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End of Life

Insurance Options for Hospice Care

Reviewed by: MySeniorCare Staff
Last Updated: 4/15/2011 1:31:18 PM

When people think about hospice they tend to think of a type of health care facility, rather an approach to health care.

Hospice care actually refers to the type of care provided to patients in the final stages of life. It's for people of all ages, including the elderly, whose life expectancy has been reduced to the next six months.

Hospice care does not only take place in health care facilities. The fact is that only 10 percent of hospice care takes place in a facility, while the other 90 percent occurs in the patient's home, according to the Hospice Foundation of America.

Goals of Hospice Care

The main goal of hospice care is to treat the symptoms of a disease or condition of a terminally ill patient, rather than to try to abate or reverse the underlying condition.

Hospice Care & Insurance Coverage

Hospice care could include any one or a combination of services from the following professionals: Registered Nurses, medical social services workers, doctors, home care aides, senior companions, hospice volunteers, and physical or speech therapists.

Before working with hospice care, it's important to receive pricing and quotes in writing, for all services. Caregivers should also ask about methods of accepted payments for the provider, hourly rates and travel fees if applicable, and the billing methods used for medical supplies when they are not part of the initial pricing, according to the Hospice Association of America.

How to Pay for Hospice Care

A number of options for hospice care payments are available, including Medicare, Medicaid, private health insurance, out of pocket payments or Tricare and military service. In some cases, the hospice care may be provided free of charge for patients without financial resources.

Medicare. Since 1982, Medicare has covered hospice care for qualifying patients with less than six months to live, as long as the patient qualifies for Medicare Part A. (Medicare.gov). The six month coverage is provided in two 90-day increments.

Should the patient live past the initial six months life expectancy, the patient or caregivers may reapply, or "recertify" for benefits in 60-day increments, according to Medicare. Coverage is mainly for hospice care in the patient's home, there is a $5 co-pay for prescriptions, and a 5% co-pay for care per day according to the Health Care Financing Administration.

Medicaid. According to the Hospice Association of America, hospice care is covered under Medicaid in 48 states.

Private health care insurance, HMOs, Managed care plans. Hospice care is covered by most private health care insurance plans. Check with your health care insurance company for details about their hospice care coverage, including deductibles, out-of-pocket maximums and the percentage of the cost that they cover for nursing care, visits to a physicians, in-patient care, home care aides, medical appliances, prescription drugs and counselors or therapists.

Out of pocket. Caregivers and patients may also pay for hospice care using their own money from income, savings or investments.

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