Who Pays for Hospice

How Medicare Coverage Works for Hospice Care

Hospice care services are covered by Medicare Parts A and B. Medicare Part A provides up to 100% coverage for hospice care that is related to a terminal illness.

For other hospice services, Medicare Parts A and B apply. That means that depending on deductibles and co-payment requirements, there may be some out-of-pocket costs.

Take note that Medicare coverage applies regardless of the setting of care. So, whether a patient is receiving at-home care or is at a nursing facility, Medicare will cover expenses.

It is important to know, however, that Medicare’s coverage does not extend to room and board at a nursing facility. That is where Medicaid coverage comes into play.

To receive Medicaid coverage for room and board, a patient must meet the eligibility requirements set by the state of Georgia.

A Medicare Advantage Plan, like an HMO or PPO, is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) benefits.

Original Medicare covers all Medicare-covered services you get while on hospice care, even if you were previously in a Medicare Advantage Plan or other Medicare health plan. Once you choose hospice care, your hospice benefit covers most of your needs.

Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions.

You can choose to get Medicare covered services that aren’t part of your hospice care through your Medicare Advantage Plan or through Original Medicare. If your plan covers extra services that aren’t covered by Original Medicare (like dental and vision benefits), your plan will continue to cover these extra services as long as you continue to pay your premium.