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Medicare FAQ: Frequently Asked Questions About Hospice Care Under Medicare

Just the Essentials

  • Hospice, or palliative care, is designed to improve the quality of life for patients with terminal illnesses, who are approaching the end of life. It involves pain and symptom management, as well as a variety of other services like homemaking and grief counseling.

  • Hospice is covered at no cost under Original Medicare, and is usually performed at the patient’s home.

  • Hospice is not euthanasia: it does not hasten death, nor does it require a DNR order. You are free to leave hospice at any point to resume curative treatment. 

Entering Hospice Can Be a Difficult Time

It’s natural to have a lot of questions when you or a loved one are entering hospice. Even though this is meant to be a comforting time, anxiety and uncertainty are normal. This hospice care FAQ is designed to address some common concerns and help you understand the role Medicare plays in the palliative care process. 

What Is Hospice Care?

Woman taking mug of beverage from tray held by nurse.

Hospice, or palliative care, is a type of end-of-life care designed to ease the symptoms of those with terminal illnesses. Entering hospice means that you are no longer seeking to cure your condition, but instead are focusing on making sure your remaining time is as comfortable as possible. 

Hospice services include, but are not limited to:

  • Skilled nursing care
  • Skilled therapy services
  • Aides and homemaker services
  • Medicine for pain and symptom relief
  • Durable medical equipment
  • Social services for patients and their families
  • Grief counseling
  • Respite care

Am I Eligible for Hospice Care?

Hospice is end-of-life care, which means it’s designed for terminal illnesses. This can include cancer, heart disease, dementia, various forms of organ failure, or other illnesses likely to lead to death. Under Medicare, hospice is meant to last the final six months of a person’s life, though it can be extended depending on the progression of the illness. 

To determine eligibility, you will need a referral from your regular doctor and a hospice doctor. Note that your primary doctor will not usually recommend hospice unless prompted. This is not because hospice is bad, or ill-advised. Doctors are in the business of treating illness, while entering palliative care means refusing further treatment and choosing instead to focus on comfort and quality of life. They may bring up the topic of hospice for consideration, but they are under no obligation to, and will never ‘prescribe’ it. The choice to enter hospice is left entirely to the patient or their designated proxy. 

Will I Die Sooner in Hospice?/Do I Need a DNR to Be in Hospice?

Hospice is not euthanasia. It does not hasten the speed of death, nor does it delay it. Instead, it focuses on improving the patient’s quality of life through pain and symptom management.  In fact, there is anecdotal evidence of hospice patients living longer than projected. 

You do not need a Do Not Resuscitate (DNR) order to be in hospice care. In fact, it is illegal for hospice providers to discriminate against people without DNRs.

Does Medicare Cover Hospice care?

Woman having hand held by nurse for support

Hospice services are covered under Medicare Part A, and are one of the few medical services offered at no cost to beneficiaries. There are only three exceptions to this rule:

  • Prescription drugs meant to manage pain or symptoms have a $5 copay. You will be asked to stop taking drugs related to treating your illness (like chemotherapy) upon entering hospice. Medicine unrelated to hospice, such as anxiety medication, is not covered.
  • You pay 5% of the approved amount for in-patient respite care, which cannot exceed your Part A deductible. 
  • Medicare will not cover room and board outside of respite care. 

Does Medicare Pay for Hospice at Home?

Medicare covers palliative care at home, or wherever you live. In fact, in-home care is the default assumption. While dedicated facilities for hospice do exist, Medicare does not cover room and board beyond normal hospital stays and respite care.

Will a Nurse Be With Me at All Times?

Woman sitting with book as nurse sits near her, smiling at camera.

No. While you will be able to contact your hospice team at all times and can expect a good deal of support during hospice, primary care duties are left to friends, family members, or privately contracted professionals. 

Am I Allowed To Go to the Hospital/See a Doctor While in Hospice?

To enter hospice care, you need to end curative treatment for a specific, terminal condition. However, you are still able to seek medical treatment for other, unrelated conditions, including regular injury and illness.

For instance, if you were in hospice care for breast cancer, you could still undergo dialysis treatments. However, if you were in hospice for end-stage renal disease, you would not be able to get dialysis. If you injured yourself and needed a hip replacement, you would be able to seek treatment in either case. You are required to sign a statement before entering hospice, which should inform you of which services you are refusing.

What if I Spend More Than Six Months in Hospice?

If you’ve made it through your normally allotted six months of hospice care, your hospice director will review your case and determine if hospice is still appropriate, or if you should resume curative care

Am I Allowed to Leave Hospice?

You are free to leave hospice and resume curative treatment at any time. Contact your hospice team if you wish to return to curative treatment.

If you have any further questions about Medicare and hospice, we’re here to help. Our team of licensed insurance agents can help you answer any questions you may have, and refer you to services and plans that may be able to expand your hospice coverage. Call us today at (800) 950-0608 to learn more.

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