How Medicare Works with Hospice Care | San Jose Elder Law Attorneys

Hospice care is a special service in which a person who is nearing the end of their life can receive comfort and support in a dignified manner. This service is generally available for those who have a life expectancy of six months or less. The care a person receives in hospice does not simply address their physical needs but also seeks to fulfill their social, emotional, and spiritual requirements as their life draws to a close. Hospice can be invaluable for allowing a person to focus on what truly matters to them.

If your loved one requires hospice care, you may have concerns about the costs of the service and who will pay for it. Fortunately for those who are currently enrolled in Medicare, their coverage will probably take care of many of the costs associated with hospice care.

Medicare Hospice Benefit

As long as a patient uses a Medicare-approved hospice program, the Medicare Hospice Benefit covers 100 percent of required services in the hospice plan of care, and there is no deductible. Costs covered include palliative medication, necessary equipment and supplies, and inpatient services if that is necessary. (For some medications, there may be a small co-payment, not to exceed $5, for which the patient will be responsible.) 

The benefit also pays for the team of professionals who will be providing care to the patient. This includes:

  • Doctors
  • Nurses
  • Social workers
  • Bereavement counselors
  • Spiritual support counselors
  • Certified home health aides

Who Is Eligible for Hospice Benefits?

To qualify for hospice benefits, a person must be eligible for Medicare Part A. Furthermore, they must receive a certification from a doctor that states that they have six months or less to live. 

Medicare-approved programs typically provide care at the home or nursing home of the patient. However, inpatient services are also available in some cases. This arrangement is typically for patients who have severe symptoms that are not possible to relieve at home. These symptoms can include:

  • Nausea and vomiting
  • Severe pain
  • Severe anxiety
  • Shortness of breath

Medicare covers the costs of inpatient care until the symptoms are under control, with the goal of returning the patient to the comfort of their own home.

Costs Not Covered by Medicare Hospice Benefit

It is important to recognize that there are certain costs that the patient will need to take care of in another way. Medicare Hospice Benefit does not pay for:

  • Nursing home room and board
  • Medications unrelated to the terminal condition (These would still need to be covered by the patient’s Medicare Part D plan with the usual cost-sharing requirements.)
  • Hearing aids
  • Routine dental care
  • Vision care

How Long Does Hospice Care Continue?

Hospice care will continue for the patient as long as the patient’s doctor or the hospice medical director re-certifies the terminal illness.

Contact a San Jose Elder Law Attorney Today

If you or a loved one are considering entering hospice and have further questions about how Medicare can assist with end-of-life care, speak to an attorney with experience in the areas of estate and elder law. They will be able to help you make the necessary arrangements so that you can focus on the things that really matter to you.  

If you live in California and need assistance getting started, we invite you to contact our San Jose elder law firm or one of our many other law firms located throughout the state by calling (800) 244-8814.

If you have any further questions about asset protection planning and strategies to shield your wealth, or if you’d like to have your current asset protection plan reviewed to make sure it still meets your needs, please contact us at our California asset protection office at 800-244-8814 to set up a consultation.

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