Does Medicare Pay for Hospice in an Assisted Living Facility?

Medicare Part A pays for hospice in an assisted living facility if you or your loved one meets the eligibility requirements. To receive hospice benefits through Medicare, your health care provider must certify that you have a life expectancy of less than 6 months. You must also sign a statement indicating that you want to receive only comfort care rather than treatment for the terminal illness. In most cases, the hospice provider will visit you in the assisted living community to provide services.

Medicare covers an initial consultation with a hospice care provider so you can decide whether you’re ready for this level of care. If you move forward with hospice, Medicare covers 100% of the cost outside of your plan premiums. You may be responsible for a $5 copayment on each medication prescribed for pain control and symptom management.

Your hospice provider will develop a personalized plan of care based on your specific needs. It can include:

• Medical and skilled nursing services
• Durable medical equipment
• Medical supplies
• Prescription drugs
• Home aid services
• Physical and occupational therapy
• Social services
• Nutrition counseling
• Grief and spiritual counseling for you and your family

If you still need hospice after 6 months, you can apply for recertification. Medicare will continue to cover these services as long as your health care team attests you remain terminally ill.