Hospice FAQ's
What Criteria Must I Meet in Order to have Medicare Pay For Hospice Care?
Who is eligible for Medicare hospice benefits? Hospice care is covered under Medicare Part A (Hospital Insurance).
You are eligible for Medicare hospice benefits when:
● You are eligible for Medicare Part A ; and
● Your doctor and the hospice medical director certify that you are terminally ill and probably have less than six months to live; and
● You sign a statement choosing hospice care instead of routine Medicare covered benefits for your terminal illness*; and
● You receive care from a Medicare-approved hospice program.
*Medicare will still pay for covered benefits for any health problems that are not related to your terminal illness.
What is Hospice?
How Does Hospice Work?
Hospice is provided by Medicare for terminally ill persons with less than 6 months to live. Your physician must certify to Medicare that this is your situation.
Then what happens?
Volunteers who are trained to help with everyday tasks, such as shopping and personal care services, like bathing and dressing. Speech, physical, and occupational therapists and other persons who are trained to give care will be assigned to you as needed.
A family member or other caregiver will be with you every day and members of the hospice team will make regular visits. A nurse and a doctor are on-call
24 hours a day, 7 days a week to give you and your family support and care when needed.
If you should need care in a hospital for your illness, the hospice team
will help arrange your stay. There is also respite care available, in which you can go to the hospital for 5 days to give your family member or caregiver a rest.
Even though a hospice doctor is a regular part of the hospice team, you can choose to use your own doctor, who is not a part of the hospice, to get care. The hospice will work closely with your regular doctor to give you the care that you need.
If you qualify for hospice care, you can get medical and support services, including nursing care, medical social services, doctor services, counseling, homemaker services.
In many cases, you and your family can stay together in the comfort of your home. Depending on your condition, you may have hospice care in a hospice facility, hospital, or nursing home.
Hospice care is covered under Medicare. To be eligible for Medicare hospice benefits, you must meet certain criteria.
See “What Criteria Must I Meet for Medicare to pay for Hospice?”
What Hospice Services Does Medicare Pay For?
Provided you are certified as eligible by your physician, Medicare covers these hospice services:
● Doctor services
● Nursing care
● Medical equipment (such as wheelchairs or walkers)
● Medical supplies (such as bandages and catheters)
● Drugs for symptom control and pain relief
● Short-term care in the hospital, including respite care, i.e. short term (5 days) care in a hospital in order to give the primary caregiver a break.
● Home health aide and homemaker services
● Physical and occupational therapy
● Speech therapy
● Social worker services
● Dietary counseling
● Counseling to help you and your family with grief and
loss
You must use a Medicare certified company to be eligible for Medicare.
You will only have to pay part of the cost for outpatient drugs and inpatient respite care
