Medicare News: Updates on Medicare Hospice and Palliative Care

Will Medicare pay for hospice care? If you’re currently in hospice, Medicare hospice benefits are available. Call us today at (800) 950-0608 to speak with a licensed insurance agent regarding Medicare hospice benefit options.

Choosing Medicare-Accredited Hospice Care Just Got Easier

If you’re currently utilizing hospice care, or you have, or have had, loved ones who require, or required, hospice care, you know how expensive it can be. The cost you pay out-of-pocket for your hospice and palliative care, or the care of a loved one, depends on a number of factors. Some of these factors include:

• How much of the cost health insurance is willing to cover
• The level of care needed
• The duration of care

Just searching for hospice and palliative care agencies that can handle your needs, or the needs of your loved ones, can feel like a long and frustrating task. If you or your loved ones are Medicare beneficiaries, your first instinct is to look for hospice and palliative care agencies that accept Medicare assignment.

This poses a set of questions: does Medicare cover hospice? Does Medicare cover palliative care?

The good news is that, yes, Medicare covers hospice. Medicare covers palliative care as well. The next hurdle is finding a reputable Medicare-assigned hospice care agency near you.

Well, it was a hurdle. Now, it’s easier than ever to find Medicare-assigned hospice and palliative care, thanks to a new initiative developed by the U.S. Department of Health and Human Services.

In this edition of Medicare News, we’ll take a look at HHS’ latest initiative to make ownership data for all Medicare-certified hospice and home health agencies available to the public. We’ll also explore what this means for you, your loved ones, and your Medicare hospice benefits.

Medicare Hospice and Palliative Care Benefits

Before exploring the HHS’ latest march toward hospice and home health transparency, it’s a good idea to remind yourself of the Medicare hospice benefits available and how they work. The same goes for Medicare palliative care benefits.

If you suffer from a terminal illness and are in need of hospice care, hospice and palliative care services are covered by Medicare Part A. Medicare Advantage plans will also provide the same Medicare hospice benefits as Original Medicare. Depending on your location and the company you’ve purchased your Medicare plan from, your plan may, in some cases, offer more Medicare hospice benefits than Original Medicare.

In order to receive Medicare benefits for hospice and palliative care services, you must meet certain qualifying conditions. The conditions that you must meet before Medicare will cover care through a Medicare-assigned hospice care provider are as follows:

• You must be enrolled in Medicare Part A
• A private physician or hospice doctor must certify you to be terminally ill with less than 6 months to live
• You must agree to palliative care (comfort care) only
• You must sign document that you are seeking hospice care over other covered treatment options

After meeting these conditions, Medicare may cover hospice care provided at home or in an inpatient facility*. Some of the things Medicare will cover for hospice and palliative care include:

• Medical equipment and supplies
• Care provided by doctors and nurses
• Prescription medications for symptom and pain management
• A physical and occupational therapist
• Grief and loss counseling, for both the patient and their loved ones
• Short-term inpatient or respite care

Medicare hospice benefits allow you to receive the palliative care you need at zero cost. The only costs you’ll need to meet Out-of-Pocket are a $5 copay for prescriptions and supplies, as well as a 5 percent copay for inpatient respite services.

HHS is Keeping Hospice and Home Health Care Agencies Accountable for Your Benefit

There are a number of new initiatives related to Medicare hospice benefits and Medicare palliative care benefits making the rounds in Medicare news. Recently, the Centers for Medicare and Medicaid Services (CMS) began cracking down on hospice fraud by requiring physicians ordering Medicare hospice services to be enrolled in the program or opted out before receiving pay. They’ve also been working with HHS on increasing transparency regarding hospice and home health agencies.

In an unprecedented move, HHS made available to all patients and potential patients ownership information for more than 17,000 hospice and home health agencies combined. This move makes it much easier for Medicare hospice and palliative care patients to choose care with an agency that will best meet their needs. As a patient, or the loved one of a patient, this means you now have more information at your fingertips when researching hospice care providers near you.

The HHS’ latest initiative only builds on previous data releases through CMS as an effort to increase transparency. The HHS information release in April 2023 follows:

• A CMS release of public data on mergers, acquisitions, consolidations, and ownership changes from 2016-2022 for hospitals and nursing homes that are Medicare-assigned (April 2022)
• A CMS data release regarding the ownership of Medicare-assigned nursing homes (September 2022)
• A CMS data release regarding the ownership of Medicare-assigned hospitals (December 2022)

You Have the Right to Secure Care That Works For You and Your Loved Ones

While finding a hospice and palliative care provider can seem tough, the new transparency measures taken by HHS have made it easier than ever. If you are a Medicare beneficiary, you now have access to more information than ever regarding Medicare-assigned hospice and palliative care providers near you.

Do you have questions about other Medicare hospice benefits? If so, our licensed insurance agents are here to help. Give us a call today to learn about Medicare plans that carry Medicare hospice benefits.