Who Pays for Hospice? Rarely the Patient or Family.
A loved one’s terminal diagnosis is one of the most difficult things a family will ever experience. In addition to the emotional toll it takes, as the loved one declines, they often require additional support and care.
Families can sometimes delay in setting up much needed care because they are concerned about added costs. In fact, “who pays for hospice care” is one of manycommon questions about hospice. It may surprise many families to learn that hospice care is available at little to no cost for the patient.
Who Pays for Hospice Care?
Hospice care is covered by Medicare, Medicaid, the Veteran’s Health Administration, and most private insurers. If a patient does not have coverage, Crossroads Hospice & Palliative Care will work with the patient and their family to ensure they receive the support they need.
Medicare Hospice Benefit.
According to the National Hospice and Palliative Care Organization, over 85% of hospice patients are covered by the Medicare Hospice Benefit. Hospice care is covered under Medicare Part A (hospital insurance) at 100%, so there is no cost to the patient or their family.
Medicare beneficiaries receive medical and support services related to their terminal illness. This includes the support of a hospice medical director, nursing care and hospice aide services, social work services, and bereavement counselling for the patient and their family. Patients also receive prescription medication to control symptoms related to their terminal diagnosis, medical equipment including wheelchairs or hospital beds, and medical supplies like bandages and incontinence supplies. The patient is also eligible for short-term respite care and additional services as recommended by the hospice team.
Patients are eligible to receive the Medicare Hospice Benefit if they have Medicare Part A, have been diagnosed with 6 months or less to live, and have elected to accept comfort care over curative treatments.
Hospice Care Through Medicaid.
Medicaid is a joint federal and state program providing free or low-cost health coverage to low income families, pregnant women, people with disabilities, and the elderly.
Hospice is covered by Medicaid at no cost to the patient. While some state Medicaid programs may have slightly different variables for eligibility, the majority of states have the same requirements for hospice care under Medicaid and Medicare: a diagnosis of 6 months or less to live and the patient must elect to receive comfort care over curative treatments.
Hospice Care Using Private Insurance.
Most private insurance companies offer full coverage for hospice care. While the majority of private insurance companies model their hospice coverage after the Medicare Hospice Benefit, it can vary. A person can contact their insurance provider to ensure that they understand what their insurance will cover and any possible costs including copays and deductibles.
Crossroads is committed to ensuring that patients received the support they need at end of life. Don’t let the question of who pays for hospice care delay much needed support. If you know someone who may be eligible for hospice care, please call Crossroads at 1-888-564-3405.
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