Hospice Costs and Benefit Options

Because the decision to seek hospice care generates intense feelings-anxiety, isolation, grief and confusion, it is helpful to know that financial support is available. As with all other aspects of aging, understanding the financial obligations and benefits before the time of need can significantly lessen anxiety.

The costs associated with hospice care are predominantly (80-90%) covered by Medicare and Medicaid. Approximately 15% is paid by third-party health insurance and private pay is very rare.

Medicare Hospice Benefits

Medicare benefits are available when an individual meets all of the following conditions:

  • You are eligible for Medicare Part A, which is hospital insurance.
  • Your doctor and the hospice medical director certify that you are terminally ill and have six months or fewer to live if your illness runs its normal course.
  • You must sign a statement choosing hospice care instead of the Medicare-covered benefits to treat your terminal illness. Medicare will continue to pay for covered benefits for any health problems that aren’t related to your terminal illness.

Many individuals fear that accepting Medicare benefits for hospice care mean that they are no longer eligible for other medical benefits they may require, but this is not the case. It is vital for patients to be informed about all of their options so that they can make the most advantageous decision at this point in their lives.

According to the National Hospice and Palliative Care Organization’s Facts and Figures 2014 report┬áthere are more than 3,900 Medicare-certified hospices in the United States. The states with the most certified hospices include California, Texas and Pennsylvania.

Medicaid Hospice Benefits

Not all states cover hospice care through Medicaid. In those states which do, the Medicaid benefits parallel the Medicare benefit, although the exact amount will vary in certain states.

Veterans’ Hospice Benefits

Hospice, including home hospice care, is a covered benefit for all enrolled veterans. Visit The National Hospice and Palliative Care Organization for information concerning hospice benefits for veterans which include:

  • provision for needed hospice care for all levels, including in-home, respite, inpatient and crisis
  • inpatient hospital bed for use in the home
  • referral assistance to area community hospices and a designated hospice contact person
  • an interdisciplinary care consult team

Private Health Insurance

During the past 10 years, it has become more common for private health insurance policies to include a hospice benefit that covers some or all of the services provided under Medicare and Medicaid. Coverage, co-pays and eligibility requirements are insurance company specific.

Long-Term Care Insurance Hospice Benefits

It is likely that private long-term care insurance does include a hospice benefit. A policy holder would verify this and the limits of those benefits at the time of purchase.

The relatively recent introduction of hospice care in the United States, as well as the sensitive nature of the need for such service, can lead to misunderstanding and may consequently hinder the full power of hospice services. The evolution of hospice, through experience and education, has been remarkable and continues to grow as it becomes an accepted and sought-after aspect of medical care.

End-of-life issues are surely a challenge for every individual, their families and friends. It is somewhat comforting to keep in mind that, at the end of the day, no one is ever turned away from hospice care because of financial reasons.

Written by senior housing writer Marky Olson.