Original Medicare does cover hospice care with certain limitations. To receive benefits, patients must meet the following criteria:
- They get care from a Medicare-certified hospice
- Their attending physician (if they have one) and the hospice physician certify them as terminally ill, with a medical prognosis of 6 months or less to live i the illness runs its normal course
- They sign an election statement to elect the hospice benefit and waive all rights to Medicare payments for the terminal illness and related conditions
Medicare will cover hospice care services but won’t pay for the cost of an assisted living facility or a nursing home’s room and board.
While using the Medicare Hospice Benefit (it is an insurance benefit), any services that are related to the terminal diagnosis and related conditions are covered by the hospice. If you desire any services in addition to what Medicare or Medicaid would normally cover – discuss those with your hospice provider prior to seeking, i.e., procedures, doctor visits, therapy appointments.
If you have a Medicare Advantage plan, your coverage may vary depending on your insurance company and policy.