What Medicare covers

You can get a one-time only hospice consultation with a hospice medical director or hospice doctor to discuss your care options and management of your pain and symptoms. You can get this one-time consultation even if you decide not to get hospice care.

Medicare will cover the hospice care you get for your terminal illness and related conditions, but the care you get must be from a Medicare-approved hospice program.

Important: Once you choose hospice care, your hospice benefit should cover everything you need. Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions, but this is very rare.

Hospice care is usually given in your home. Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:

  • Doctor services
  • Nursing care
  • Medical equipment (like wheelchairs or walkers)
  • Medical supplies (like bandages and catheters)
  • Prescription drugs
  • Hospice aide and homemaker services
  • Physical and occupational therapy
  • Speech-language pathology services
  • Social worker services
  • Dietary counseling
  • Grief and loss counseling for you and your family
  • Short-term inpatient care (for pain and symptom management)
  • Short-term respite care
  • Any other Medicare-covered services needed to manage your terminal illness and related conditions, as recommended by your hospice team

What Does the Medicaid Hospice Program Cover?

Hospice services are covered as part of your Medicaid benefits. Services are provided by a team to meet your needs. The hospice team may include you, your family, and others who can help meet your physical, psychosocial, spiritual, and emotional needs. Your needs are written in a plan of care, also called a plan.

The benefits listed below are examples of hospice services you may receive:

  • Physician services provided by the hospice agency;
  • Nursing care;
  • Medical equipment;
  • Medical supplies;
  • Drugs for symptom control and pain relief;
  • Hospice aide and homemaker services;
  • Physical therapy;
  • Occupational therapy;
  • Speech-language pathology services;
  • Social worker services;
  • Dietary counseling; and,
  • Short-term inpatient care for pain control, symptom management, and respite care.

Hospice benefits may also include anything needed to manage your terminal illness and related conditions that is normally covered by Medicaid. The following hospice services must be provided directly by hospice employees:

  • Nursing care;
  • Physician services;
  • Medical social services; and
  • Counseling.

Other hospice services may be provided, such as visits by a physician who specializes in your illness. Hospice benefits may be different in each State. Check with your State Medicaid agency about hospice benefits in the area.

Private Insurance

Most insurance plans issued by employers and managed care plans cover hospice care benefits. The coverage is similar to Medicare benefits, however there may be some differenced in coverage.  Contact us for more information about private insurance hospice care coverages.