Hospice - Medicare Coverage
For patients who meet the eligibility requirements, Medicare pays for the following services:
- Medical equipment and supplies
- Medical care available around-the-clock
- Medication for symptom control or pain relief
- Home health care
- Physical therapy to improve mobility and reduce pain
- Occupational therapy to help the patient remain as independent as possible
- Speech therapy
- Counseling by a social worker
- Dietary counseling
- Grief and loss counseling for the patient and family members (up to one year after the patient's death)
- Short-term inpatient care (may not exceed 20% of total number of hospice days)
- Respite care
There may be a co-payment for some of these services.
Medicare will NOT pay for:
- Curative treatment for the primary diagnosis (a patient may be eligible for curative treatment of a medical condition or disease that is not the basis for hospice eligibility)
- Care from a provider other than a member of the hospice team
- Room and board
- ER visits, inpatient care, and ambulance trips, unless arranged by the hospice team
For more information about what hospice services are covered by Medicare, read the publication Medicare Hospice Benefits (published by the Centers for Medicare & Medicaid Services).
Medicare required patients to be periodically recertified as qualified to receive hospice. The hospice medical director or other hospice doctor must recertify that the patient is terminally ill:
- After the first 90 days on hospice
- After the second 90 days on hospice
- Every 60 days after the first 180 days on hospice
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