When choosing a hospice care provider for a loved one, concerns about the cost and duration of the entire service naturally arise. Medicare is the premier health insurance. It offers coverage for elderly health needs and disabilities that people face. Hospice care is also covered under its umbrella.
One of the most asked questions that healthcare providers face when suggesting Medicare-covered hospice is – how long will Medicare pay for hospice care? People also worry about the coverage of services. Also, how much will it set back their pockets?
In this article, we will take a close look at Medicare, and how you can extract maximum benefit from the box of benefits it offers.
What is Medicare?
Medicare is a national health insurance program in the United States, that covers the healthcare needs of people aged 65 or older and younger people affected by disabilities. Approximately 67 million individuals are covered by its remit. One of the largest insurance programs by spending in the entire world, Medicare can require funding of as much as $900 billion.
The program is divided into several parts:
- Part A covers hospital, nursing, home health, and hospice.
- Part B is concerned with outpatient services, durable medical equipment and most of the prescription drugs.
- Part C services cover all the advantages of Part A, Part B, and often, Part D. These are generally known as Medicare Advantage Plans.
- Part D generally covers self-administered prescription drugs.
Initially debuting in 1965, today, it is managed by the Center for Medicare and Medicaid Services (CMS).
How Medicare Hospice Benefits Work?
First of all, to meet the basic requirements for Medicare-covered hospice care, you must meet the following conditions:
- Your hospice doctor and your regular doctor certify that you have six months or less to live. The certificate by a regular doctor is only needed if you have engaged one.
- You sign a statement declaring that you choose to forgo treatment of your condition in exchange for palliative care.
- You sign a statement waiving off the Medicare coverage of your terminal illness, instead choosing to receive Medicare coverage for hospice.
Important to note here is that you have the right to change your mind at any time and start receiving treatment for your terminal illness again. It will not change how long Medicare will pay for Hospice Care. However, it is advisable to make your mind up in advance so that complications don’t arise further down the line.
Your Hospice Care Team
Your hospice care team includes you and your family members. It may also include:
- Doctors
- Nurses
- Counselors
- Social Workers
- Pharmacists
- Therapists
- Language Therapists
- Hospice Aides
- Homemakers
- Volunteers
These work closely together to monitor your health and provide any additional services that the situation may demand.
Finding a Hospice Provider Under Medicare
To avail of the Medicare benefits, you must strictly choose from a list of Medicare-approved hospice providers. Alternatively, if you belong to Medicare Plan C, you can ask your plan to help you find a suitable hospice provider. They are obliged to do so.
Hospice Services Covered by Medicare
Depending on your insurance plan, your underlying condition, and any related conditions, your Medicare coverage for hospice may include:
- Doctor Services
- Nursing Services
- Medical Equipment
- Prescription Drugs
- Aide and Homemaker Services
- Physical and Occupational Therapy
- Speech-Language Pathology Services
- Social Worker Services
- Dietary Counselling
- Grief and Loss Counselling
- Short-Term Inpatient Care
- Short-Term Respite Care
- Any other Medicare-covered services recommended by your hospice team.
How Long Will Medicare Pay for Hospice Care?
Your hospice begins with two 90-day benefit periods. At the start of each of these periods, your doctor must recertify your terminal illness. If you exhaust the initial two periods, you can avail of unlimited 60-day benefit periods. At the start of each of these periods, your doctor must recertify.
To extract maximum benefits from your Hospice Care plan, you must know about services that are not covered under Medicare:
- Treatments that intend to cure your condition.
- Prescription drugs that doctors don’t recommend for your terminal illness or any related conditions.
- Third-party care providers that your hospice team did not set up.
- Accommodation expenses.
Your Hospice Expenses Under Medicare
The original Medicare covers your hospice entirely, and there are no deductibles that you need to pay. In tandem with this, you’ll need to pay:
- Your monthly Medicare Part A and Part B premiums.
- A copayment of $5 per prescription for all prescription drugs.
- 5% of the Medicare-approved amount for inpatient respite care.
Summing it Up
Medicare has comprehensive coverage for almost all the services that any patient may need during hospice. Plan A, Plan B, and also Plan C of the program cover this service. Having no deductible means you can focus on providing the best care for your loved one. Medicare will take care of all the expenses. We hope that you have found the answer to how long will Medicare pay for Hospice Care.
Work closely with your healthcare and insurance providers to choose the best hospice care plan.
