Does Insurance Cover Hospice?
If you're considering hospice care for yourself or a loved one, you may be wondering about the cost and whether insurance will cover it. Hospice care is covered by Medicare, Medicaid, and most private insurance plans. However, there may be some out-of-pocket costs associated with hospice care, such as copays or deductibles. It's important to check with your insurance provider to see what is covered under your plan.
Does Medicare Cover Hospice Care?
Yes—Medicare fully covers hospice for eligible patients. If you’re over 65 (or qualify due to disability) and enrolled in Medicare Part A, hospice care is included once your doctor certifies a life expectancy of six months or less and you opt for comfort care over curative treatment. Here’s what’s covered:
Medical Services: Nursing, doctor visits, and pain management.
Medications: Most hospice-related drugs come with a small $5 copay.
Equipment & Supplies: Hospital beds, wheelchairs, and oxygen, as needed.
Support Services: Counseling, social work, and spiritual care.
Note: Medicare doesn’t cover room and board if you’re in a facility like a nursing home—only the hospice services themselves. For full details about what Medicare covers, click here to visit their website. (https://www.medicare.gov/coverage/hospice-care)
Does Private Insurance Cover Hospice Care?
While most insurance plans have hospice benefits, every private insurance plan is different. When calling your insurance provider, be sure to ask about coverage and copays/deductibles for:
Nursing services in your home
Medication coverage
Respite care coverage
Coverage for rental equipment, like beds, wheelchairs, etc.
Coverage for other medical supplies required for your care
Physical, speech, and/or occupational therapies, if you require them
Of course, we take care of gathering all this information for Coastal Home Health & Hospice patients, so you don’t have to worry about remembering everything. Insurance can be complicated and confusing, but we strive to make the process as easy as possible for you.
Does Medicaid Cover Hospice Care?
Medicaid is a state-based program that provides health coverage to low-income individuals and families. As such, many people assume that Medicaid doesn't cover hospice care. However, this is not always the case. In fact, many states cover most types of hospice care through their Medicaid programs.
Typically, Medicaid coverage is very similar to Medicare. This page on the Medicaid.gov website has up-to-date coverage information. (https://www.medicaid.gov/medicaid/benefits/hospice-benefits/hospice-payments/index.html)
While there are many factors that contribute to the cost of hospice care, it is important to know your options when choosing a provider. By understanding your insurance coverage and its impact on costs, you can make an informed decision about where to receive hospice care.