Does Medicare Cover Hospice?

Although Medicare does cover some hospice services for those who qualify, it does not cover all services, including room and board in a hospice residential facility or nursing home.

A Medicare Supplement (Medigap) plan can help cover hospice costs you might be required to pay out of pocket, such as Medicare deductibles, coinsurance, copays and more.

Medigap plans can help cover hospice care costs like Medicare deductibles, coinsurance and copays.

What Hospice Services Does Medicare Pay For?

Hospice helps maintain the quality of life for a person who has a disease or illness that is unlikely to be cured.

Hospice is a unique form of health care that focuses on care, not treatment. Health experts consider hospice a model for quality and compassionate care.

When one chooses hospice, he or she benefits from a team-oriented response, with support that includes pain management, emotional support and spiritual support.

Hospice is usually provided at one’s home, but may also be provided at a hospice inpatient facility.

Medicare typically pays for hospice care that can include:

• Physician services
• Nurse services
• Medical equipment and supplies
• Prescription drugs that limit and control pain
• Homemaker services and hospice aides
• Occupational therapy and physical therapy
• Speech-language pathology care
• Counseling on one’s diet (nutrition therapy)
• Grief counseling for the patient and the patient’s family

Does Medicare Have Hospice Coverage Limits?

Medicare covers several hospice care services, but not everything.

Some hospice services that Medicare does not cover include:

• Treatment designed to cure one’s terminal illness
• Care from a hospice provider that wasn’t arranged by your hospice team
• Room and board in your home or in a nursing home or hospice inpatient facility
• Outpatient care
• Transportation by ambulance

What Part of Medicare Covers Hospice, How Much Does It Cover?

Medicare Part A should provide coverage for most of your hospice care. However, you may need to pay for prescription drugs that offer pain relief and symptom control.

In most cases, the Medicare copayment for each prescription drug is capped at $5. 

You may also need to pay 5% coinsurance costs of the Medicare-approved amount for respite care. Respite care is temporary care provided at a nursing home, hospital or hospice inpatient facility, in order to provide rest for a caregiver.

Medigap Plans Can Help Pay for Hospice Care

Medicare Supplement Insurance can help pay for certain Medicare out-of-pocket costs — including deductibles, copayments and coinsurance.

Each of the 10 standardized Medigap plans available in most states offers coverage for Medicare Part A hospice care coinsurance or copays.

A licensed agent can help you decide on a Medigap option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

Learn more about Medicare coverage of common procedures.