Who Pays for Hospice?
‘Who pays for hospice?’ It’s a very common question. And it’s a very good question. If you are considering hospice care for someone you love (or maybe for yourself), you have a lotof things to think about. Worrying about how you are going to pay for hospice care should not be one of them.
At Ohio Valley Hospice, we strive to provide exceptional care for our patients and their families. This begins with providing education and resources to ensure everyone involved understands what to expect when choosing our hospice services. That being said, we want to dive into how hospice is paid for.
Medicare Part A covers hospice through the Medicare Hospice Benefit, which states you pay nothing for hospice care. To qualify for hospice care, a hospice doctor and your own doctor (if you have one) must certify that you are terminally ill. This means you have a life expectancy of 6 months or less, should the disease run its natural course. When agreeing to hospice, you will sign a statement that confirms you are choosing hospice care rather than other benefits Medicare covers to treat your terminal illness and related conditions. Simply put, you are agreeing that you are choosing comfort care instead of curative treatment.
- All items and services necessary for pain relief and symptom management
- Medical, nursing, aide, social, and spiritual services, as well as grief counseling for you and your family
- Drugs for pain management
- Durable medical equipment for pain relief and symptom management
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. It also pays for hospice care for terminally ill individuals in many states. Similar to Medicare, hospice services through Medicaid include:
- Medical social services
- Physician services
- Counseling services for the patient and their family/caregivers
- Short-term inpatient care
- Medical appliances and supplies
- Home health aide and homemaker services
- Physical therapy
- Speech-language pathology services
To qualify, a hospice provider must obtain a physician certification that a patient is terminally ill, and hospice services must be reasonable and necessary for the management of the terminal illness and related conditions. A hospice plan of care must be established prior to services being provided.
The Department of Veteran Affairs (VA) covers hospice care for Veterans who are in the final phase of their lives. They work closely with community and home hospice agencies to provide care in the home. Since hospice is part of the VHA Standards Medical Benefits package, all enrolled Veterans are eligible for services as long as they meet the clinical need for service.
There are no copays for hospice care, whether it is provided by the VA or an organization with a VA contract.
Private Health Insurance
Many private insurance companies provide some coverage for hospice care. Check with your insurer to determine whether hospice is covered. Qualifications and covered benefits vary based on the private insurer.
What if you don’t have insurance?
If you don’t have insurance coverage and cannot afford hospice care, it may be provided free of charge through financial assistance such as donations, gifts, grants, or other community sources.
Still Have Questions?
Please feel free to contact us if you’d like more information about how hospice care is paid for. Our team is always here to answer any questions you may have.