How Much Does Hospice Care Cost?
Decisions involving end-of-life care are made every day. It’s important to make these decisions based not only on a patient’s needs but also on financial considerations
A common inquiry surrounding hospice is the cost of receiving this specialty care during the end of life’s journey. Medicare is the largest insurer of medical care provided at the end of life but hospice care is covered by other government and private entities. Some questions you may have surrounding the cost of hospice care are:
- Who’s eligible for Medicare’s hospice benefit?
- What will my hospice benefit cover?
- What won’t my hospice benefit cover?
- What if my hospice provider doesn’t accept my insurance?
During an already difficult and stressful time, hospice provides relief to the patient from painful symptoms and to families or caregivers from the monetary burden of healthcare. Hospice care is covered by various government entities, including Medicare, Medicaid and other healthcare programs such as the one sponsored by the Veterans Administration (VA) as well as private medical and long-term care insurance. Medicare is the largest insurer of medical care provided at the end of life.
Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) require that all medically necessary hospital and doctor care is paid for by Medicare, regardless of the cost or condition of the patient. The Medicare hospice benefit has paid for the care of eligible patients since 1982.
Who’s eligible for Medicare’s hospice benefit?
A patient must have Medicare Part A and meet all of the following conditions in order to be eligible to receive this benefit:
Be diagnosed with a terminal illness
Be certified by a doctor that life expectancy is six months or less
Accept comfort care instead of curative care
Have a Medicare-approved hospice provider
What will my hospice benefit cover?
Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:
- Doctoral and/or nursing care
- Medical equipment including wheelchairs, walkers and portable oxygen
- Medical supplies
- Hospice aide and social worker services
- Grief support for you and your loved ones
- Short-term inpatient or respite care
What won't my hospice benefit cover?
- Treatment intended to cure your terminal illness
- Prescription drugs (this excludes those for symptom control or pain management)
- Care from any provider outside of your hospice care team (however, you can still see your primary doctor if you elect them to supervise your hospice care)
- Room and board (however, if your hospice care team determines you need short-term inpatient or respite care that they arrange, Medicare will cover your stay in the facility)
You always have the right to stop hospice care at any time. According to Debt.org, Medicare provides care for two 90-day periods in hospice, followed by an unlimited number of 60-day periods. At the start of each period of care, a doctor must re-certify that a patient has six months or less to live.
Once a patient chooses hospice care, almost all the bills related to care of the patient’s terminal diagnosis are paid for by their health insurance. At Hospice of Southwest Ohio, we do a prior authorization application for all patients to determine whether we take your insurance or not. If we don’t take your insurance, we will see if we can obtain partial coverage or determine what we need to do to get credentialed so that we can take your insurance. The patient and family can rest easier knowing they are receiving excellent care without worrying about how to pay for it.