St. Gabriel's Hospice and Palliative Care

Who Will Pay For Hospice Care?

Whenever any type of medical care is placed upon a person, the patient asks him or herself:  1) How much will it cost? and 2) Who will pay it?  When it comes to hospice care, there are various means, by which, hospice-care costs can be paid.  The four most common would include Medicare, Medicaid, the VA Administration, and individual health insurance. 

Let's take a closer look at the various sources that provide financial coverage for hospice care:

Through the Medicare Hospice Benefit, patients have their costs covered which would include a full scope of medical and support services for the patient's life-limiting illness.  More than 90% of hospices in the US are certified by Medicare.  Even if one remains in a Medicare Advantage Plan (HMO or PPO) or other Medicare Health plan, the hospice benefit is intended to cover everything related to the terminal illness.  The hospice benefit allows the patient to remain in the comfort of his or her home.  Care can be provided in any setting, however; and if in-patient care at a hospital is required at some point for the terminal illness or related conditions, the cost of that care is covered by the hospice benefit.  A hospice provider must make any arrangement for inpatient care, or one could be responsible for the entire cost of the hospital care. 

Once the hospice benefit starts, Original Medicare will cover all costs related to the terminal illness; though the care must be from a Medicare-approved hospice provider.  Additionally, once the hospice benefit begins, Medicare will not cover care from any provider that was not set up by a hospice medical team.  As a side note:  Medicare Supplement Insurance, or Medigap, will cover your hospice costs for drugs and respite care.      

Through the Medicaid Hospice Benefit, those with limited income and assets have their hospice expenses paid, in most states.  The medicaid benefits for hospice care, almost, duplicate those benefits offered by the Medicare Hospice Benefit program.  Medicaid will work with the person and their family to ensure needed hospice services, equipment and supplies are provided which can include physician's services, nursing care, physical therapy, drugs for pain relief, social worker services, spiritual counseling, short-term inpatient care, and much more. 

Veteran's Health Administration
If one is enrolled to receive health care services from the VA as a qualified veteran, one is eligible for hospice care through the VA.  VA hospice coverage is very similar to that of the Medicare Hospice Benefit program, and is arranged and coordinated with a VA social worker at the facility where one receives their health care.

Individual Health Insurance
A number of private health insurance companies provide, at least, some coverage for hospice care.  As would be expected, there are certain stipulations and variances with qualifications among different insurers; and speaking with your insurance agent would be extremely important to glean all the details.

Free or Reduced Coverage
A less-common source that absorbs hospice-care costs is free or reduced coverage.  This type of financial assistance caters to those who do not have insurance coverage and do not have the financial means to pay for hospice services.  Some hospices provide this free or reduced coverage on a sliding scale, with the money having been sourced from grants, private donations and other means.

Regardless of who pays for hospice services, it is comforting to know that patients have access to a hospice nurse and doctor at any time, day or night, to provide support and care when needed.     

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