who pays for hospice care at home?

Who Pays for Hospice Care?

Insurance Coverage for End-of-Life Comfort Care

Hospice care helps your loved ones live their best lives possible during their final days, weeks, and months. It is the much-needed support of the mind, body, and spirit.

Hospice is specialized care that can include nursing, social work, home health aides, and chaplain services, not to mention the emotional and social support that comes with it. Hospice services focus on upholding our patients’ dignity and providing compassionate care for patients of all ages.

Paying for hospice care at home sometimes poses a challenge. Some families are puzzled by the question, “How do I pay for hospice care at home?” Let’s discuss a few sources that can cover the funds for the service, including federal and private insurance plans and more. 

Understanding Hospice

Who Qualifies for Hospice Care?

Who Qualifies for Hospice Care

To be eligible to receive hospice care, a patient must have a terminal diagnosis with a life expectancy of six months or less.

They must have ceased curative treatment and are focused instead on quality of life.

Finally, the patient’s physician must order a hospice evaluation in order to have their patient admitted for services with a hospice provider, either at home or in a care facility.

Most patients are eligible for an insurance benefit that covers all their hospice-related expenses. There are three types of insurance plans we will look at, along with other options for people without insurance or whose medical insurance doesn’t cover hospice care. 

Conditions that qualify a patient to receive hospice care can include cancer; heart, lung, renal, or liver disease; dementia; COPD; Alzheimer’s; stroke; ALS or multiple sclerosis; HIV, and nutritional problems, sometimes called “failure to thrive.”

Paying for Hospice Care with Medicare

A frequently-asked question arises when it comes to Medicare and whether it can cover the costs of hospice care at home. The short answer is yes. Medicare patients are eligible to have hospice care costs covered, provided they meet the criteria for receiving hospice care.

Although the criteria state that a terminal illness with a life expectancy of six months or fewer is required, hospice care can be longer if your hospice doctor decides it is medically necessary.  

Medicare covers the costs of hospice care at home or in a facility with no out-of-pocket expenses. The service is fully covered by the insurance plan as long as it relates to the terminal diagnosis and involves no payments out of your pocket. The Medicare hospice benefit offers the following:

  • Hospice care services:
    • Nursing and medical services
    • Social services
  • Medication:
    • Drugs for pain management 
    • Medical supplies
  • Equipment:
    • Necessary equipment for pain relief and symptom management 
  • Short-term inpatient care (as long as it takes place in a Medicare-approved hospice facility)

Respite care for a family member or a hospice caregiver

Paying for Hospice Care with Medicaid

Medicaid is another government program available to many Americans from low-income families. The program also pays for hospice care at home and has similar eligibility criteria to Medicare. However, coverage can vary from state to state.

Even if you don’t currently have Medicaid, you could qualify for coverage due to life-limiting illness and the inability to work.

Like Medicare, you will not pay any out-of-pocket costs for hospice care with Medicaid. Medicaid also covers room and board in certain facilities that accept Medicaid patients.

Paying for Hospice Care with Private Health Insurance

Depending on your plan, your private insurance plan could cover the costs of hospice care. Some coverages may pay in full, while others may cover only select expenses. As for any insurance, you should check the criteria to determine whether the patient can benefit from it.

If you are unsure of whether your private insurance will cover hospice, contact your plan provider or talk to an insurance specialist at Phoenix Home Health Care.

Get in Touch with Phoenix Home Care & Hospice for More Information About Hospice Care

Hospice care near me

Phoenix Home Care and Hospice is dedicated to helping you and your loved ones live with comfort and dignity while we provide for your mental, physical, and spiritual health. Hospice care at home lets your loved ones stay in a familiar place filled with heartwarming memories, while living with dignity after a terminal diagnosis.

Contact us today to discuss hospice care in detail.

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