Search Site
Menu
Understanding Medicare’s Hospice Benefit

Medicare’s hospice benefit covers any care that is reasonable and necessary for easing the course of a terminal illness. It is one of Medicare’s most comprehensive benefits and can be extremely helpful to both the terminally ill individual and his or her family, but it is little understood and underutilized. Understanding what is offered ahead of time may help Medicare beneficiaries and their families make the difficult decision to choose hospice if the time comes.

The focus of hospice is palliative care, which means helping people who are terminally ill and their families maintain their quality of life. Palliative care addresses physical, intellectual, emotional, social, and spiritual needs while also supporting the terminally ill individual’s independence, access to information, and ability to make choices about health care.

To qualify for Medicare’s hospice benefit, a beneficiary must be entitled to Medicare Part A, and a doctor must certify that the beneficiary has a life expectancy of six months or less. If the beneficiary lives longer than six months, the doctor can continue to certify the patient for hospice care indefinitely. The beneficiary must also agree to give up any treatment to cure his or her illness and elect to receive only palliative care. This can seem overwhelming, but beneficiaries can also change their minds at any time. It’s possible to revoke the benefit and reelect it later, and to do this as often as needed.

Medicare will cover any care that is reasonable and necessary for easing the course of a terminal illness. Hospice nurses and doctors are on-call 24 hours a day, 7 days a week, to give beneficiaries support and care when needed. Services are usually provided in the home. The Medicare hospice benefit provides for:

  • Physician and nurse practitioner services
  • Nursing care
  • Medical appliances and supplies
  • Drugs for symptom management and pain relief
  • Short-term inpatient and respite care
  • Homemaker and home health aide services
  • Counseling
  • Social work service
  • Spiritual care
  • Volunteer participation
  • Bereavement services

Services are considered appropriate if they are aimed at improving the beneficiary’s life and making him or her more comfortable.

Because the beneficiary is electing palliative care over treatment, there are things the hospice benefit will not cover:

  • Treatment to cure the beneficiary’s illness.
  • Prescription drugs other than for symptom control or pain relief.
  • Care from a provider that wasn’t set up by the hospice team, although the beneficiary can choose to have his or her regular doctor be the attending medical professional.
  • Room and board. If the beneficiary is in a nursing home, hospice will not pay for room and board costs. However, if the hospice team determines that the beneficiary needs short-term inpatient care or respite care services, Medicare will cover a stay in a facility.
  • Care from a hospital, either inpatient or outpatient, or ambulance transportation unless it arranged by the hospice team. The beneficiary can use regular Medicare to pay for any treatment not related to the beneficiary’s terminal illness.

To download Medicare’s booklet on the hospice benefit, click here.

 

Client Testimonials
  • "In October 2009, my fiancé (and future wife) and I wanted to have estate documents prepared. Upon the recommendation of friends, we contacted an elder law firm in Sarasota, FL. We were assigned to Teresa K. Bowman, an estate planning and elder law attorney. Over the course of several months, she helped us to develop and refine our documents to our exact specifications and requirements, with our complete satisfaction. During the next few years, various modifications to our documents were required, and she helped us to implement these changes, always with absolute professionalism and precision, and with a warm, friendly manner. Incidentally, Teresa Bowman, serving in the role of Justice of the Peace, presided over our wedding ceremony in May, 2010. It was the first wedding ceremony she had ever performed, so we trust that it is just as memorable an event for her as it was for us. In 2014, when Teresa Bowman established her own Estate Planning and Elder Law practice, we, of course, transferred our accounts to her new firm. She has since implemented additional modifications to our estate documents, with the same high level of service that we have come to expect and appreciate. We would have absolutely no reservations in recommending Teresa Bowman and her firm to anyone who has need of the services she renders." - Robert G. and Judith L. Hores

Awards & Achievements
Reviews & Ratings
  • google
    5.0/5.0

    I have been lucky enough to work with Teresa and her team with several clients and find her service and advise to be consistently of the highest of standards. She is a pleasure to deal with and nothing is ever too much trouble for her. I cannot recom...

    Read more

    rob galkoff

  • google
    5.0/5.0

    Teresa is easy to talk to and is understanding of the situation brought to her. I would highly recommend her for your legal representative.

    Read more

    Theresa Wheeler

  • google
    5.0/5.0

    Teresa and Paula have been helping us with setting up a POA and all of our mother’s paperwork and will be filing for Medicaid for her for us. They really are very helpful and explain things in laymen’s terms.

    Read more

    Beth Williams

  • google
    5.0/5.0

    Great team to work with. Questions answered in layman's terms!

    Read more

    Rita Zuchelli

  • lawyers
    5.0/5.0

    Teresa Bowman and her entire team were very easy and pleasurable to work with. Every question was answered in an non-condescending manner and discussed thoroughly in layman's terms.

    Read more

    Client

See all reviews
Contact us

Quick Contact Form