When considering hospice care for a loved one, cost is a common concern for many families. The good news is that most hospice care is covered by Medicare or Medicaid. Let’s take a second to clarify details regarding how much hospice care costs, what’s covered by Medicare/Medicaid, and what isn’t.
How Much Does Hospice Care Cost?
Most hospice care patients are eligible for Medicare or Medicaid. Both of these programs will usually pay 100% of hospice care costs, regardless of whether the patient is at home or in a healthcare facility. Not only does this include costs associated with the team of individuals that provide care for you, but also any costs associated with any medications or durable medical equipment the patient needs.
For many, this can sound too good to be true, and though most costs are covered, hospice care can vary from case to case. Be sure to speak with your hospice provider for direct answers to any of your questions on costs, or for more specific details regarding your loved one’s needs.
Determining Eligibility for the Medicare Hospice Benefit
Medicare completely covers hospice care costs, but only if your loved one is eligible to receive the benefit. In order to be eligible for the Medicare hospice benefit, your loved one must meet the following criteria:
- Be at least 65 years old, or younger than 65 with a disability
- Be eligible for Medicare Part A benefits
- Have a life-limiting, chronic condition
After these criteria are confirmed, your loved one (or caregiver) will need to sign a statement choosing hospice care instead of other Medicare-covered benefits aimed at rehabilitation of the condition. They’ll also need to ensure they choose a hospice care service provider that is approved by Medicare.
Types of Hospice Care that Medicare Will and Won’t Cover
So you know that Medicare covers all hospice care costs — but what services are actually included in that? The answer depends on your loved one’s unique needs and the specialized care plan that is built to fulfill them. Here’s a list of the services and products hospice care will cover for your loved one if their care plan calls for them:
- Products and services needed for pain relief and symptom management
- Medical, nursing, and social work services
- Home health aide and volunteer services
- Prescription medications for pain management (with no more than a $5 copay for each)
- Durable medical equipment
- Spiritual care and grief counseling for your loved one and family
- Any other form of care that your loved one’s doctor or hospice director deems necessary
However, once your loved one signs the statement choosing hospice and their benefit starts, they’ll no longer be able to receive some other Medicare-covered benefits. The healthcare services that Medicare won’t cover during hospice care include:
- Any treatment aimed at curing their condition, including prescription medications
- Any care from service providers that was not set up by their hospice team
- Any care in a hospital inpatient or outpatient facility, or ambulance transportation
- Any room and board costs in a healthcare facility
Medicare vs. Medicaid Hospice Benefit
The Medicaid hospice benefit functions very similarly to the Medicare hospice benefit. The same hospice services are covered, and the same non-hospice services aren’t covered. The only difference between these two programs is that Medicaid is available for those who do not qualify for Medicare.
Get Quality, Affordable Hospice Care at West Michigan Hospice
At West Michigan Hospice, we believe in going above and beyond to provide quality hospice care for each patient — and we’re happy to say that most of the costs associated with it are fully covered by Medicare or Medicaid. This way, you can enjoy making valuable memories with your loved one without suffering any financial stress. For more information on how we can help, contact our team.