As caregivers and individuals learn how hospice care can help patients live with a life-limiting illness in San Diego, how hospice is paid for is a common question asked, but shouldn’t be a barrier in accessing this vital resource. Medicare provides a comprehensive hospice benefit that helps to cover the cost of hospice care. In addition, most private health plans, Medi-Cal, TRICARE and HMOs provide some form of coverage for hospice care as well.

The Medicare Hospice Benefit is covered under Medicare Part A. Medicare beneficiaries who choose hospice care receive a full scope of medical and support services.

Services covered by the Medicare Hospice Benefit include:

• Visits by the hospice team
• Medical supplies (like bandages and catheters)
• Medications related to the hospice diagnosis
• Home health aide and homemaker services
• Medical equipment (like wheelchairs or walkers) 
• Dietary counseling
• Grief support

According to the National Hospice and Palliative Care Organization, more than 90% of hospices in the United States are certified by Medicare. Eighty percent of people who use hospice care are over the age of 65, and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the person or family.

Services not covered by the Medicare Hospice Benefit include:

• Treatment intended to cure the illness.
• Care given by another healthcare provider that was not arranged for by the patient’s hospice provider; and
• Care from another provider which duplicates care the hospice is required to provide
• Medications not directly related to the hospice diagnosis
• Nursing Home Room and Board

Questions regarding insurance coverage or hospice care

If you have questions regarding insurance coverage for hospice care, or if hospice care is appropriate for your situation, talk with your healthcare provider or contact your local hospice program for more information. Trained specialists will help in answering your questions to assist you in making an informed decision regarding hospice as a healthcare resource.