Does Medicare Cover Hospice Care?

Does Medicare cover hospice care? It seems like a straightforward question. Unfortunately, many family members discover that it’s difficult to find a simple answer when they start researching the Medicare benefits their loved ones are entitled to. We hope we can help.

The caregiving team at MJHS Health System understands that your focus is on the health and well-being of your loved one. That’s why we’ve untangled the often-confusing web of Medicare rules and regulations to give you valuable information about some of the most common questions related to coverage for hospice care and related costs.

What is Hospice Care?

Considered the model of quality compassionate care for people facing a life-limiting or terminal illness, hospice care provides expert medical care, pain management, as well as emotional and spiritual support expressly tailored to a patient’s needs and wishes.  Hospice care focuses on a patient’s comfort and quality of life by combining these services under one umbrella. It also extends support to family members.

Hospice care can be provided in a variety of settings including the safety and comfort of your own home as well as, hospitals, hospice residences, nursing homes or assisted living facilities. You can also keep your own doctor as your attending physician.

Medicare Coverage for Hospice Care 

When it comes time for hospice care for your loved one, you may be concerned about costs. Fortunately, Medicare does offer hospice care benefits to help make this important care affordable. If your family member has Original Medicare, then they must meet the following criteria to be eligible for hospice care benefits according to Medicare.gov:

  • A hospice doctor and the patient’s primary physician must certify that your loved one is terminally ill, which means that they have a life expectancy of 6 months or less.
  • Your loved one must choose to accept hospice care and end treatments that are intended to cure their illness or condition.
  • Your loved one, or someone with power of attorney, must sign a statement choosing hospice care over other Medicare-covered benefits.
  • You and your loved one must choose a Medicare-approved hospice program.

Patients often live longer than expected when they receive hospice care and support. In the event your loved lives longer than 6 months, they would be reassessed for eligibility and can remain on Hospice.

What Hospice-Related Services Does Medicare Cover?

If your loved one meets the above criteria, then Medicare will cover a variety of hospice-related services. These include doctor’s services, nursing care, medical equipment, medical supplies, prescription drugs for symptom control, physical therapy, dietary counseling, bereavement services, short-term inpatient care, and other Medicare-covered services to manage pain and other difficult or distressing symptoms related to your family member’s terminal diagnosis.

While Medicare covers many hospice services, it also excludes things. Once hospice care is chosen, Medicare will not cover any treatments or medications that are intended to cure your loved one’s illness or condition. Also, Medicare doesn’t cover the cost of room and board in a nursing home, hospice residence, or assisted living facility.

Hospice Services  Above and Beyond What Medicare Covers

Certain hospice support and specialty care programs are not covered by Medicare. However, as a not-for-profit, mission-driven hospice program, MJHS chooses to offer additional services like art and music therapy, supplementary Home Health Aides (HHA) hours for qualified patients/families, and spiritual support, that address the emotional wellbeing of our patients and their families. These invaluable services are made possible through charitable donations to MJHS Foundation.

If you are looking for a hospice program with a strong tradition of caring for patients with compassion, dignity and respect, we hope you’ll remember that MJHS is here. It would be an honor for us to care for you and your family during such a crucial period, allowing you to make the most of your time together. Please feel free to contact MJHS with your questions about hospice care.