Does Medicare Cover Palliative Care?

Yes, palliative care may be covered by Medicare if it is medically necessary. Palliative care is medical care focused on pain management/relief and improving quality of life for those who are ill.

Medicare Part A typically covers palliative care as part of hospice care for terminally ill patients. However, it’s also possible for patients who are not terminally ill to receive palliative care as part of treatment for a disease or condition. Medicare may cover such palliative care if a doctor says it is medically necessary.

Smiling home health care nurse talking with a patient

What is the difference between hospice care and palliative care?

Hospice care and palliative care are often confused and used interchangeably. However, they are different:

  • Hospice care provides end-of-life support for terminally ill patients who have decided to stop curative treatment for their disease or condition.

    Medicare beneficiaries are usually eligible for hospice services if a doctor certifies they have six months or less to live.

    Palliative care — which is designed to alleviate pain and make patients more comfortable — is just one component of hospice care. It can also include a wide variety of other end-of-life services delivered by a hospice care team, including medical equipment and supplies, social work services, grief and loss counseling for families, spiritual support and other services.
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  • Palliative care isn’t exclusively a hospice care service. Palliative care may be used in conjunction with curative treatment for a number of chronic conditions.

    A cancer patient undergoing chemotherapy may need palliative care to help him or her deal with the side effects of the chemotherapy treatment. However, they are still actively pursuing curative treatment, unlike a hospice patient.

Medicare may cover palliative care if a doctor says it is medically necessary, even if it is not part of hospice care. Patients suffering from chronic diseases such as cancer, amyotrophic lateral sclerosis (ALS), kidney failure, heart disease, lung disease, Alzheimer’s disease, HIV/AIDS, and others may be candidates for palliative care, for example.

Always check with your doctor and Medicare provider (whether it is Original Medicare or a Medicare Advantage plan) to see if the palliative care you are considering is covered.

Find a Medicare Advantage plan today

Medicare Advantage plans are private alternatives to Medicare Part A and Part B (Original Medicare). By law, they must cover the same benefits as Original Medicare. If you receive hospice care, you will still receive it from Medicare Part A, however.

To find a Medicare Advantage plan in your area, call a licensed insurance agent at TTY Users: 711 24 hours a day, 7 days a week.

 

Learn more about what Medicare covers

 

1 National Institute on Aging. What Are Palliative Care and Hospice Care? (May 17, 2017). Retrieved from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care.

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