Does Medicare Cover Palliative Care at Home?

Yes, Medicare covers palliative care at home for eligible beneficiaries. This type of care focuses on providing relief for individuals diagnosed with serious illnesses. Medicare benefits can help cover palliative care costs, lessening the financial burden of seniors and their loved ones when contracting at-home support.

Palliative care serves as a holistic approach to managing serious illnesses and chronic health conditions. It includes pain and symptom management, emotional support, spiritual guidance and assistance with decision-making about treatment options. Unlike hospice care, which typically involves individuals in end-of-life scenarios, palliative care proves beneficial at any stage of illness, alongside curative treatments.

Medicare Part B covers palliative care when provided by a team of health care professionals. This team includes doctors, nurses, social workers and licensed spiritual counselors. With these services, patients enjoy a high quality of life while receiving professional care that addresses their physical, emotional and psychological needs.

Medicare Part B provides coverage for palliative care services delivered at home. This service includes visits from health care providers, necessary medical equipment and prescription medications for symptom control. To qualify, a Medicare beneficiary must have a serious illness or chronic health condition and a referral from their primary care physician or another recognized health care professional, such as a registered nurse or a licensed therapist. Palliative care services covered under Medicare include:

 

• Physician and nursing care
• Social work services
• Physical, occupational and speech therapy
• Counseling and spiritual support
• Medications for symptom control and pain relief
• Necessary medical supplies
• Durable medical equipment

Medicare doesn't cover nonmedical care services, including help with activities of daily living, such as bathing or dressing, unless they are required by an individual's doctor-directed palliative care plan. 

Seniors and families considering palliative care at home should work with a medical provider who can coordinate a plan of care facilitated by a multidisciplinary team of health care professionals. This plan ensures the individual receives the care they need at every level, whether physical, emotional or psychological. Support groups and spiritual counselors can offer much-needed assistance during this challenging time. 

In some cases, coverage limitations can prevent individuals from accessing financing for all necessary services. In addition to Medicare, other resources may help seniors and their families cover the costs of palliative care. Seniors may explore utilizing Medicaid, long-term care insurance and supplemental Medicare policies, such as Medigap. While Medigap plans may not cover palliative care directly, they can cover deductibles, copayments and coinsurance for Medicare-approved services related to palliative care. Contact your local Aging and Disability Resource Center for further benefits counseling.