• Who Pays for Hospice?

    One of the most frequently asked questions concerns about hospice care is who pays for it and how is it paid for. As with any form of healthcare, cost is a valid concern. However, when you are dealing with an illness that may require hospice care, paying for it is the last thing you want to worry about. Fortunately, hospice care is covered under most types of health plans and requires very little to no out of pocket patient cost.

    Photo by Nathália Bariani

    To qualify for under these health plans, the patient must meet the basic hospice requirements. These requirements state that the patient be diagnosed with a terminal illness and no longer be pursuing aggressive treatment and have a life expectancy of less than six months.

    Nearly 90 percent of hospice costs are paid through government programs and most of it comes through Medicare. Most hospice patients are Medicare eligible and Medicare will pay all costs of hospice care except for co-pays on prescription drugs.

    Medicare covers a broad range of services including nursing, therapy, social work and even equipment and supplies. Room and board is not included in these services. The only stipulation to Medicare coverage of hospice care is that it will not cover treatment to cure the illness or treat it, beyond palliative care of the symptoms. The upside to this is that there is no limit to how long Medicare will provide for hospice care as long as the patient remains eligible.

    For those that do not qualify for Medicare, Medicaid also provides coverage in much the same way. Eligibility requirements for Medicaid vary from state to state and can be found on the program’s website, www.medicaid.gov

    Additionally, if the hospice patient is a veteran or military personnel, hospice benefits are provided for by Tricare, the medical care benefit of the armed services. Eligibility and care stipulations are nearly identical to those of Medicare.

    Finally, although most private insurers such as Blue Cross Blue Shield and Humana cover hospice care, their plans vary across providers. Of course self-pay is also an option and many charities exist to help those less fortunate to have the comfort and dignity they deserve.

    We know that is a difficult time for all involved if you are considering or pursuing hospice care, so the cost of care should be the least of your concerns. Bridgeway Hospice will work with you to determine the best method of payment and provide the best level of care, no matter your situation to make this time as comfortable and peaceful as possible.