How Long Will Medicare Cover Hospice?

Medicare Benefits Solutions
Jan 24, 2022

Modern hospice care was first created in 1967, and it works to improve the quality of life while providing comfort for anyone who is in the last phases of a terminal illness. For anyone who is not currently looking for treatment for their condition, hospice works to relieve your symptoms and give you pain relief. Additionally, it can help give spiritual and emotional support to both patients and their families. 

Medicare will cover the costs of hospice care in the United States if it takes place at the patient’s home or at an inpatient facility. If a family member, someone in your care, or yourself has a terminal illness, you’ll want to know all of the information regarding Medicare benefits and hospice care. 

Hospice care and Medicare coverage

Any Medicare recipient who has Medicare Part A under Original Medicare can get coverage for hospice if they have a certification from their doctor that states they have a life expectancy of six months or less. You also have to sign a statement that says you’re choosing to go into hospice instead of pursuing treatment options for your illness. You can also decline hospice benefits after you start your care, and you can sign up once again any time you like. 

If you have a Medicare Advantage plan, you’ll also have coverage for hospice care because Original Medicare covers it. You may also get additional benefits, but it will depend on which type of policy you picked out. Even though Part A and Part B offer full coverage for hospice, you might have to pay a copayment for any prescription drugs you get while you’re getting care in your home. It shouldn’t exceed $5.00 per medication. You might also be responsible for paying 5% of the Medicare-approved amount for any respite care as an inpatient. 

If you don’t have Medicare insurance or any other type of insurance coverage, you’ll find out that hospice care costs are high. The average cost for this type of care in some facilities is right around $10,000 per month. The final costs will depend on what care level you need. For at-home care, you’ll generally pay $150 a day, and general inpatient care runs around $500 a day. 

How long Medicare covers hospice care

When people who have Medicare coverage sign up for hospice care, their health care provider has to certify that they have six months or less to live. This is why many people believe that Medicare will only cover hospice care for six months. However, this isn’t the case. Once the six months pass, you can keep getting hospice care if a doctor or the director of the hospice facility recertifies that you’re terminally ill. 

You can initially get coverage for two 90-day periods under Medicare. After these two periods, you can get unlimited coverage for hospice in 60-day increments. When the very first 90-day period starts, your doctor has to certify that you have a terminal illness and you’re not expected to live past six months. They’ll have to do this at the start of each subsequent benefit period. The recertification process is what allows you to stay on hospice care and get coverage. For every new benefit period for your hospice care, you have the right to switch your hospice providers once. 

If you don’t need hospice because your illness went into remission or you have a health improvement, you can stop this care. You can also terminate the care at any time you wish. If you want to stop it, you have to sign a dated form stating so. 

If you’re someone who requires hospice care, or if a loved one does, you want to know all of the essential facts about Medicare Part A benefits and hospice care. Your hospice care provider or doctor can give you all the necessary details to ensure that you get the coverage you need.