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Do Medicare or Medicaid Cover Hospice?  

When your loved ones need to enter hospice care, there are many different concerns for family members. One of the top issues is often determining how to pay for hospice and trying to understand the various benefits and options that are associated with your specific coverage. While Medicare and Medicaid often cover hospice, there are some considerations to keep in mind before relying on these payment options. The good news is that you can often find alternative funding for hospice, so you are able to confidently make the right decisions for your loved one during this final phase of life.

Medicare and Medicaid for Hospice: How it Works

With hospice, doctors have generally exhausted all options for helping the patient prolong their life and are simply looking for ways to make their final months or years more comfortable through pain management. Nearly half of Americans with a terminal illness are placed in hospice care, making it vital to understand how these two insurance options can work together — and the out of pocket costs you can expect during hospice care.

  • Medicare Part A, also known as Hospital Insurance, provides hospice care for eligible Americans when your doctor certifies that you are terminally ill with an expected life span of fewer than 6 months. You may also have the option to choose hospice care instead of undergoing additional treatments for certain illnesses. While the care itself may be paid for, your room and board may not be covered if you are accepting hospice care in a facility such as a nursing home or other inpatient facility.
  • The Medicaid hospice benefit is an optional state plan that provides for physician services, counseling, nursing, and other social services to individuals that are terminally ill. Just as with Medicare, individuals accepting a Medicaid hospice treatment must acknowledge that they are no longer attempting to treat their illness, but are instead trying to provide pain management either in the home or in a treatment facility. Medicaid coverage includes various payments for routine home care, continuous home care, inpatient respite care, general inpatient care, and service intensity add-on care.

Navigating the world of insurance as it relates to hospice care can be confusing, but the caring professionals at Santé are here to help. Whether your loved one needs home health care or hospice, our team-based approach provides you with a wealth of knowledge and experience to provide an exceptional continuum of care. Contact the team at Santé at 480-563-2402 for more information or to schedule a one-on-one interview to learn more.

Note: Please check with your individual insurance plan for more information.

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