The Medicare Hospice Benefit was enacted in 1983 to provide Medicare coverage to those beneficiaries who required comprehensive care at the end of life.
Any patient who is eligible for Medicare is eligible to elect the Medicare Hospice Benefit if they meet the following conditions:
- Have Medicare Part A, and
- Be certified by your doctor and the hospice medical director to have a terminal diagnosis with a prognosis of six months or less if the disease runs its normal course according to his/her best guess, and
- Sign a statement choosing hospice care in lieu of other Medicare-covered benefits to treat the terminal illness, and
- Get care from a Medicare-approved hospice program.
A patient may revoke the Hospice Benefit and return to regular Medicare coverage at any time.
Medicare will still pay for covered benefits for health problems that aren't related to your terminal illness.
Medicare will pay for these hospice services for your terminal illness and related conditions:
- Physician services
- Nursing Care
- Medical equipment (hospital bed, wheelchair, oxygen)
- Medical supplies (wound care supplies, catheters)
- Drugs for symptom control and management
- Home health aide and homemaker services
- Physical and occupational therapy (as a comfort measure)
- Speech therapy
- Social worker services
- Dietary counseling
- Grief and loss counseling for you and your family
- Short-term inpatient care
- Short-term respite care
- Any other covered Medicare services needed to manage your pain and other symptoms
Medicare will not pay for:
- Treatment intended to cure your terminal illness.
- Prescription drugs to cure your illness rather than for symptom control or pain relief.
- Care from any provider that wasn't set up by the hospice medical team.
- Room and board
- Care in an emergency room or other inpatient facility, unless it's arranged by your hospice medical team.
- Ambulance transportation, unless it's arranged by your medical team.
Hospice care is provided in periods of care. You can receive hospice care for two initial 90-day periods followed by an unlimited number of 60-day periods. At the beginning of each period of care, the hospice medical director must recertify that you are still terminally ill, so that you can continue to get hospice care. You may live longer than six months and continue to get hospice care, as long as a hospice medical director recertifies that you are terminally ill.
This information was obtained from the Centers of Medicare and Medicaid Services. More information can be found on their website www.medicare.gov/publications and type in keyword hospice.