Medicare is the nation’s largest health insurance program, offering coverage to people over the age of 65, or to those under 65 who have been totally and permanently disabled for at least ten years. Below is an outline of everything you need to know about coverage for your hospice needs.
The world of Medicare can be a confusing journey, you don't have to navigate it alone-there's help. Medicare has clear guidelines for the compassionate care provided through hospice services. Hospice Care is not an everyday service or experience, so it’s normal to have many questions about what to expect.
How much of Hospice care is covered by Medicare?
Medicare covers everything you need for a terminal illness and there is no deductible. However, Hospice care must be covered by a Medicare-approved hospice provider. Services include:
Physician services
Nursing services
Physical and occupational therapy
Speech-language pathology services
Dietary counseling
Short-term inpatient care (for pain and symptom management)
Social Services to connect you with local Community Resources
Medical equipment (e.g wheelchairs, walkers)
Medical supplies (e.g bandages, catheters)
Prescription drugs
Hospice Aide & Homemaker Services
Grief and loss counseling for you and your family
Short-term respite care in a Medicare-approved facility to help family caregivers take a break
What is required for Coverage?
For Hospice care you need Medicare Part A. The first two benefit periods last 90 days each, followed by an unlimited number of 60-day periods. To continue hospice care for each period, a doctor must confirm that you are terminally ill. Your doctor will determine if you meet the following conditions:
Your hospice doctor and your regular doctor (if you have one) to certify that you’re terminally ill if you’re expected to live six months or less.
You accept palliative care, for comfort, instead of care to cure your illness.
You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions. Please remember that only your hospice doctor and your regular doctor (if you have one) can certify that you’re terminally ill and have six months or less to live.
You always have the right to stop hospice care for any reason, and you can go back on hospice at any time.
What would I need to pay?
Medicare covers almost everything you need related to your terminal illness. Original Medicare will cover services for any health problems not related to your terminal illness.
The few costs you can expect are as follows:
Your monthly Medicare Part A and Part B premiums
A copayment of up to $5per prescription for outpatient drugs for pain and symptom management
5 percent of the Medicare-approved amount for inpatient respite care if your loved ones need to take a break from caring for you at home
A plan in two parts
Medicare is made up of two components: Part A, and Part B.
Part A at a glance:
You are eligible for Part A when you turn 65 if you or your spouse has paid in enough quarters while working.
It is sually available at no cost to you.
Helps pay for inpatient hospital care as well as hospice
If you did not pay Medicare taxes, you may be able to buy Part A.
Part B at a glance:
You can purchase Part B when you turn 65.
You or another payer, such as Medicaid, pay a monthly premium.
Part B also includes some hospice provisions.
Helps pay for doctor’s services, outpatient hospital care, some medical services and some home healthcare.
Part B covers outpatient hospital visits and some medical services that Part A does not.
How to find coverage
Anyone can make a Referral to hospice care. You don’t have to wait for a doctor.
Call Goldencare Hospice and Palliative Care at (855)655-0500 anytime 24 hours a day, seven days a week to speak with a Registered Nurse who can help determine if hospice care may be an option for you or a loved one and find services in your area. We are here to answer your hospice care questions.
You can also call 1-800-MEDICARE (1-800-633-4227) to find the number of your state hospice organization. TDD/TYY users can call 1.877.486.2048.
Medicare Source:
1. Medicare.gov
3. Medicare Part B: State Health Benefit Plan Enrollment website
Medicare Part A: What Part A covers
Medicare Part B: What Part B covers
10. Local Help for People with Medicare in Georgia: Counseling Locations
Medicare/Medicaid Enrollment Highlights:
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