HOSPICE COVERAGE AND COST

 

hospice Hospice care is fully covered under the Medicare Hospice Benefit of 1982, which was designed to provide help to terminally ill patients with the expenses incurred at the end of life. In addition, hospice care is covered by a large amount of Medicaid and private insurance plans, with little to no out-of-pocket expense. Heart to Heart Hospice is licensed as a Medicare provider and must comply with Federal and State Regulations governing hospice care.

Medicare beneficiaries who elect hospice care receive non-curative medical care and supportive services for their terminal illnesses. All of the services, treatments, hospital stays, medical equipment, and medications related to the terminal illness must be provided by and authorized by the hospice interdisciplinary team for Medicare to maintain financial responsibility.

The Medicare Hospice Benefit includes home care, as well as inpatient care when needed, and additional services that would not typically be covered by Medicare. The patient, the patient’s attending physician and the hospice team will establish a plan of care that will help create positive outcomes and reach desired goals.

Under Medicare, hospice care is available if the following eligibilities requirements are met:

1. The patient must be eligible for Medical Hospital Insurance (Part A);
2. The patient’s attending physician and the hospice medical director must certify that an individual's life expectancy is six months or less if the terminal illness runs its normal course;
3. Hospice care under Medicare includes home care, as well as inpatient care when needed, and additional services that would not typically be covered by Medicare;
4. The patient elects hospice care, rather than standard Medicare benefits for their terminal illness;
5. The patient receives the care from a licensed hospice Medicare provider.

Medicare will still pay for covered benefits used during hospice services for health problems that are not associated with the terminal illness. The Medicare Hospice Benefit differs from the Medicare Home Health Benefit, in that it is limited to beneficiaries who are terminally ill. Please view the “Medicare Home Health Benefit vs. Hospice Benefit” information sheet for details about differences in coverage and costs.


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