Under Medicare, Hospice is seen as a comprehensive program for patients and families. Hospice provides all the reasonable and necessary medical and support services for the management of a life-limiting illness.
BASED ON THIS PHILOSOPHY, THE HOSPICE MEDICARE BENEFIT COVERS 100% OF THE FOLLOWING SERVICES:
SERVICES
HOSPICE COVERAGE
PATIENT COVERAGE
Short-term inpatient hospice care for acute and chronic symptom management
100%
0%
Prescription drugs for pain and symptom control
100%
0%
Durable medical equipment (hospital bed, wheelchair, etc)
100%
0%
Home visit by members of the Hospice Care Team (nurses, physicians, social workers, counselors)
100%
0%
Chaplaincy and pastoral counseling services for the patient and family members
100%
0%
Home health aides to do personal care of the patient and homemakers to perform household chores
Volunteers are available to provide friendly visits, respite sitting, running errands, transportation or other non-clinical services
100%
0%
Short-term inpatient respite care to give families a break from home care responsibilities
100%
0%
Continuous nursing care at home in periods of crisis
100%
0%
Bereavement care and counseling for family
100%
0%
WHO IS ELGIBLE?
The patient is eligible for Medicare Hospital Insurance (also known as Medicare Part A). The patient’s physician certifies that the patient has a life-limiting illness The patient signs a statement choosing hospice care. The patient receives care from a Medicare certified hospice program.
ARE OTHER MEDICARE BENEFITS AVAILABLE TO THE PATIENT IN ADDITION TO HOSPICE CARE?
When a person with Medicare chooses the Medicare Hospice Benefit, the Hospice Benefit replaces their standard Medicare benefits for the treatment of the life-limiting illness. A hospice patient can qualify for standard Medicare Benefits in addition to the Hospice Benefit if: The patient requires services for the treatment of a condition not related to the life-limiting illness, Medicare Part B continues to cover the services of the patient’s regular physician.
WHAT IS NOT COVERED?
All services for the treatment of the life-limiting illness must be provided by or through the hospice. When a person with Medicare chooses Hospice care, Medicare will not pay for:
Treatment for the life-limiting illness which is NOT for symptom management and pain control.
Care provided by another hospice or healthcare provider that was not arranged by the patient’s hospice.
Care from another provider which duplicates care the hospice is required to provide.
ADDITIONAL PAYERS MEDICAID COVERAGE
Medicaid benefits vary from state to state. Many states offer a Medicaid Hospice Benefit. In states that offer a Medicaid Hospice Benefit, it is patterned after the Medicare Hospice Benefit. To qualify for hospice benefits, you must meet certain income requirements and be a state-approved Medicaid recipient.
