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.

 

Awards & Achievements
Reviews & Ratings
  • 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

  • lawyers
    5.0/5.0

    Teresa K. Bowman, P.A. is both professional and personable. Her expertise and experience are invaluable. Her ability to understand my needs and her patience in communicating made working with her very worthwhile.

    Read more

    Client

  • lawyers
    5.0/5.0

    Teresa knows her stuff. My parents have been working with Teresa's practice for a number of years and I have recently been taking over their financial management. She has been patient, personable, and insightful in helping me assume this new role...

    Read more

    Client

  • lawyers
    5.0/5.0

    I have referred multiple clients to Teresa over the past few years and I have received positive feedback from each client in regards to how Teresa was able to handle their specific situation. She is able to make a complicated process easy and always ...

    Read more

    Client

  • lawyers
    5.0/5.0

    My wife and I went to Teresa for our wills, Power of attorney and medical directives. She made a difficult process almost seamless and now I have the peace of mind if anything happens to me or my family we are protected. I highly recommend her and h...

    Read more

    Client

See all reviews
Contact us

Quick Contact Form