Medicare and Hospice Coverage

The inclination to call hospice usually comes once you have decided you no longer want to receive aggressive treatments that may allegedly cure your terminal illness. An alternative reason may be that your doctor has determined the efforts being made are ineffective, and the best option would be to contact a hospice service provider for assistance. Most assume hospice is covered 100% by Medicare, and in many cases, this is true.

Medicare covers a plethora of services while receiving hospice care such as medications, durable medical equipment (e.g., hospital beds, wheelchairs, and air mattresses) and incontinence supplies are just to name a few; however, let us examine components the Medicare Hospice Benefit does not cover:

  • Treatment intended to cure your terminal illness and/or related conditions. Please remember that you always have the right to stop hospice care at any time.
  • Prescription drugs to cure your illness (rather than for symptom control or pain relief).
  • Care from any hospice provider not prearranged or approved by your hospice medical team.
  • Room and board. Medicare does not cover room and board while you receive hospice care. This includes, but not limited to your monthly mortgage or rent payments, nursing communities or hospice inpatient facilities. If it is determined by your hospice team that you require short-term inpatient or respite care, Medicare will cover your stay in the facility. You may, however, have to pay a small co-pay while in respite.
  • Care in an emergency room, inpatient facility care, or ambulance transportation, unless your hospice team arranged it, or it is unrelated to your illness.

Contact your hospice team before you receive any of the services listed above or you may be responsible for the entire cost. Next month, I will share what Medicare does cover and who is eligible. To learn more about hospice care at Methodist ElderCare, please contact Kenya Y. George at 614-451-6700 or e-mail her at www.kgeorge@mecsrc.com.


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