Does Medicare Cover End-of-Life Care?
End-of-life care, also known as palliative care, is specialized health care that provides support and medical services for patients who are going through life-ending illnesses. Palliative care focuses on the physical comfort of the patient, the mental, emotional, and spiritual needs of the patient and family members, and everyday tasks that still need to be completed like paying bills or caring for pets or houseplants.
Entering hospice (palliative or end-of-life) care is an emotional and stressful time for patients, family members, and their friends, so it’s important to know what to expect and what Medicare insurance covers during these difficult times.
Does Medicare cover end-of-life care?
Hospice care is covered by Original Medicare Part A (hospital insurance). Even if you have a Medicare Advantage (Part C) plan, your hospice care reverts to Medicare Part A coverage. If you have other medical care outside of hospice care while you’re in hospice, your Medicare Advantage plan typically continues to cover it.
To be eligible for Medicare-covered hospice care, you must meet the following criteria:
- Your physician and your hospice physician both certify that you’re terminally ill with a life expectancy that doesn’t exceed six months.
- You agree to receive only palliative care regarding your life-threatening illness (rather than curative care).
- You sign a statement declaring that you choose hospice care rather than other types of treatment for your illness and related conditions that would otherwise be covered by Medicare.
Original Medicare Part A covers Medicare-certified palliative care in hospices, nursing homes, or other medical facilities that accept Medicare assignment. You can also receive your hospice care in your own home if you choose.
If you choose to enter hospice care, your Medicare benefits may cover the following services:
- Physician services
- Nursing services
- Medical services
- Durable medical equipment needed for pain relief and symptom management
- Medical supplies
- Prescription drugs needed for pain and symptom management
- Homemaker and aide services
- Physical, occupational, and/or speech-language pathology therapy
- Social services
- Dietary counseling
- Spiritual counseling for you and your family members
- Grief counseling for you and your family members
- Inpatient care for pain and symptom management (on a short-term basis)
- Inpatient respite care (You may have to pay five percent of the Medicare-approved amount for inpatient respite care. This copayment mustn’t be more than the inpatient hospital deductible for the year though.)
Medicare pays 100 percent of the cost of hospice care. However, you may have to pay for room and board if you’re living in a nursing home or similar type of facility while getting hospice care.
You may also be charged a copayment of no more than $5 for prescriptions of outpatient drugs. However, you may have coverage for these drugs through your Medicare Part D plan, if you have one.