Medicare and Hospice

Find out When Medicare Helps Pay for Hospice Care


What It Is

Hospice care for terminally ill patients, at home or in a hospice inpatient facility or hospital.

What's Covered

Medicare Part A covers hospice care, including nursing, personal care, medication, and respite care, provided by a Medicare-certified hospice. To qualify, a treating physician must certify that the patient has a terminal illness and probably has less than six months to live.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for hospice care, contact the plan directly.

What Medicare Pays

Medicare Part A pays the full Medicare-approved amount for hospice care. The patient is responsible only for up to five dollars for each prescription medication provided by hospice. For each day the patient is a hospice inpatient in a hospital or hospice facility, the patient must pay a co-payment of 5 percent of the Medicare-approved amount for that inpatient hospice care.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

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14 Comments So Far. Add Your Wisdom.

Anonymous said over 1 year ago

thanks


over 1 year ago

I'm worried about my father in law .My husband & I moved in with him to take care of him. His wife died in May 2012. He has congeital heart desease. He fell a couple of months ago and craked a couple of ribs on the left side. The Dr put him on Cumitin. I my self don't like this medication. Well 2 weeks ago at 2am he went to get out of bed & his feet slipped out of bed (his feet were on the floor) when he got up his feet went out from him & he fell backwards and landed on his shoulder and all the weight 175 pounds fell in the bed. He waited till 4am before he woke my husband. We took him straight to the hospital. It takes us a hour to get there, When we got to emergency his arm and hand was swelled & black & blue.They took x-rays , brain scan and when we got back to the room I couldn't beleive how black & swelled it was. I was shocked because he never all the time he has fallen he never has been in this condition. The Dr. infromed me that the cumintin was what caused the brusing and swelling. They kepted him in the hospital over night to watch him. He stayed 5 dayed .He got fluid in the lungs they took out 1,000 cc out . He has a-fib. Now he is in rehab.He has fluid back in the lungs. They don't know what it is. They are nice but they don't have bed rails so I'm scared he is going to fall . If he got hurt just falling in bed what will happen when he falls , I don't want to dicuss the rails. I want to know about Hospice . He is can't controll his urine and bowels. and in the night he gets up and goes to the bathroom and says he need his underware. He uses diapers. He has dementia but what do we think He is 90. My husband and I are both handicap. We can't change his diapers and when he falls we can'ck him up. I want to know if he would be able to go to Hospice ? Thanks


almost 2 years ago

My husband is in a Hospital tonight, this is the fourth time in three weeks. He is 86 years old and his poor body has been thru so much. The Doctor say he is in a fragile state and any operations are out of the question because he would not be able to survive them. Tonight the Doctor suggested Palliative Care by Hospice to help him deal with his end of life situation. He is such a good man with warm hands and a giving nature. He is 86 and I am 80, we have been married for nine years and knew out time together would not be long but I don't want him to go, I am not ready to be without him and it is breaking my heart. I kid around with him and make him laugh but inside I am in pain. I have two wonderful son's who live out of State and they do all they can to help us but they have families and jobs and problem's they don't talk about so how can I burden them with mine? They have always respected their Step-Father and treated him well, I am so proud of them. Now it is just me and my old Teddy Bear, Freddy to hang onto. I just wanted to tell somebody how I feel, thank you for the opportunity to do so. He has the beginning of Dementia and is deaf in one ear but never complains. At least we have a wonderful nine years, hope we have more time together.


almost 2 years ago

Hello all....I am new to this site, and it really seems like this is going to be a big help..to all of us..to help our Mother through this crisis, and needs..Thank You and gob Bless all of you, as I know how hard this is on all of you!


almost 3 years ago

Knowing of the care and support of this fine! organization, "hospice". I was going to the bereavement group in 2005 and found everyone to be very supportive.


Anonymous said almost 3 years ago

I am printing out these pages for future reference.


over 3 years ago

Hi jdb, Thank you for your comment. If you'd like to do some more research about hospice in your area, you can do so in our local directory here: ( http://www.caring.com/local/hospices ). As for your Medicaid troubles: each state runs its own version of Medicaid, with slightly different rules and coverage. To get one on one advice about Medicaid, contact a government health insurance counselor. You can find your local government health insurance counselor in our local directory: ( http://www.caring.com/local/government-health-insurance-counselors ). If you'd like to learn more about Medicaid, check our our article How Medicaid Works: ( http://www.caring.com/articles/how-does-medicaid-work ) I hope that helps! Take care -- Emily | Community Manager


over 3 years ago

my husband and I have been exploring hospice options in our area for his 91 year-old mother. She has had a couple of strokes, has COPD and other cardiovascular issues. She is very frail and on oxygen most of her waking hours. Ideally we would like to keep her in her home but she would need round the clock supervision. There are some decent hospice facilities in the area but they're very expensive. She has very limited resources and Medicare and Medicaid can be very confusing. It's hard to get straight answers. We're the sole caregivers in our late 50's & early 60's and have a 16 year-old....any advice?


Anonymous said over 3 years ago

What Medicare pays and the patient's responsibility.


over 3 years ago

Hi Acidegirl, losing a loved one is always difficult, especially when it's a parent. If you'd like to help prepare yourself for your mother's passing, you can check out our End of Life section located here: ( http://www.caring.com/end-of-life ). Though you may not be grieving now, we also have a wonderful section all about grief, here: ( http://www.caring.com/grief ). In addition to these resources, we have an End of Life forum where you can talk to others about how you feel about losing a loved one, ( http://www.caring.com/forums/end-of-life-forum ). I hope these resources help even just a little bit. Take care of yourself. -- Emily | Community Manager


over 3 years ago

My mother is 83 years if age and has been in a nursing home since 12/17/2010. She has ALZ and is in mid servere stage. Diagnosed in 2007. My concern is that I don't know if I will be ready for her passing.


over 3 years ago

After being in pain for at least two years, my mother--who lives in rural KY-- was diagnosed with stage 4 terminal Adenocarcinoma (lung cancer) in March 2010. She has underwent 7-8 rounds of chemo and radiation once. The last round of chemo almost killed her. Her white cell count was at 0.2!! Lately she's been in severe pain and seeing double vision, and I found out today (Dec. 3 2010) that she now has an inoperable tumor in her brain behind her sinus cavity--most likely causing the vision problems. She was giving roughly 3 months and is starting hospice care on Monday, Dec. 6 2010. I've come to accept that I probably will never see her again-- I live in the DC area and finances are strapped-- but I still can't come to terms with the fact that my 20 month old son, who my mother's only met once, will grow up not knowing his paternal grandmother. I am glad that she will finally be comfortable and pain-free for the first time in years.


almost 4 years ago

My mother in law is 96 and has Lymphoma. She lives in NJ but the majority of the family lives in the Philly and York areas. Can I get her into a local York Hospice? She is terminal and has announced that she wants to pass on and it would be good for her and the rest of us to be there with her .


over 4 years ago

my husband is at this time in a nursing home,and in a hospitalfor elder care,, i hope to bring him home under hospice care....


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