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Do Medicare/Medicaid and Private Insurance Cover Hospice?

by Viki Kind, End-of-Life Expert
January 08, 2015

Question: What aspects of hospice is covered under Medicare, Medicaid and private insurance?

Answer:

All hospice benefits are covered by Medicare, Medicaid and private insurance.  Even if you don’t have insurance, hospice companies will provide you hospice services.  Hospice pays for any necessary medical equipment, a hospital bed, oxygen, medications relating to palliative care, a visiting nurse, doctor, social worker, chaplain, home health aide, as well as volunteers, etc. 

Hospice does not cover life-prolonging medications or treatments.  (The hospice rules are slightly different for pediatric patients).  Hospice also doesn’t cover full-time care in the home.  Hospice is sometimes given in a special place, but oftentimes, the services are given in the patient’s home, assisted living, board and care, or skilled nursing facility. 

To get hospice benefits, the hospice doctor will evaluate the patient and if he or she meets certain medical criteria and is considered sick enough to die in the next six months, then the person should qualify.  But just because someone qualifies for hospice doesn’t mean that the person will absolutely die in the next six months.  Many people live for years because of the great care they get from hospice.  Not only does the patient benefit from the services and support, the family does as well. 

Viki Kind is a clinical bioethicist, professional speaker, and hospice volunteer. Her book, The Caregiver’s Path to Compassionate Decision Making: Making Choices For Those Who Can't,” guides families and professionals through the difficult process of advocating for those who can no longer speak for themselves. She has recently launched a DVD that includes a template to create a quality-of-life statement.

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