat the terminal illness
  • The patient receives care from a Medicare-approved hospice program

Services Hospice Provides Under the Hospice Medicare Benefit:

  • Doctor services
  • Nursing care
  • Medical equipment
  • Medical supplies
  • Social worker services
  • Spiritual care
  • Dietary counseling
  • Volunteers
  • Grief counseling for patient and family
  • Medications for symptom control or pain relief
  • Medical supplies and equipment related to the terminal diagnosis
  • Hospice aide and homemaker services
  • Physical and occupational therapies, as appropriate for the plan of care
  • Music, pet, and/or massage therapies as appropriate for the plan of care. Call to see if available in your area
  • Speech-language pathology services, as appropriate for the plan of care
  • Short-term inpatient and respite care
  • Any other Medicare-covered services needed to manage pain and other symptoms, as recommended by the hospice team

IMPORTANT: Medicare will still pay for covered benefits for any health problems that are not related to the patient’s terminal illness.

Services Medicare Does Not Cover While Under Hospice Care:

  • Treatment intended to cure the terminal illness
  • Prescription drugs to cure the illness rather than for symptom control or pain relief
  • Room and board. However, room and board is covered for Respite and General Inpatient (GIP) level of care
  • Care in an emergency room, inpatient facility care, or ambulance transportation, unless it’s either arranged by the hospice medical team or is unrelated to the terminal illness