Does Medicare Cover Hospice?
- January 12, 2024
- Reviewed by John Krahnert
Medicare Part A does cover hospice services for those who qualify, but it doesn’t cover everything. For example, Part A doesn't cover room and board, ambulance transportation or curative treatment you receive while in hospice care.
If you have a Medicare Advantage plan (also called Medicare Part C), you still get your hospice benefits from Medicare Part A. Your Medicare Advantage plan may offer benefits that Original Medicare (Part A and Part B) doesn't cover.
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How does Medicare cover hospice?
Typically, hospice care is given in your home, but it may also be covered in a hospice inpatient facility. Some of the hospice services that may be covered by Medicare include:
- Doctor services
- Nursing care
- Medical equipment such as walkers or wheelchairs
- Some prescription drugs (for symptom control or pain relief only)
- Short-term respite care
- Hospice aide and homemaker services
- Physical and occupational therapy
- Social worker services
- Speech-language pathology services
- Dietary counseling
- Grief counseling for you and your family
- Short-term inpatient care (for pain and symptom management)
Medicare does not cover room and board, ambulance transportation or treatment intended to cure your illness or a related condition while in hospice care.
How long does Medicare pay for hospice?
Technically speaking, Medicare will pay for an unlimited number of days of hospice care. But there’s a little more to it than that.
To be approved for hospice coverage, you must be given a life expectancy of six months or less. Once approved, Medicare begins its hospice coverage with two 90-day benefit periods that will take you until the end of that six-month time frame. If you still require hospice care after six months, you must be re-approved for a 60-day benefit period.
There is no limit to the number of 60-day benefit periods for which Medicare will cover your hospice care, but each one must be approved.
Does Medicare cover 24-hour hospice care?
Yes, Medicare Part A provides coverage for inpatient hospice care in a hospital, skilled nursing facility or hospice center in which health care professionals are available around the clock. Hospice care administered 24 hours per day is only considered medically necessary by Medicare when the patient’s symptoms are severely limiting or continuous.
Medicare does not cover 24-hour hospice care in the home, but it does provide coverage of doctors and nurses to be on call in case help is needed at any time.
Who is eligible for Medicare hospice coverage?
To be eligible for hospice benefits, you must be enrolled in Medicare Part A and meet all of the following conditions:
- Your primary care doctor and your hospice doctor certify that you are expected to live six months or less
- You are no longer seeking care to cure your illness and are instead accepting palliative care (for comfort)
- You sign a statement choosing hospice care instead of other treatments for your illness and related conditions
Does Medicare Part B include hospice coverage?
Hospice care is covered under Medicare Part A. However, Medicare Part B may provide coverage for certain items that are used during at-home hospice care such as walkers or wheelchairs, portable oxygen equipment, and other items that qualify for Part B coverage as durable medical equipment.
Does Medigap cover hospice?
Medigap, or Medicare Supplement Insurance, does not specifically cover hospice care. However, a Medigap plan may pick up the cost of some of your out-of-pocket responsibilities during hospice care.
Medicare Part A deductibles, copayments, and coinsurances charged to the patient for hospice services may be covered in part or in full by a Medicare Supplement Insurance plan, depending on the plan you have.
Does Medicare Advantage cover hospice care?
Medicare Advantage plans provide the same benefits as Original Medicare (Medicare Part A and Part B). However, one exception is hospice care.
If you are enrolled in a Medicare Advantage plan, you still receive your hospice care coverage from Medicare Part A.
Unlike Original Medicare, which is administered by the federal government, Medicare Advantage plans are sold by private insurance companies.
To learn more about Medicare Advantage plans and to compare Medicare Advantage plans that may be available in your area, call today to speak with a licensed insurance agent.
About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
